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Running Head: SERVICE LEARNING PROPOSAL

Service Learning Proposal


Tyler Nickels
Ferris State University

SERVICE LEARNING PROPOSAL


Abstract
This proposal describes the location of where my service learning will be in the semester
of January 2016. Covering the clinic, what my role will be, along with expected objectives and
outcomes while completing the service learning. An evaluation will be discussed on the learning
and how activities participated in will affect the community.

SERVICE LEARNING PROPOSAL


Service Learning Proposal
Service learning is a form of practical experience that enhances learning in all areas of a
nursing program, and the experiences of service learning reinforces the moral and civic values
inherent in serving others (Frequently asked questions). This helps to get in touch within the
communities we live in and apply what we have learned so far, incorporating it into the
community. It is also a requirement by Ferris State University to have completed by graduation
date of the nursing program.
Agency Description
The agency I will be fulfilling my service learning at, will be the Interprofessional Wellness
Clinic in the Ferris State University College of Optometry building. The clinic was developed in
2004 to assist in those of the community to promote a better lifestyle and education on
preventative measures that can lead to further illnesses (Ferris State University, n.d.). Volunteers
from the clinic include students and instructors of Ferris State University. The students and
instructors assess the patients, evaluate them and educate them on any lifestyle changes they can
make to improve themselves. For contact information about the clinic see Appendix A.
Volunteer Role Description
As a volunteer nursing student, I will be helping the clients of the clinic with obtaining
their vital signs, height, weight, as well as drawing blood to determine diabetic measures and
cholesterol levels. Use of computer is required as all patient information is stored electronically.
Patients will be educated on ways to manage their diabetes and to live a healthier life.
Objectives as Related to Program

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The objectives to accomplish while in the diabetic clinic will be to further enhance my
knowledge on diabetes and develop better patient care and instruction. Communicating with
patients and teaching them is a large role of the nurse, gaining confidence in patient care is
important to develop to inform patients on what needs to be done to better their lives. Having
direct contact with patients and asking them questions about themselves develops a better nurse
to patient relationship. I can hone in on my interpersonal communication skill before becoming
an RN. The most important objective is to improve myself as a student nurse and get closer to
becoming an RN. With confidence and structured questions aimed at the patients I can establish a
better initial assessment on the type of patient I will be caring for.
Activities to Meet Objectives
The clinic works with the nursing students, pharmacy students and optometry students.
Together we will care for the patient and help to educate them. Working with other programs
develops a greater knowledge on care for patients. I can see how other professions interpret
patients and will be able to gain further insight to add to my experience. Communicating with
pharmacy and optometry students will prepare me for care as an RN as communicating
pharmacy is often important to be sure patients are getting the medications they need and the
right dosage. Assessing vital signs and interpreting cholesterol and blood glucose levels will help
to cement knowledge on values often gathered in the hospital setting. Learning how diabetes
impacts patients will enhance my care and education for those I care for in the future.
Evaluation Plan
Throughout my service learning, I will evaluate what I have learned and how it has
benefited me. Toward the end of my volunteer time I plan to ask the patients how I did and what

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they liked about me, and what they think I can improve on. This will help me to know what I
need to do better with from someones perspective because it can be hard to determine ones own
need for improvement. Journal logging will be kept for each clinic day, it will help me to
remember my experience and reflect on the day. Feedback from my peers and those overseeing
the clinic will help to develop myself as an effective nurse. Receiving feedback and adjustments
from it improves my care toward patients as I strive to become an RN.

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References
Ferris State University. (n.d.). Michigan College of Optometry: Interprofessional wellness
clinic. http://ferris.edu/HTMLS/colleges/michopt/patient-care/Patient-Care.htm.
Frequently asked questions. (2013, June 12). In Ferris State University. Retrieved from
http://www.ferris.edu/HTMLS/colleges/alliedhe/Nursing/RN-to-BSN/Frequently-AskedQuestions.htm

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APPENDIX A
Contact Information
Susan Owens, PhD, RN, FNP-BC
Assistant Professor
Chair, School of Nursing
Ferris State University
200 Ferris Drive VFS 400
Big Rapids, MI 49307-2740
(231) 591-2267-office
(231) 591-2325-fax
susanowens@ferris.edu
Site
College of Optometry
Wellness Clinic
1124 S. State St. MCO 101A
Big Rapids, MI 49307
Phone: 231-591-2000
Fax: 231-591-3991

