NURBN1003: Communication - Safety Issues - Gibb’s Reflective Cycle - Nursing Assessment Answer

Subject Code: NURBN1003 Internal Code: E_AI_DHJI_ACA

Nursing Assessment Answer

TASK: PART: Critical Reflection submission 1. Description: Provide the context for reflective writing. Include background information, such as what it is you’re reflecting on and tell the reader who was involved. It’s important to remember to keep the information provided relevant and to-the-point. For example: “I was required to undertake the role of the Airway Nurse within the context of a deteriorating patient simulation scenario of a patient with increased shortness of breath”. Introduce the reader to the aspect of your skill you are reflecting on. 2. Feelings: Discuss your feelings and thoughts about the experience of undertaking that particular skill. Consider questions such as: How did you feel at the time? What did you think at the time? What did you think about the incident afterward? Why is it important for nurses to consider their feelings after an incident or challenging situation? What are the potential implications of these thoughts and feelings when faced with a similar situation? You can discuss your emotions honestly, but make sure to remember at all times that this is an academic piece of writing, so avoid ‘chatty’ text. 3. Evaluation: What helped or hindered you in undertaking the skill? If you are writing about a difficulty, did you feel that the situation was resolved afterward? Why/why not? 4. Analysis: Examine and explore the experience by identify an overarching issue (use the issue identified in the evaluation section), or key aspect of the experience that affected it profoundly for example, “communication”, “safety issues”. Use evidence-based practice resources (references) to support this discussion. 5. Conclusion: It is important to acknowledge: whether you could have done anything else; what you have learned from the experience; consider whether you could you have responded in a different way. If you are talking about a positive experience...discuss whether you would do the same again to ensure a positive outcome. Also consider if there is anything you could change to improve things even further. If the incident was negative...tell your reader how you could have avoided it happening and also how you could make sure it doesn’t happen again. 6. Action plan: An Action Plan sums up anything you need to know and do to improve for next time. These need to be real and tangible plans you can make for yourself. Perhaps you feel that you need to learn about something or attend some training – what article will you read? What training would be relevant? What clinical practice guideline will you review? Could you ask your tutor or placement supervisor for some advice? What goals will you include for your clinical placement? What can you do which means you will be better equipped to cope with a similar event? 7. Reference List: List any resources you have cited as per APA 6th ed. Guidelines. There is no minimum number of resources, however if you are using the work of other authors, they must be acknowledged. Sourced information can include journal articles, text, contemporary and current clinical practice guidelines or nursing standards. An example of reflective writing in a healthcare assignment using Gibbs Reflective Cycle. Ensure you follow the assignment submission guidelines located on Moodle. Description In a placement during my second year when I was working on a surgical ward, I was working under the supervision of my mentor, caring for a seventy?two-year-old gentleman, Mr. Khan (pseudonym), who had undergone abdominal surgery. I had been asked to remove his wound dressing so that the doctor could assess it on the ward round. I removed the dressing under my mentor's supervision, using a non?touch procedure, and cleaned the wound, as requested by the doctor. My mentor was called to another patient at this point, so at her request, I stayed with Mr. Khan while we waited for the doctor to come to see him. The doctor had been with another patient, examining their wound, and I noticed that she came straight to Mr. Khan to examine his wound, without either washing her hands or using alcohol gel first. I also noticed that she was wearing a long?sleeved shirt, and I was concerned that the cuffs could be contaminated. I thought for a moment about what to do or say, but by the time I had summoned enough courage to say something, I thought it was too late as she was already examining Mr. Khan. Feelings I was alarmed by this, as I had expected the doctor to wash her hands or use alcohol gel before examining Mr Khan. However, I felt intimidated because I felt that the doctor was more experienced than me as a second-year nursing student; and I didn't want to embarrass her. Also, I didn't want to make Mr Khan concerned by confronting the doctor in front of him. Later, I spoke to my mentor about the incident. She suggested that we speak to the doctor together about it. My mentor took the doctor aside, and asked her whether she had washed her hands before examining Mr Khan. She looked quite shocked. She said that she had been very busy and hadn't thought about it. My mentor discussed the importance of hand hygiene with her, and the doctor assured her that she would wash her hands before examining every patient in the future. Evaluation The incident was extremely challenging for me. I regret that I did not act to challenge the doctor's practice before she examined Mr. Khan. However, I am pleased that the doctor responded so positively to the feedback of my mentor, and I have observed that she has now changed her practice as a result of this incident. I too have learned from the incident, as it has taught me the importance of acting assertively with colleagues, in a sensitive manner, in order to safeguard patients' well?being. Analysis The Royal College of Nursing (2005) states that hand hygiene is the single most important activity for reducing cross?infection, and points out that many health care professionals do not decontaminate their hands as often as they should. Recent guidance published by the Department of Health (2007) highlights the possibility of staff transmitting infections via uniforms, and the need to review policies on staff dress. The Nursing and Midwifery Council Code of Professional Conduct (2004, section 8) explains that as a nurse you must act to identify and minimise the risk to patients and clients. As the student nurse caring for Mr Khan under my mentor's supervision, this also applies to my own practice as a student nurse. Conclusion Looking back on this incident, I can see that I should have acted sooner, and that I should have ensured that the doctor washed her hands before examining Mr Khan. I can now see that my inaction in this incident put Mr Khan's well?being at risk. After discussion with my mentor, I recognise that I need to develop the confidence to challenge the practice of colleagues, putting the well?being of clients at the forefront of my mind. I realise that I need to be supportive to colleagues, understanding the pressures that they may be under, but ensuring that their practice does not put clients at risk. Action Plan In the future, I will aim to develop my assertive skills when working with colleagues, in order to ensure that the well?being of clients is maintained. In my next placement, I will make this a goal for my learning, and will discuss this with my mentor to work out strategies for how I can achieve this.

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