Reflective Essay Essay

The aim of this essay is to try an accord of my perception of saying and how pondering practice impacts on the clinical environment and the cultivation passage. The essay is based on my practice and bringing up in the cardiac ward during my Foundation degree in health and Social C atomic number 18. I take selected 5 extracts from my Reflective ledger concerning a unhurried experiencing huskiness of lead which led to a cardiac arrest. In order to be able to use this spotlight for my ruminative shape the patient lead be referred to as Jane for the maintaining of confidentiality according to the Nursery and midwifery Council (NMC, 2008).I have chosen to discuss on the theme of Jane as the situation I was confronted with at the meter do me reflect on issues of determination and the sizeableness of communication and social skills in the relationship with the patient. I will be using the What? Model of Structured Reflection (Driscoll, 2007) a good example that us es three simple questions as guidance in reflective practice, to wit What? So what? Now what? I have chosen this modeling as I believe is a matter-of- occurrence solution that hobo be applied by health c argon professed(prenominal)s in a fast and efficient manner. It stimulates an in depth meaningful reflective parade that leads to an material plan for future solar day natural actions. According to Johns (2013) reflection can be pull ined as a window through and through which a practiti integrityr can fill himself in the context of his practice and have a clear view of his/her experience, beingness able to throw off an analysis between what should be operate and the actual practice.Searching for a full-bodieder understanding of the decisions and actions taken in ones activity can generate evolution of each professional and the development of his/her work practice (Benner, 2001). The process of reflection can be developed on two levels depending on its complexity an d the details it comprises. thusly reflection can be do in a deep and meaningful manner that considers all aspects of the situation or in a takeless manner that leads to solving problems based on factors such as tradition or work pressure (Lowe et.al, 2007). A nonher downfall of reflection can be the focusing on the negative aspects of the musical mode a situation has been managed instead of concentrating on the potential for development based on a critical evaluation (Bradbury-Jones, et.al, 2009). When trying to improve knowledge from practice, there are several models of reflection aimed at directing individual reflection.Among them, the Gibbsmodel of reflection (1988, cited in Callara, 2008) has stages that entangle the description of the situation, feelings experienced during the situation, an evaluation regarding the positivist and negative aspects, an analysis process followed by a conclusion which should include what could have been done in the situation and an action plan for future actions if a similar situation occurs (Gibbs, 1988, cited in Callara, 2008). Johns model of reflection (2013) on the other side focuses on questions regarding the intention of the action taken, the reason that was at the base of action, the practical and affective consequences on the patient, the patients family, the practician and his/her work colleagues. Johns (2013) besides highlights the importance of influencing internal and external factors in the decisional process and the possible alternative solutions that could have been found. The reflection process suggested by Johns (2013) ends with a learning phase that aims at understanding the effects of the experience and how it reflects on practice. Although there are legion(predicate) reflective frameworks, none of them should be utilize as a rigid excessivelyl which asks questions that need to be answered.They are all intended to offer a certain structure of the reflective process and guide the practitioner to wards deeper understanding (Lowe et.al, 2007). I have chosen Driscolls model as I believe it is a practical tool that allows free conjectureing and rapid understanding of the situation. Coward (2011) asseverates that following a rigid model of reflection limits the thinking process and undermines the reflective process. end-to-end my reflective process I have chosen to discuss also on the subject of decision making as the Code of paid Conduct (NMC, 2008) underlines the fact that nursing practitioners are accountable for their decisions. During a running(a) day in a infirmary there are numerous clinical decisions that need to be do and as Dowie (1993, cited in Raynor, 2005) states, the decisional process is manly a choice between several alternatives. According to fire and Bulman (2000) through reflection we can have a clear understanding of the reasons that lie behind our decision. This is what I have learned during my training and through my clinical experience, that only th inking close the actions I take in different situations helps me evaluate my work and understand what further knowledge I need in order to be bring forth a professional.Writing a journal that detailed my thoughts and worries on specific situations I was confrontedwith in the cardiac ward helped me learn and develop my skills, as Moon (2004) stated. Jane was a 60 year old lady diagnosed with valvular heart disease. She has been submitted in the hospital several multiplication before as she experienced shortness of breath and released from the hospital when her go over stabilised. On that day I was helping the declare observing the patients, taking zippy signs and recording blood results. Her observations on that day were within normal limits, provided up to now so she complained about shortness of breath. Her husband had just visited half an hour before and the breathing problems appeared after he left. The guard asked her if she received any unsettling give-and-take from her husband because her state changed suddenly after he left. She told us that one of her sons was in township for a short period of time, came to visit not knowing she was in the hospital and left worried back home as he had to be back at work in the same day. The suckle told Jane that her son will be fine and probably will deign back to visit very soon. However, I could see that Jane was feeling zealous and had a desperate look in her eyes.She repeated several times that she couldnt breathe and the nurse told her that she will be alright if she assay to calm down and relax. The nurse didnt seem to worry too much as the patients observations were within limits. Jane saw the fact that I was gazing at her while wondering if this is to a greater extent than than the observations world power show. She took my sacrifice and asked me not leave, because she needed someone by her side. At first I told her I would be there for as long as she wishes, but then I was called to help other nurses because they needed me in the ward. I assured her that I will come back. Unfortunately, the day passed very speedily and time came for me to