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Service Learning Journals
Journal 1
January 23, 2015
Ferris State University College of Optometry: Interprofessional Wellness Clinic
Day 1: The Observer (4 Hours)
I have been completing my service learning at the Interprofessional Wellness Clinic at
Ferris State College of Optometry. I had plans to do my service learning at Hospice of Michigan
but there were communication difficulties with staff and I was not able to find an agreed time to
meet for training to volunteer. Due to this, and with and opening at the Interprofessional
Wellness Clinic, I decided to change the agency for my service learning to the clinic. The
diabetic clinic runs on Fridays from 8am to noon. Four students collaborate together, between
schedules to meet on these Fridays. The first day at the clinic I observed my other classmates as
they cared for patients. I witness vitals being assessed along with foot care. Patients had their
blood drawn to calculate lipid levels and A1C level. Patients were also asked questions regarding
their health history and what they are doing to help control diabetes. I followed patients around
and familiarized myself with the clinic. There are three locations patients are referred to, the eye,
nursing assessment and pharmacy. At each location patients are assessed and asked questions
regarding their health. From there they are educated, and suggestions to care for their diabetes to
improve their lifestyle. The first day I did not assist in direct patient care, I observed and
shadowed the clinic to understand how it functions.
The first patient we saw was a very vocal older gentlemen. He had a story about almost
anything. This made it difficult to assess him as he was talking so much and was more into

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discussing his stories rather than discuss why he was at the clinic. He was well kept and managed
his diabetes appropriately. He mentioned his feet being cold often and wearing multiple layers of
socks. We discussed foot care at this time, educating him on how to properly care for his feet,
especially if he has poor circulation and his feet are cold from this. After visiting with us I
followed him to the ophthalmology student where she looked at his eye for any signs of decline
due to diabetes. He was then taken to the pharmacist. When all the medications were looked over
and the client was taking them as prescribed the pharmacist walked him out as it was the end of
the visit.
The next client we had was an overweight woman who had some cyanosis in her toes.
Her vitals were assessed by my fellow students and I watched on as another was documenting
them. She was asked questions regarding her diabetes management and what her diet consisted
of the past 24 hours. After this she had her A1C and lipid levels tested via blood sample. Prior to
assessing her feet she mentioned that a few of her toes were a tinged blue in color. This was
visible when the client removed her socks and shoes. We educated her on the importance of foot
care especially if she has limited feeling in her toes and poor circulation in her feet. She was then
sent to the ophthalmology student to get her eye examined and to pharmacy to be sure she was
taking medications as prescribed.
I did not provide many services on my first day because I was learning how the clinic
was run and what is done to assess patients. I met goals in having knowledge of what the clinic is
about and ways it benefits the community. One nursing goal I met this day was Health Care
Environment, I have not been in a clinic before, so I gained experience in this different setting. I
have worked in the hospital for a few years as a nurse tech so caring for patients in a clinic
setting would be something new to me.

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Journal 2
Ferris State University College of Optometry: Interprofessional Wellness Clinic
February 6, 2015
Day 2: Assessing Patients (4 Hours)
The second day I performed more care to the patient. We had two patients this day and I
assessed vitals and the individuals feet, along with obtaining height and weight. We had another
student with us from the clinic in the fall to better transition me into using the computer since I
did not have a username at the time. We were having computer problems trying to find the
program to open up and how to access the patients chart to record their assessment details. We
had one patient this day so it was not as much to do compared to last week. We had more time to
practice on the computer and navigate through the menus to open the patients chart. It helped to
become familiarized on where to find programs in the computer and how to properly chart the
patients assessment details. I had time to practice on a fellow student how to draw blood for the
A1C and lipid test. This allowed me to gain more confidence because I was able to practice on a
student before doing it on a client.
The patient was a gentlemen who was short in stature and a little overweight. He was
dressed appropriately and a kind individual. He told us about how he has managed his diabetes,
being sure to check his blood sugar often throughout the day and watching his intake of
carbohydrates. He was easy going which made it more comfortable for me to assess him as it
was my first time doing so in the clinic. I gathered his vitals then gave them to another student so
they could be entered into the computer. His vitals were appropriate and he had no concerns to be
noted on his feet. I did not draw his blood because I did not have experience doing so until after

