The End

As this semester comes to a close, I’m realizing I’ve learned a lot more than I originally thought I would. Even though we have years of experience at the Cleveland public schools, working at the Lorain County General Health District introduced me to other responsibilities of the public health nurse. Public health nurses educate, prevent, protect, and advocate not only for individuals but an entire community. I have had the opportunity to participate in Bureau for Children with Medical Handicaps visits, Children Service visits, Adult Health Clinic appointments, newborn visits, and immunization clinics. At first I was very uncomfortable with the idea of walking into someone’s home and being the health “expert.” I kept thinking if I say something wrong they are going to throw me out and I’ll be stranded. I can be quite dramatic. However, every family and member of Lorain County that I came in contact with was very receptive to us and wanted to better their health.

In addition, the Lorain County General Health District offers many other services through their Health Education Department and Environmental Services Department. I am impressed by the amount of services the health department offers in comparison to the amount of members they have on staff. Their small staff does so much for the community.

I learned a lot from working with an agency and working with a partner as well. I have learned the art of negotiation and how to conduct myself in a professional setting. Teamwork is key to being productive and you don’t always have to be in control. In regards to research, sometimes it doesn’t work out and that’s okay, try again!

Overall, my whole perspective of public health nursing has changed. I have more respect for what they do and realize it is a complex, difficult field. There are many things that affect the care they can give, such as funding, governmental policies, amount of resources, culture, and receptiveness of the community.  I enjoyed my experience at the Lorain County General Health District. The staff has been eager to teach us and went the extra mile to get to know us as people too. I plan to keep in contact with many of the staff members in the future. I would like to thank them all and the agency for this semester. I hope that we have done a project that is beneficial to them and they have enjoyed having us as well!

So loooong CCBH cubicle!

I learned a lot at CCBH. I really enjoyed the people there, and everyone was very attentive to us students. What I learned most about myself at CCBH was that I hate sitting in one place for an entire work day. The cubicle I was assigned to was not for me. I twiddled my thumbs, I did laps around the cubicle farm, I drank extra water so I had to use the restroom more often, you name it- I probably considered it or actually attempted it.

I loved working in the family planning clinic, going on home visits, visiting different colleges and so forth. If it got me out of my cage, I was willing to try it at least once. I loved working with the older nurses who had worked in hospitals for years prior to the board of health; who could tell me a number of different stories about different things they've seen and where they've worked. I liked meeting new people and CCBH helped me do just that... once I could spread my wings and enjoy the outdoors again.

All in all, I really enjoyed my time spent at the board of health. I'll definitely miss the people I worked with there. I'll especially miss my preceptor and the family planning clinic. The clinic was always so interesting with different types of people every day. I'll miss the diversity, but hopefully as I enter my preceptorship and graduate I'll encounter much more diversity down the road that will be just as good-- if not better. I'm excited to start the next chapter in my nursing career and my life. See ya CCBH, so long cubicle... and HELLO preceptorship!

CCBH at JCU

At the Cuyahoga County Board of Health, we work in the family planning clinic at least once a week. This particular week, instead of participating at the board of health, we went to John Carroll University and performed STI and pregnancy tests for any students who requested it. This service was a free walk-in basis in the school's health services office.

Working with the health department was different for this type of endeavor. First, we were working with the same age range as we were, so approximately ages 18-22. To top it off, we knew that majority of the students that came into the office were educated, as JCU is a very well accredited school. I must say, this was much different than working with adolescents or young adults in the family planning clinic at CCBH. The people who come into CCBH know Case is a great school, but to a lot of JCU kids, I felt they just thought of us as students from the school down the street-- or rather that's what I feared they would think about us. Turns out, they didn't. Most of the students were happy to have a person his or her own age in the vicinity. I think we helped alleviate the stress of them going into a scary, and potentially life changing, situation.

After helping out at the health screens at JCU, I felt much more comfortable in my role in the family planning clinic. It was a nice change of pace and a very nice boost of confidence in myself and in my education.

Capstone coming to an end

             As we have come to the end of our capstone experience, I have realized Iam excited to move onto preceptorship; but will miss going to the site of Southwest General, for the staff we were lucky enough to meet were so wonderful. It has been very interesting to see what has become of our final project, and everything has come together very smoothly. Creating the poster was without a doubt tedious, but I have learned so much from the process.
            Looking back on all of the experiences I had at Southwest, I am more than grateful for our placement. Even though we had a late start, I rather have had that late start at Southwest than have been at another site. We were able to see such a wide variety of public health situations, ranging from home visits, to community screenings, and even to outpatient hospice. The specific project we developed was enlightening and I hope that the data we have gathered and analyzed, and conclusions we have come to, make a positive impact for the transition nursing program. Hopefully what we have started will provide other capstone groups with information to build off of during capstone projects next year. Listening to everyone else's presentations this morning and afternoon was very exciting.  Furthermore, finally getting to present what we have been doing to our professors and classmates all semester was very fulfilling, thank you!