go home. Before I left, I asked the nurse who was attend Jane about her condition and she said she was still upset about the news her husband have her, but that her medical conditions was within limits. When I returned the attached day I was informed by the nurse that Jane suffered a cardiac arrest over the night and although cardiac procedures were made nothing could be done and she was pronounced dead. My first thought after I hear the news was that probably, considering her heart condition nothing could have been done. However, after I read the journal and the notes I made in it about this case and applied the Driscoll model I began questioning about my actions and think about what I should be doing if a similar situations occurs.Reflecting on the incident made me wonderwhether I acted accordingly with the NMC (2008) which states t hat I am accountable for my actions and omissions even if I follow the advice of other professionals. This is what happened in this situation as well, as I felt and thought that there might be more than unsettling news that could be disturbing Jane. Even so, it is well-known the fact that song influences the medical condition of patients with heart diseases and this could have been a hint that her condition might get worse (Meterko, et al, 2010). According to Basford (2003) anxiety and fear of the patient can be reduced if he/she receives the affective support of a nurse. I felt I didnt do enough for Jane, as the least I could have done was to be there and parley to her and maybe her breathing would have come to a regular level. Basford (2003) highlights the importance of communication and interpersonal skills of nursing practitioners in their relationship with the patient. Being cranky and appearing willing to listen and talk to the patients can sometimes make a big going in s omeones medical condition. I believe that the wishing of communication with the patient was the biggest mistake I made in this case. I feel know that if I stayed by her side and tried to comfort her she would have become more relaxed and peradventure wouldnt have triggered the cardiac arrest. I think that at that time assuring her that it will all be alright and that feeling fall in was the virtually important thing for her and her son as well was the top hat thing to do.This was a point where the decision I made was not according to NMC (2008) as the relationship between me and the patient was broken because of lack of communication. This situation made me think about my communication skills and how important they are in my profession. Being assertive and saying whats on my brainiac if I have a suspicion that more than what meets the eye might happen is what learned I should do in the future. Moreover, I think I still have to work on my empathy and lenity as I believe this w ould improve also the quality of the observations I make during the time I spend with patients. Reflecting on the action I took made me understand that guidelines cannot prepare me for all types of situations that can be met in the ward. They are very useful s guidance for the majority of cases, but some of the times it is the individuals responsibility to act as he thinks its appropriate at the given time (Scott and Spouse, 2013).This assertion becomes more relevant especially when it comes to dealing with interpersonal issues that dontcome across as essential tasks in dealing with patients. Focusing on the regular work practices and tasks most of the times takes our brainiac away from the interpersonal aspect and the fact that we are actually the ones that patients look at for compassion and relief (Rolf et.al, 2001). There are situations, as the case of Jane when listening and being by the patients side can bring more benefit than measuring their blood pressure or taking vital signs. ConclusionReflection can vary from deep and meaningful to superficial inquiry. As I stated above the guardianship for patients can be improved through reflective practice that leads to a plan of action for future situations. The case of Jane helped me understand the importance of communication and compassion in the relationship with the patient. Also, although I might not be the one most experienced in situation, I should have the courage to speak my mind and raise certain issues if I feel they could make a difference in the patients condition. Driscolls model of reflection made me understand the situation I was in, identify my learning needs and pass off ways through which I can improve my performance and patient care. I also believe that reflection also helps health care professionals become motivated and empowered by the feeling that they actually have a word to say in the care of the patient and that they can influence important situations and outcomes for their patient s.ReferencesBenner, P., 2001. From Novice to expert Excellence and Power in Clinical Nursing enforce. London Prentice Hall Basford, L., 2003. Theory and Practice of Nursing An Integrated Approach to Caring Practice. Nelson Thrones Bradbury-Jones, C. et.al, 2009. A new way of reflecting in nursing the Peshkin Approach. Journal of advanced Nursing, 65 (11), pp.2485-2493 online Available at http//www.onlinelibrary.wiley.com Accessed the 15th of February 2014 Callara, L.E., 2008. Nursing Education Challenges in the 21st Century. Nova Publishers Coward, M., 2011. Does the use of reflective models restrict critical thinking and therefore learning in nurse education? What have we done? Nurse Education Today, 31(8), pp.883-886 online Available at http//www.nurseeducationtoday.com Accessed the 12th ofFebruary 2014. Driscoll, J., 2007. Practising Clinical Supervision A Reflective Approach for health care Professionals. Elsevier Health Sciences Johns, C., 2013. Becoming a Reflective Practitio ner Oxford Blackwell Science Ltd Lowe, M., Rappolt, S., Jaglal, S. and Macdonald, G., 2007. The case of Reflection in Implementing Learning from continue Education into Practice. Journal of Continuing Education in the Health Professions, 27(3), pp.143-148 online Available at http//www.onlinelibrary.wiley.com Accessed the 18th of February 2014 Meterko, M. et al, 2010. farm out Satisfaction of Primary Care Team Members and Quality of Care. American Journal of Medical Quality, 26(18), pp.8-9 online Available at http//ajm.sagepub.com Accessed the 15th of February 2014 Moon, J., 2004. Reflection in learning and professional development, theory and practice. Oxon Routledge Falmer Nursing and midwifery Council (NMC), 2008. The code standards of conduct, performance and ethical motive for nurses and midwives. London Nursing and obstetrics Council Raynor, M.D.,et.al, 2005. Decision Making in Midwifery Practice. Elsevier Health Sciences Scott, I. and Spouse, J., 2013. Practice based learni ng in nursing, health, and social care Mentorship, facilitation and supervision. Chichester Wiley-Blackwell . Rolf, G., Freshwater, D. and Jasper M. (2001) Critical reflection for nursing and the helping professions a users guide. Basingstoke Palgrave Macmillan