Purpose of Assignment

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The purpose of this assignment was to reflect on the leadership roles witnessed at the Interprofessional Clinic (IPC), a clinic affiliated with Sentara’s Ambulatory Care Clinic (ACC). The leadership styles utilized personally and by other nursing leaders at the clinic were evaluated using knowledge gained during this course. 

 

Student Approach to Assignment

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The IPC gave me the opportunity to be a nursing leader in an official role. While my time at the IPC was not my first time in a leadership capacity, it was my first experience organizing professionals in other careers in order to reach the common goal of assisting a patient towards better health. A large part of the nursing role is proactive management of health care issues within the community. The IPC and ACC are perfectly poised to meet this need within the underinsured and uninsured populations of the Hampton Roads area.

 

Reason for Inclusion of this Assignment

 

This assignment is included in order to showcase my abilities as a undergraduate nursing student to be a leader among my peers. The ACC and IPC allowed me the opportunity to advocate for those in my local community while simultaneously taking on leadership opportunities outside of the typical role of an undergraduate student.

 

Critical Thinking

• ​Revises actions and goals based on evidence rather than conjecture

  • The IPC would have patients come to the clinic for initial appointments and then again in 3 to 6 months for a follow-up appointment. After the initial appointment, patients were frequently sent home with a list of at least 5 tasks to accomplish before returning to their next appointment. After volunteering in the IPC for over year, my colleagues and I began to see that patients often returned to their follow-up appointments having contacted none of the provided resources and still feeling as “stuck” as they had felt during their initial appointment. Because of this, we determined that we needed to revise our approach during the initial appointment in order to help patients to feel successful as soon as they left that appointment. We hoped that this would motivate them to continue to contact the resources provided once they left the appointment. For example, when one patient came back to his follow-up appointment and had not yet contacted Medicare or Medicaid, we made the call with him while he was at the office. In this way, we were able to ensure that the patient checked off one item on his list of tasks, which helped him to feel more successful moving forward.

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​Teaching

• Evaluates the efficacy of health promotion and education modalities for use in a variety of settings with diverse populations

  • During the intake questions that we would ask each new patient at the clinic, we would ask about how well patients felt that they understood the medical information that had been presented to them by their doctors at any previous medical appointments. If we determined that a patient had low-level medical literacy, then we would explain procedures or medications or treatment plans as much as we were able by looking up the patient's chart. If the patient had seen a doctor outside of the Sentara network, then we would follow up with a call to the patient once they were home and had their medical records in front of them at home. Lastly, in order to promote the health of these patients, we would often help them to schedule further medical appointments, connect them to resources, and help them fill out applications to see if they were eligible for Medicaid or SNAP. ​

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Leadership

• Assumes a leadership role within one’s scope of practice as a designer, manager, and coordinator of health care to meet the special needs of the population.

  • The role of the nursing student at the IPC was to build rapport and to ask intake questions of the patient. Once we had the answers to our questions, we would give this as a report to the other members of our group. Each professional concentration would then ask questions that were more specific to their own specialty. Once we had all of the necessary information, we would compile resources and give them to the patient. If the patient was amenable, we would help them to make contact with these resources while they were still in the office.  

• Initiates community partnerships to establish health promotion goals and implements strategies to meet those goals.

  • The group created a brochure for patients to describe the role of the clinic, how it can benefit them, and clarified recurrent confusions. For example, in the ‘things to remember’ section we indicate this is not a doctor’s appointment, which many of them thought it was.

  • After a few occasions at the IPC, we realized that many of the patients presented with similar complaints. For example, many struggled with homelessness, so we connected these patients with the Community Services Board (CSB) and Norfolk Emergency Shelter Team (NEST). By connecting people with these resources, we were able to help alleviate some of their anxiety about that issue.

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Culture

• Integrates knowledge of cultural diversity in performing nursing interventions

  • A prerequisite of being a client at the IPC was that you had to be under-insured or uninsured​. It was to serve this population that I original left my career in teaching and was drawn to nursing. I understood many of the social determinants of health (SDOH) that deterred these patients from seeking medical care because the population was similar to the demographics of the school where I had taught. I was able to use some of this knowledge during my time at the IPC but also had the opportunity to continue to learn from all the clients. One of the factors that I had not thought would be a social determinant of health was waiting to get an appointment at a local doctor's office. One of the clients that we had at the IPC has kidney disease and believed that she was suffering from a bladder infection because her symptoms were similar to a prior experience. However, she had to wait for 3 weeks to see her doctor and to get a prescription for the antibiotics she needed, even though she was in excruciating pain. This experience allowed all of us at the IPC to talk about how sometimes these patients can slip through the cracks of the system because doctors' offices do not prioritize patients without insurance. However, we discussed how it is our responsibility at the clinic to call the appropriate doctor's office to advocate for our clients.