Running head: REFLECTIVE PRACTICE THROUGH A COMMUNITY

Reflective Practice Through A Community Assessment Assignment

Student Name: Lara Pabandero-de Lasan
Student No.: N00180321
Date Submission: Monday, May 25, 2015
NURS153: Practical Nursing Practice Three
Clinical Instructor:
Humber College

Running head: REFLECTIVE PRACTICE THROUGH A COMMUNITY

Introduction
As a nursing student, I am constantly being taught that nursing is not bound to the patient and the
four corners of the hospital room, it goes beyond that. Holistic nursing is about the whole patient
but can also include their family, the community and the population in or outside of the hospital.
The goals of community health nursing are to keep individuals healthy, encourage client
participation and choice in care, promote health-enhancing social and physical environments,
and provide in-home care for ill or disabled clients (Potter & Perry, 2014, p.42). For the
purpose of this paper I will venture outside of the hospital setting, talk about my experience in
the community service learning (CSL) placement and reflect how it changed me as a future
nurse. Self-reflection assists the nurse in identifying the values and biases that her/his approach
and interventions, and their impact on the client (College of Nurses of Ontario, 2009, p.4). I will
also discuss two community resources available and how they support two social determinants of
health that affect the publics health and well-being.
Salvation Army Thrift Store
I did my community service at Salvation Army Thrift Store, Canadas largest
international, Christian non-profitable and non-governmental organization that runs purely on
donations for more than 100 years now (Salvation Army, 2014). Dropped off donations to the
thrift store are mostly gently used clothing and other goods that can be reused again, which the
workers or volunteers sort out and resell at a cheaper more affordable price catered to the less
fortunate families or anyone looking for rare items and a good deal. 100% of all proceeds go
towards helping charity and providing social assistance to the needy. The thrift store that I went
to was on Keele and Finch area, a predominantly Black and Latin community. This was an

Running head: REFLECTIVE PRACTICE THROUGH A COMMUNITY

evident customer population however I also noticed that it was mainly women of all ages with
their children and a few gentlemen looking for shoes, furniture or electronics.
My experience volunteering in the organization changed a lot of my assumptions towards
thrift stores, the negative stereotype connected to second hand stores. I remember distinctly back
when my family just immigrated to Canada in 1993, my sister and I used to get teased at school
that our clothes came from Goodwill and that we were too poor to afford new clothes. I did not
like that feeling. I witnessed how hard the employees and volunteers physically work sorting
items out and the creativity and care they put towards making the store presentable. I observed
what families will do to budget their funds, how customers take their time to look through every
single item and haggle with the cashier so that they can buy clothes for their children and put
food on the table too. I learned to multitask and manage my time while performing multiple jobs
such as tending the customers, keeping the sales floor neat and tidy, opening the washrooms and
fitting rooms while getting to know the community as well. I also touched on some leadership at
times when there was a shortage of vital workers I initiated and volunteered myself to help the
team finish their production quota. These skills will help me juggle tasks and make productive
and holistic nursing care to clients while avoiding getting overwhelmed and burnt out in the
future. One of the workers said, Salvation Army runs on their volunteers, and that is why we
are very grateful to you guys and that touched my heart. I did not know what nursing had to
do with volunteering at this place but as I did my hours, I learned to appreciate how they helped
the community especially families in dire financial situations which essentially to me, what a
good nurse does, helping and caring for those in need.

Running head: REFLECTIVE PRACTICE THROUGH A COMMUNITY

Determinants of Health
The CNA or Canadian Nurses Association (2005) state, social determinants of health
have a significant impact on the predisposition of individuals and groups to illness, as well as the
way in which they experience and recover from illness (p.1). The two determinants of health
that I will focus on are employment and job security and poverty because these two issues have
significant correlation with an individuals well-being and health status. Toronto is the most
multicultural city in the world, this means that people from all parts of the world come and
choose to live here, taking chances, hoping for better life. Starting fresh in a foreign country
especially if English is not your first language, the case for many immigrants old or new, is very
difficult. McElmurry, Park, and Buseh (2003) say that, immigrants face several challenges in a
new culture (e.g. poverty, inadequate housing, racism, lack of employment opportunities)
associated with poor health outcomes (p.275). Employment leads to financial stability
therefore, if an individual has no job, then it is challenging to have the basic necessities in life
such as food and shelter. Unemployed people and their families often experience great
psychological and financial problems which leads to an increased risk of stress and premature
death (CNA, 2005, p.4). Furthermore, there is also a problem with job insecurity, only 63% of
Canadians had permanent full-time jobs in 2000, and the rest are either temporary workers that
are given minimal hours a week or kept on contractual work that lasts only up to six months and
then terminated (CNA, 2005, p.4).
Absolute poverty: not having access to food and shelter on a regular basis, the basic
necessities, have an extreme effect on a persons health and well-being. It is alarming that every
one in six children in Canada are living in poverty (CNA, 2005, p.2). Thinking about not
knowing when your next meal will be or where you to sleep for the night is distressing, what