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he left when we had time while no patients were arriving. While the blood tests were being
performed by the computer we asked him questions regarding his diet and how he manages his
diabetes. He was able to recall what he ate in the past 24 hours and all of it was in mind of his
carbohydrate intake. When we were done with him he was directed to the eye exam with the
ophthalmology student. He spent around half an hour with the student doing an overall eye exam
to determine any negative impacts of diabetes. When this was completed he sat down with a
pharmacist and a pharmacy student. They discussed his medications and made sure he was taking
them as prescribed. When finished with this he was free to go.
My care for the patient benefited the agency by meeting the expectations of accurately
recording vitals and educating patients if they are within normal limits. I acted in a professional
manner toward the patients, leaving them with satisfaction and comfort with care. . I gained my
long in for the charting system so when we had down time I was able to navigate through the
menus to understand how to get to patients charts and record information properly I plan to meet
my goals more as the weeks follow with the diabetic clinic. I did develop a level of confidence
with patients and educating them on controlling their diabetes. This could be one goal met as I
need to improve on my confidence in caring for patients. One nursing goal I met this day was
Collaborative Leadership. This was met when we all worked together to care for the patient and
make sure what was assessed was done accurately and effectively. When working together it
made it easier for us to care for the patient, I felt it helped the patient with the three of us
unifying our care directed at him.

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Journal 3
February 13, 2015
Ferris State University College of Optometry: Interprofessional Wellness Clinic
Day 3: Caregiver of the Clinic (4 Hours)
Today I was more comfortable with the setting and used the computers a little more.
There was just two of us and we cared for two patients throughout our time the day. I was the
first one who arrived so I set up the clinic. When setting the clinic up we have to power on the
computer, take out the A1C and lipid profile tests out of the refrigerator. Gloves, lancets, the tool
to draw up blood and alcohol wipes are in a cupboard when not in use, so I took them out and set
them on the table. This was all done while waiting for the computer to warm up. After it was
warmed up I logged into it and opened up the program to document the patients information. We
had a little time before the patient came so I double checked on how to open pages and navigate
through the menus before the patient arrived.
We cared for two patients again but did not have any communication and
education difficulties. Patients were mindful of their diabetes and controlled it well for the most
part. One of the patients had high lipid levels which can suggest possible cardiovascular arterial
disease, or high risk for stroke, heart attack. This patient then told us that he had McDonalds
before coming in. This can affect the values from the lipid tests because patients are to be NPO
for at least 8 hours before the test is done. They are told this but some forget or do not think it
will affect their results from the test.
The blood sugar was also high, which relates to not fasting, but his A1C test was high which
does not require fasting, his lipid levels were what stood out the most. After we were told this by

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him we informed him that next time be sure not to eat anything the morning of because it makes
it really difficult to know what his levels are normally without food impacting the results. His
vitals and other assessments were within normal limits.
Personal goal I continue to meet are caring for the patient and gaining confidence in it. I
am becoming more familiar with the clinic so it makes things easier to guide patients were to go
and explain to them what the clinic is about. It also helps to care for the patient when you are
familiar with the environment. This growing in care and communication really helps me in the
future. It is a major part of the job as a nurse, if you cannot communicate with patients or have
confidence in caring for a one it can make for a difficult time.
The nursing goal I met this week would be that of Scholarship for Practice. Some of the
current evidence based practice for nursing I have been including in my patient care. One
specific one would be that of wiping the patients finger with alcohol swabs before using the
blood lancet to draw blood. This prevents infection to the patient as their finger is exposed to the
environment when punctured. Another one I use that is not considered evidence based, but is
highly used in the nursing field is to check who the patient is. I ask who they are and what their
date of birth is. It is more common for those receiving medications or doing an invasive surgery,
but it is a good habit to develop for nursing practice. It also helps to establish for documenting
the patients information on the computer, we could confuse the patient with someone else if they
are not double checked what their name and date of birth is.

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Journal 4
February 20, 27
Ferris State University College of Optometry: Interprofessional Wellness Clinic
Day 4 and 5: Caregiver of the Clinic (8 hours)
I have now been doing my service learning for just over a month and am getting more
comfortable each day. I understand how to use the computers and am familiarized with the other
students and the ophthalmologist there. I am enjoying my time with the fellow students and the
patients. It has been a good experience and I am able to educate patients often on how to manage
their diabetes. All of us that are volunteering have now had several weeks here and we feel like
we are making a difference. We have had complements by the ophthalmologist who runs the
clinic saying he is impressed with our professionalism and is happy we are there to help the
clinic. When it comes to the census of patients it is beginning to be more of a pattern of having 2
patients each day. We are suspecting it could be due to the colder weather we have been having
and many patients do not want to face the elements to come into the office and make
appointments. The weather has been very cold many nights it is getting 20 degrees below zero
and the mornings the clinic opens it is still below zero. My car has been having difficulty starting
it has been so cold. So, this weather most likely is impacting the number of patients visiting the
clinic.
February 20 did not entail much variation in patients from the last few weeks. Many
coming in are aware of their diabetes and know how to control them very well. It is becoming
difficult to reflect on the days as each week they are very similar in patients education and

