Saturday, February 23, 2019
Nursing Relection Essay
This essay will theorize on my personalised and professional arrestment during my original year on the nursing diploma programme. I will do this by discussing my pay back with the five essential skills clusters which include flush, tenderness and confabulation, medicine precaution and sustenance and politic management. I will relate the five skills by masking an understanding of a recognised model of reflection. Reflection, is a way of analysing some conviction(prenominal) incidents to promote acquisition and improve true(p)ty, in the delivery of health grapple in pr crookice. For the purposes of this essay I suck up chosen the Gibbs reflective calendar method model (Gibbs, 1988, cited in OCaroll & Park, 2007, p86), will be followed, as it gives an chance to produce a structured account of the discussion. Gibbs (1988) consists of six stages to complete nonp beil cycle which is fit to improve my nursing practice continuously and learning from the experience for b etter practice in the future.The cycle starts with a verbal description of the situation, next is to summary of the happenings, third is an evaluation of the experience, fourth stage is an analysis to make sense of the experience, fifth stage is a conclusion of what else could I induce done and final stage is an action proposal to machinate if the situation arose a deduct. In order to respect the endurings and provide members self-confidentiality ( treat Midwifery Council, (NMC), the code of standards of conduct, performance, and ethics for obligates and midwives, 2008), the precise spot of this military position will non be named. Consent (NMC, 2008) has been obtained from patients mentioned within this essay, although in the interest of maintaining confidentiality (NMC, 2008) of the patients, and so pseudonyms will be employ.Both of the posture areas I was allocated were general kidrens holds which both included a day social unit and inpatient beds for surgical a nd paediatric patients. A electric razorrens ward provides health accusation for children aged from birth to seventeen. The role of any nurse including childrens nurses is to play a major role in promoting healthy behaviours (Moules and Ramsey, 1998). Nursing a child is not just a question of compassionate for a miniature adult. You have to understand how a healthy child develops towards adulthood and know how to minimise the impact of illness or infirmary admission on the child. This involves snuff iting in musical compositionnership with the parents, or whoever looks by and by the child at home.Another factor that complicates treatment of the younger child is that of communication. While adults can express what they pure tone and need or grade the severity and nature of pain a child may not be open to say in such(prenominal) detail and the nurse demand to interpret behaviour and reactions intelligently. Childrens nurses need to be able to spot when a childs health tak es a expel for the worse, which can happen rapidly. (NHS, 2011)Health problems can have an effect on a childs development and its vital to work with the childs family or carers to ensure that he or she does not suffer additionally due to the stress of being ill or in hospital.I was both excited and apprehensive about head start my spatial relation on this ward. I was excited beca white plague this was going to be a refreshing experience and the opportunity to gain an shrewdness into diametric illnesses and conditions, save I felt apprehensive beca utilization I was unsure of what to expect in terms of how illnesses affect an individualistic and their parents and what challenges they may face and how I would respond. I was conscious of my lack of experience and noesis of illnesses and viewed this as a dominance weakness, which I thought it was imperative to be self sensible of my personal strengths and weaknesses before I commenced my placement. Self awareness is dealw ise essential to be able to interact effectively with patients. Personal beliefs and opinions can influence all negatively or positively, in the way of viewing other individuals. consciousness strengths, weaknesses, and the ability to reflect on personal characteristics, are necessary for be non judgemental. The NMC (2008, code of conduct), states as nurses we must make the care of multitude our branch concern by treating them as individuals and respecting their dignity. I know it is imperative to guidance on treating the patient and not the behaviour. My learn gave me an all overview of the different types of patients we would see, which included their different health diagnosis, and overly their individual rehabilitation and recovery plan, which helped me to have an insight into the needs of all(prenominal) patient and how illness can impact on an individuals life. I felt more confident afterward my mentor had given me this entropy to be able to approach individually individual patient and to be able to start to build a nurse patient family. Brown & Eby (2005, p63) suggests that a nurse patient affinity has three phases these are the orientation phase, the working phase, and the termination phase.Many people including myself believe prime(prenominal) motion-picture visual aspects usually form a lasting impression so I am very conscious on how I introduce myself to others. On introducing myself to the patients on the unit I treasured to prove a rapport, which is the foundation of the nurse patient relationship (Timmins, 2007, p438). I wanted to show a warm, caring and compassionate person to enable put and respect to develop with each patient which is an essential requirement of caring. fondness and compassion is a natural warm, informal communication skill, which is an important part of social ex careen (Baughan, Smith, 2008, p3). Roach (Roach, 1987, cited in Eby & Brown, 2009, p50) suggests there are 5 attributes of caring which are th e 5 Cs.These are commitment, which is to provide the care