Running head: REFLECTIVE PRACTICE THROUGH A COMMUNITY

more for the person actually experiencing it. My mom used to say, You make dollars there!
Exchange rate to Philippine Peso is $1:40, but the reality is, even in a rich country like Canada,
life is tough. These stressors take a toll on someones health. Living on low income causes
psychosocial stress, which damages peoples health. The lower the household income, the higher
the incidence of these problems (CNA, 2005, p.2). This is why we strive to be employed, to be
out of the poverty line and afford to provide food and shelter for their family.
Community Resources
Goodwill and Habitat for Humanity are current community resources that support the
determinants of health discussed above. Goodwill, a $4 Billion non-profit organization that runs
in 15 other countries and the main office is located at 350 Progress Avenue, Scarborough,
Ontario. They rely on donations and there are several stores scattered in the GTA to ensure our
local communities remain sustainable, healthy and self-sufficient (Goodwill, 2015). They resell
donated goods which creates jobs and millions in revenues that fund job training programs
contributing sound investments in the economic health of local communities (Goodwill, 2015).
There is no cost for registration or to attend their programs or services. Goodwill aids the
community in many ways. They help the adult in employment services and centres like JobLink,
or assist in finding a course or training opportunity to become employable. Youth Employment
helps the youth completely out of school, find a job within four to six months and provide
transportation and training allowances until the individual is financially stable. Another is
LiveGood Project, where Goodwill partners with companies to provide paid internship for the
marginalized youth. These services are very helpful in making persons learn to be independent
and be self-sufficient, boosting the self esteem and ego, which leads to a healthier well-being.

Running head: REFLECTIVE PRACTICE THROUGH A COMMUNITY

The Habitat for Humanity national office is located at 477 Mount Pleasant Road, Toronto.
The Restore locations are spread in the GTA very accessible to public transportation where they
utilize volunteers and community partners to build affordable housing and promote
homeownership as a means to breaking the cycle of poverty, a world where everyone has a safe
and decent place to live (Habitat for Humanity, 2015). The Restore is the place where donated
furniture or anything that can help build a home is stored and maintained, this is where most of
the volunteers can do their hours besides going to actual building sites to build the houses. The
homeowner family is preselected with requirements such as low income family, 500 volunteer
hours, and willingness to buy a home with no down-payment, interest-free mortgage that is
geared to their income (Habitat for Humanity, 2015). Many low income families benefit from
this program because they have the autonomy and dignity of owning a home that is priced
specifically to their financial situation.
Summary
Nurses need to be able to deliver responsive healthcare to meet the needs of individuals,
families and communities (Jackson, Andrew & Cleary, 2012, p.141). This community service
learning experience brought back my childhood memories as a new immigrant in Canada. I will
be able to relate and empathize with patients in their current situation especially when focusing
on community health nursing care because caring for people in the community is more complex,
with different issues other than their diagnoses. The knowledge of resources such as Habitat for
Humanity and Goodwill that tackle concerns of poverty and employment to name a few will help
me guide families that I encounter in the community. Having awareness about these resources
are fundamental to aid in providing holistic care. Client education such as health teaching,
prevention, giving important information and providing vital resources are as important as

Running head: REFLECTIVE PRACTICE THROUGH A COMMUNITY

bedside care tasks like giving medication on time or wound care. The skills that I have further
developed while volunteering, such as having initiative and leadership, will improve my nursing
practice. Jackson et al (2012) articulate, leadership is crucial to the ongoing development of
nursing roles, leadership qualities and actions emerge as central to making and maintaining
clinical improvements and enhancing outcomes for individuals, families, and communities
(pg.142). The community health nurse does exceptional work with limited means, being creative
to stretch resources whenever possible. I have realized many things while completing all the
components for this course, and have come to an understanding and appreciation why they are all
important in teaching me become a better future nurse.

Running head: REFLECTIVE PRACTICE THROUGH A COMMUNITY

References
Canadian Nurses Association. (CNA). (2005). Social determinants of health and nursing: A
summary of the issues. Retrieved from: http://www.cna-aiic.ca/en/
College of Nurses of Ontario. (CNO). (2009). Practice Guideline: Culturally Sensitive Care.
Retrieved from: http://www.cno.org
Goodwill. (2015). About us: Our mission. Retrieved from: http://www.goodwill.org/about-us/
Habitat for Humanity Canada. (2015). Mission, vision and values. Retrieved from:
http://www.habitat.ca/en/about/mission
Jackson, D., Andrew, S., & Cleary, M. (2012). Family and community health nursing:
Challenges and moving forward. Contemporary Nurse: A Journal For The Australian
Nursing Profession, 41(1), 141-144.
McElmurry, B., Park, C., & Buseh, A. (2003). The nurse-community advocate team for urban
immigrant primary health care. Journal of Nursing Scholarship, 35(3), 275-281.
Potter, P., & Perry, A.G., (2014). In Ross-Kerr, J., Wood, M., Astle, B., & Duggleby, W. (Eds),
Canadian fundamentals of nursing (5th ed). Toronto: Mosby.
The Salvation Army in Canada. (2015). Giving hope today: Mission & values. Retrieved from
http://www.salvationarmy.ca/missionandvalues/

Running head: REFLECTIVE PRACTICE THROUGH A COMMUNITY