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management of diabetes. Therefore I could not think of anything that was done that I have not
already included in the journal, it is becoming repetitive with similar patients.
However, February 27 a patient came in with uncontrolled diabetes. She was mentally
challenged but functioned independently for the most part and around the age of 30. When asked
about her medical history she was neither unsure or the information given did not seem sensible.
She says she checks her blood glucose but does not seem to understand what the values relate to
when checking it. Telling me that her blood sugar is normally 5 when she checks it. She also
does not monitor what she eats, eating freely not concerned about high intake of carbohydrates. I
did my best to educate her on the numbers and how they relate to her diabetes, along with
educating diet and exercise. She tells me that she lives with her parents and her medical history
says she has had a c-section. This makes me wonder how the baby is being cared for properly if
she is not able to care for herself very much, I would believe her parents care for her child. It
sounds as if her parents make her food often, they did not come in with her, so educating her
parents on carbohydrate counting was not successful. I believe if we could have reached out to
her parents then her diabetes would have been well controlled. When we got the results from her
A1C and blood glucose they were pretty high. I explained as best as I cold what these numbers
mean and how they can affect her health long term if they are not managed well. It is difficult to
determine if education was a success as patient has a flat effect and does not speak much.
These two weeks were great in better implanting the knowledge and technical aspect
while at the clinic. I will not be back in the clinic for nearly a month as I begin my clinical
rotation which conflicts with the Fridays that we volunteer at the clinic. I believe I have done
well to educate patients on the important of monitoring their blood sugar and what the impacts of
not managing diabetes can do to the body. I think I have benefited the clinic and community by

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doing this as people often forget the importance of monitoring their diabetes. I believe that one
goal I have achieved thus far is my communication toward the patients. I did not communicate to
them much the first few weeks as I wanted to familiarize myself more with the clinic and did not
have the confidence to educate them. As I have gotten further along in the clinic I have become
more confident and have communicated with the patients more. Which will help a lot when
working as a nurse. Communication and patient education is a very important part of nursing. I
feel I have done well in meeting those parts while at the clinic. I think one of the goals I have
met is the professionalism part. As mentioned early the ophthalmologist of the clinic thought we
were doing a good job at the clinic and applauded our professionalism while caring for patients.

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Journal 5
April 24
Ferris State University College of Optometry: Interprofessional Wellness Clinic
Day 6: Reflection and Education of Clinic
This week the clinic was canceled because we did not have any patients. It would have
been my first time back in almost 2 months. I was eager to get started again as it has been so
long. Due to this being canceled it is difficult for me to write on my experience at the clinic
because I was not able to experience anything. So I decided I would do a reflection of the clinic
and how it has been so far and the importance of teaching for diabetes.
Diabetes is something that is considered chronic as it is a lifelong condition that affects
your lifestyle. It can be difficult for people with diabetes to manage a lifestyle especially type 2
as they developed diabetes instead of being born with it. Diabetes have to watch their blood
sugar levels many time a day and monitor what they eat. If blood sugar is dropped or too high it
can make them unstable and can cause serious further health problems such as seizures or
possibly death. One phrase I have learned working in the hospital is, cold and clammy, need
some candy, this relates to those with low blood sugar as it can cause diaphoresis and cool to
the touch. On the other end, hot and dry, sugars high, I have kept both of these in mind when
first assessing patients. If a patient were to be in these states, they would need immediate
intervention and would have to go to the ER for proper intervention. As students, we do not have
the equipment available to treat patients with this state, nor are we allowed to give them
medications to the patients. It is very important for patients to monitor what they eat and to make
sure they are taking their insulin. If they are not taking insulin or eating too many carbohydrates