necessary for each patient, Compassion that involves sharing in the emotional notionings of some other and showing empathy which means trying to understand how another person feels. competence of understanding and giveing the nursing process by problem solving and the close making process. Confidence (believe in oneself), and self confidence to enable to gain trust of the clients, and confidence of the clients to trust the nurse. Finally, having a conscience and having an ethical curse or belief about what is remedy or wrong, and acting in accordance of the nursing profession.I wanted to spend quality time getting to know each patient on an individual bag to enable each patient to be able to develop a relationship found upon trust, honesty and mutual respect. I wanted each patient to be able to trust me and have the confidence in my ability to bring home the bacon the take into account care and support to meet the ir individual needs. The ability to empathise and relate to each patients emotions is key in showing care and compassion. The ability to understand and perceive feelings and their meanings are at the core of empathy. (Reynolds & Scott, 2000, 31, (1), p226). Having an understanding of what it would be like to be in a patients position enables interaction and engagement to be more supportive and motivated which I wanted to convey to the patients on the unit and show positive regard. I was looking forward to expenditure time speaking to each patient and getting toknow them over the duration of my placement within an inpatient setting, as this would help me to moreover develop the communication skills that I learned in my first placement , which would also enable me to develop my nursing skills further.Communication is an essential fraction demand for the nurse patient relationship and is at the heart of satisfactory nursing care (Stein Parbury, 2009, p274), and therefore effecti ve communication skills are crucial. whitethorn (2004, p488) suggests communication is a complex two way process that involves firing a message between people using verbal or non-verbal communication skills. Showing genuine interest and concern is necessary to supply the patient to speak openly and feel comfortable within the conversation. The footstep and mannerisms paralinguistic used during the conversation and the patients perception of this will all enhance the relationship or inhibit the development. A comment make can be damaging to self esteem and identity (Miller, 2002, 17, 9, p46). I felt comfortable communicating with the patients and I feel I have true(p) communication skills which is one of my interpersonal strengths, although I did feel a little cautious at times, for example if I was asked a question of which I was unsure of the answer.I observed my mentor and other health professionals engage in conversation with the patients in these situations first before en gaging in a meaning conversation, to ensure I was using effective and appropriate communication skills and remained objective. The level of interaction and communication I received from each patient did vary initially which reflected on the age of the individual and their parents understanding, and also on their ability to trust me as a student nurse.Listening is one of the most important skills needed for communication. This non verbal communication will establish a lot of worthy information to the patients wishes and concerns. The information given will also give an insight into the care needed and allow time to offer an appropriate reply. It is equally important to offer gestures of intense listening such as comfortably eye contact, facial expressions, and appropriate nodding to bang ageneral interest. Listening to the patients will also give the opportunity to observe their body language and to observe any conflicting areas of speech and movement that may suggest they are d isquieting with certain topics or are experiencing symptoms of cognitive impairment.I wanted to show I was listening to each individual and I was genuinely evoke in what they were saying to me and to develop the patients trust so they could be open and honest with me and be able to disclose their thoughts and feelings based upon mutual trust and respect. The care, compassion, and communication skills I demo to the patients on the ward were paramount for a therapeutic relationship to develop. A therapeutic relationship will be of mutual clear to meet the holistic needs of the patient and for nurse to gather the relevant information to offer the appropriate hitchs (McQueen, 2000, 9, p724).I was particularly looking forward to being able to develop my fellowship and skills in medicament management during this placement. Medicine management relates to the safe use of medicines to ensure patients get the maximum benefit from the medicines they need, while at the same time minimisin g potential harm. (Medicines and Healthcare Products restrictive Agency, (MHRA), 2004 p3). I did have some opportunity in my first placement to administer medication to patients, so I did have some knowledge into how to administer medication correctly and also in accordance with the NMC medication guidelines (NMC, 2010). I gained some confidence in my ability to be able to administer medication to patients safely from my first placement and was able to demonstrate safe practices from the onset of my encourage placement.I knew it was imperative that I adhered to the octette rights of medication which are the right patient, right medicine, right time, right date, right dose, right route, right preparation and the right documentation, which needed to be use to each patient before I administered any medication. I was highly conscious of the accountability nurses face in relation to medication management and therefore I wanted to learn as much as possible during this placement to ensu re I was competent and also inform myself with the legislation that underpins medication management such as the Medicines