End of Capstone

Now that capstone is complete, I've had a chance to reflect at this semester.  Throughout the last 10 weeks, my perception of public health has changed.  First, there are many more aspects to public health other than nursing than I originally thought.  The environmental services department and health education department play pivotal  roles in promoting wellness and preventing the spread of disease.  Health education brings the tools and resources to staff and clients alike.  I got to see how the environmental services department prevents the spread of disease through mosquito control.  In addition to that, they help maintain other aspects of our daily lives that often goes without thought, such as food safety at restaurants.

The nursing department is involved in many programs that I have and have not heard about.  Programs including WIC, BCMH, Children Services, Adult Health Clinic and newborn visits are all things that I was able to participate with during my tenure in Lorain.  Prior to this experience I never fully appreciated the scope of nursing practice in the public health setting and how much they monitor in the community.

Overall the capstone experience was good and I look forward to the next stage in the process of becoming an RN.

Our Ohio Family Planning Insurance Marketing Campaign

Development of my group’s actual Problem Solving for Better Health (PSBH) project was perhaps one of the most challenging, insightful, and rewarding learning experiences of the semester. Prior to Capstone, I’ve had plenty of PSBH experiences but this Capstone project definitely tested and enforced the valuable concepts of the PSBH model that I have learned in previous coursework. Our first step was planning and assessing our community: Brooklyn, Ohio. During this time, I learned a lot about the health problems inflicting the communities as well as strengths and weaknesses present within the community. This portion of the project taught me important lessons about community partnerships and finding community resources in order to better solve community health problems. We met with CCBH staff and staff at the Old Brooklyn Family Service Center for guidance developing our project. After meeting, I was excited that we agreed to implement a marketing campaign for recent Ohio Medicaid family planning expansions. During my experience in the Title X clinic, I found that this was such an important community need. It is a critical program that many community residents are not aware of. By attempting to raise awareness for Ohio Medicaid, I realized that I would be playing an instrumental role in helping disadvantaged individuals gain health care access to critical family planning health services. It was great to witness how such a small project could have such a large potential impact on the community. I found research that supports that this program can provide more people with health access and thus contribute to a reduction in unintended pregnancies and STI rates.

            Our marketing campaign went well. We visited many, at least 300, different locations businesses in Brooklyn. We spoke with many Brooklyn residents and patients in the clinic. Alone we directly referred more than 2 dozen patients to Medicaid. This does not seem like a lot; however, like Medicaid family planning expansions, the Title X clinic is new. Thus, it has not established that large of a clientele when compared to other clinics. Additionally, we also went to local colleges near the community. Overall, I feel our marketing campaign was a success and made a valuable impact in the community.

My experience in a Title X Family Planning Clinic

This Capstone has been an excellent learning experience. I was stationed at the Cuyahoga County Board of Health (CCBH). Specifically, my partners and I were mainly focused on the Title X family planning clinic at CCBH. Over the course of the semester, I learned so much about various health topics including Medicaid, family planning, the Title X program, and other health and socioeconomic issues relating to reproductive health and wellness. I learned about my targeted community and how to implement an actual problem solving for better health project. Before my first day at CCBH, I knew that I would be working primarily in a STD testing clinic. However, I was not expecting this experience and was not expecting to have the opportunity to work in one of the Ohio family planning clinic with Title X funding.

            Title X clinics, such as the one at CCBH, play a significant role in ensuring access to a broad range of family planning and related preventative health services for millions of low-income and uninsured individuals as well as others. These clinics have a different set of guidelines, protocols, and initiatives. For example, during the patient interviewing process CCBH staff are required to ask questions about general health topics in addition to sexual health ones. I did not expect this initially but it was not uncommon to find staff providing education on smoking cessation for a patient visiting the clinic to for a routine HIV screening. It was interesting becoming familiar with the various functions and responsibilities at a Title X clinic.

            Furthermore, the clinic serves a wide variety of patients. The patient population at the clinic was very interesting. According to the clinic’s priorities, I saw many low-income and uninsured individuals as well as those able to afford family planning services. I learned about the health care delivery system in terms of family planning services and how health disparities such as lack of insurance coverage can have major consequences for entire groups of people within a community. During my time at the clinic, I had a lot of opportunities to provide patient education. Each time, imparting critical knowledge to these patients became easier and easier for me. Finally, I learned about more extensive details and nursing implications for sexually transmitted infections, contraception, and general reproductive health issues.