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frequently and consistently, they can get in hot and dry state, because the blood sugar is getting
to high. If they were to take too much insulin or did not each much they could have a drop in
their blood sugar, this would lead to the cold and clammy state. With this in mind I have done my
best to inform clients of the importance to monitoring diabetes. The important things for a
diabetic to do is to take check their blood sugar after meals, take insulin daily and after meals,
and to monitor what carbs they are eating. Patients may have to increase their insulin if they have
had a larger amount of carbs. Today there are electronic devices that monitor blood sugar and
inject insulin, they are expensive but great for those who find it difficult to remember to check
blood sugar levels and take insulin.
So far in this clinic I have really enjoyed my experience. I have come closer to the chair
of the nursing program who assists in running the clinic, the nursing student portion. I would
have not gotten to know her more without my volunteering at the clinic. Which I find very
fortunate as there are hundreds of students that come in and out of Ferris States nursing program
that she is not able to know their names directly and know them on a personal level. I enjoy
working with the other nursing students, the ophthalmology students and the doctor who works
with them, and the pharmacist and their students. Everyone has been very friendly to us and
willing to teach us what they can to improve our knowledge.
I could not meet any personal goals this week as the clinic was closed. I did keep in mind
a goal that I have achieved throughout my experience at the clinic. I have grown in confidence,
as mentioned in other journals, but with my clinical experience in public and home health I have
gained insight on how uncontrolled diabetes can affect a persons health. Many patients had
necrotic toes that would not heal. This helped to establish a goal in knowing long term side
effects of diabetes and how I can educate patients on the results of not caring for diabetes. I plan

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to emphasize this next week if I note patients who are not managing their diabetes or their feet
are suffering from neuropathy. Throughout my clinic I have had a lot of experience. This
experience has given me the opportunity to implement theories and my knowledge of nursing,
science, and humanities into my care of patients. This has helped me to meet the nursing
outcome of Theoretical Base for Practice. I could really use my knowledge from previous
courses and implement them into my care of patients to improve the quality of care.

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Journal 6
May 1
Ferris State University College of Optometry: Interprofessional Wellness Clinic
Day 7: Refresher to the clinic (4 hours)
It has been quite some time since I have been in the clinic. I have been off for a while due
to spring break, and clinical schedule. It has been a little over 2 months since I have been
volunteering at the clinic. This is also due to the clinic being canceled last week because we did
not have any patients. I was a little nervous coming back but I was comfortable caring for
patients and thought it would be best if I assessed the patients while the other student accessed
the computer as I was less familiar with the computer. We had three patients today and all
showed on time or early. It was a good day, friendly patients and everything went smoothly.
Our first patient was there at 8 and we waited for ophthalmology to see her first to
dispense the eye drops to dilate her pupils. She was a younger woman who was pleasant and
cared for her diabetes well. She was fasting which gives us a better value of blood glucose and
cholesterol levels. The second patient was older who was very nice. She was dealing with a little
irritation of her bowels this morning so we had a delayed introduction at first as she needed to
use the restroom right away. She was not fasting this morning so her blood sugar was elevated
due to this. The last lady was overweight and she was not fasting as well. She was younger, just
over 30, and did not have teeth nor dentures. She appeared a little mentally delayed as some of
her responses to our questions were not normal responses. She was the most interesting patient as
she did not control her diabetes and was not monitoring her carbohydrate intake. She was below
8 for her A1C hemoglobin test which I was glad to see with an uncontrolled diabetes.

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For all these patients, I was responsible for doing an assessment on them. I checked their
height, weight, vitals, assessed feet, and tested the blood sugar and A1C hemoglobin with a
blood lancet. We educated the last patient on importance of monitoring intake of carbohydrates
to better herself in caring for her diabetes. The other two did not need much additional education
as they were aware of responsibilities to care for diabetes. Using a professional and friendly
attitude benefited the agency. Patients were more comfortable and less nervous as many may feel
when visiting a clinic. I also benefited the community by educating the patient on how to care for
her diabetes with proper dieting, this will prevent further complications if it was not brought up.
This week my goal was to come back from being off for so long and come back without
forgetting steps or how the clinic operates. It was not difficult to do this as I felt comfortable still
even though I was off for over 2 months. It also was helpful that the clients were easy-going,
making it less challenging for me to return and not add any stress to the situation.
The nursing program goal I met was General Nursing Practice. Throughout this
I clinic I have cared for several clients. Many of who had families, were different race, age, and
gender. I cared for a large range of clients with needs in many diverse populations. If needed,
education was done for these patients to achieve a goal of a healthy individual and the
community.
My time at the diabetic clinic has been great. I was able to meet some wonderful people
and had an expanding learning experience of nursing practice. I gained more familiarity with
diabetes in patients and how they can impact the human body especially the eyes. I was not as
aware of how much the eye can indicate future problems that may arise. I developed confidence
in caring and educating patients on their diabetes. I also collaborated with other nursing students
and volunteers at the clinic well. I truly feel I met all the goals of the nursing program with this

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clinic. It is well rounded and a great opportunity for nursing students to volunteer and to develop
their care and communication skills directed at patients.