Act, (1968), misuse of drugs act (1971). All administration of medication needed to be accurately put down inaccordance to the NMC guidelines and Trust () policy.Nutrition and hydration is an important aspect of maintaining good health and childhood diseases can often be complicated by ugly nutrition. unhurried B has type 1 diabetes and is treated by insulin injections twice daily. Diabetes develops when the body is unable to produce the hormone insulin, which is produced by the pancreas (Diabetes UK, p4, 2008). enduring B is also overweight with a body mass indicant (BMI) of 27 and is considered to be clinically obese. Patient B also suffers from reparation urinary tract contagious diseases (UTI). When Patient B was admitted to the ward in October, he received an initial baseline nutritional assessment following the clinical guidelines of the National In stitute For Health And Clinical Excellence (NICE, 2006), Essence Of upkeep (DH, 2003, P89), and also implemented by .An intervention plan identify for Patient Bs nutritional needs to be closely monitored and nutritional tools such as a daily food and fluid using up charts and a weekly food menu chart were to be used to remember an accurate account of his diet and fluid intake. Patient Bs weight also needed to be monitored and recorded on a weekly basis. The intervention plan also highlighted that a poor diet and fluid intake was a trigger factor into why Patient Bs health was deteriorating.Supporting Patient B to maintain a healthy diet and accurately recording the nutritional information became part of my daily routine while on shift, which gave me an invaluable insight into the importance of monitoring a patients daily diet and fluid intake, and also the importance of accurate documentation and continuity of care. Good record keeping is essential to the provision of safe and e ffective care (NMC, 2009). collectible to monitoring Patient Bs fluid and diet intake, it became apparent(a) to that Patient B was becoming reluctant to maintain a continual diet independently and also his fluid intake was slowly change magnitude which was having an impact on both his diabetes and his physical health.My mentor approached me and asked if I would like to carry out an assessment and formulate a care plan for patient B, I was excited and did feel I had gained enough knowledge and understanding of this process during my two longplacements. To formulate a care plan, I first needed to identify the current risks that were present or were likely to occur. A risk relates to a negative event or an adverse affect, which is likely to cause harm (, 2009 p5). I needed to use an evidence-based approach by ensuring all the relevant data relating to Patient Bs current health care needs were accurate and apply an evidence-based approach to minimize the risk. Once I obtained all th e relevant information from Patient Bs care documents and nutritional assessment tools I was then able to plan an appropriate plan of care and intervention plan based upon the identified risks. The main areas of risk I identified were Patient Bs parents also needed guidance in helping him maintain a healthy diet and fluid intake.During my placement I also administered an intra muscular (IM) cytotoxic injection to a patient A. During the administration process it was imperative that I applied infection, prevention and obtain mathematical processs. The risk of infection is always present to both staff and patients and therefore Infection Prevention and Control procedures are aimed at breaking the infection chain (, 2011, P5). I initially felt overwhelmed by the process as there appeared to be a lot of precautions needed but after I had observed my mentor several times and understood the process, I felt more at ease with the procedure.The process I followed was script hygiene ensuri ng I washed my hands before starting the procedure and applying my personal protective equipment (PPE) such as my gloves and apron, the safe use and temperament of sharps ensuring the Needle was not bent or broken before use or disposal and the needle was safely throw out into a cytotoxic sharps container. All PPE along with items used which contained bodily fluid from the patient was discarded into clinical waste before washing my hands after complemental the procedure.On reflection of my experience on my placements, I think I would do exactly the same. I feel proud of what I have achieved so far and continued to develop my skills and enhanced my knowledge from my first placement. I feel I have become more aware and confident within the 5 key clusters of care I have discussed within this essay and I have demonstrated my willingness to learn and demonstrated a professional attitude throughout both of myplacement settings. I feel my experience gained has been very positive and I h ave learnt new skills and have gained confidence in my ability needed to be a nurse. Although looking back on my experiences, there are areas I would change for future placements. I would prepare better for each placement by ensuring I research further around the specific client grouping and setting.I feel that this would have been very beneficial to me in my second placement as I felt I was not amply prepared when I administered my first injection, and how each individual patient may be affected in different ways. My first week on placement I was still a little unsure how to communicate with some patients and although my communication skills will develop further with experience, I feel if I was better prepared I would have been more confident and relaxed with the patients and the environment and able to communicate effectively from the onset. Overall I feel this has been a positive experience and I have gained a good insight into the importance of developing and maintaining my nu rsing skills in relation to care, compassion and communication, medicine management, infection prevention and control, nutrition and hydration, and organisation of care.