The capacity to reflect on an action or procedure results in the ability of continuous learning. Reflective learning is an important feature of practice based professional learning, Gibbs 1998 says that there are six stages of reflective learning, description, feelings, evaluation, analysis, conclusion and action plan. This allows the care to always improve and develop standards. Its beneficial for a practitioner to constantly analyse their work and aim to give the best support possible, having insight into your personal development ensures a high quality of standards. Actively seeking feedback will help eradicate any issues that may have gone unseen (reference needed). Self review is a conscious effort to consider how an event could have a different outcome if done differently.
“Reflective practice is an active dynamic action-based and ethical set of skills, placed in real time and dealing with real complex and difficult situations.” (Moon J 1999).
During this essay I will be using the Gibbs model (1998), It contains six different steps. Description, feelings, evaluation, analysis, conclusion and action plan. Reflective learning allows an individual to be constantly assessing their selves, this allows new techniques to be put into place, as it triggers thought processes and active thinking, this results in better quality of care. Reflective practice is paramount to patients individual care and changing needs, this underpins person centered care ( Draper and Tetley 2013). learning from your own experiences is a lot more practical than learning formally or from knowledge transfer. It helps decipher theories from practice, Benner (1984 ) acknowledges through this practice I can improve if a similar situation occurs.
It was during my first placement where I met Mrs Ross (pseudonym) in order for me to use this scenario, the patience name will be changed this adheres to the Nursing and Midwifery Council confidentiality code of confidentiality. Mrs Ross was a fifty year old, admitted to the ward due to a suicide attempt MEDICATION OVERDOSE, following a cerebral vascular accident. She had no sensation down the right side of her body and her speech was impaired, she could only communicate using monosyllabic speech. Mrs Ross was a very positive and pleasant lady, she took a lot of pride in her appearance she enjoyed the company of staff and was happy when I would French pleat her hair and paint her nails. Now and then staff noticed changes to her behavior, Mrs Ross would cry for days and shout out, she became physical and would hit herself in the head or pull her hair. I had gone into Mrs Ross room to give her the supper meal, she was crying, shouting and shaking her head. I was aware that we should “treat people with kindness, respect and compassion” (NMC 2015), I asked her if she wanted her meal, she shook her head in response, I asked if she felt sick to which she would sometimes nod yes, but this time she continued crying and shouting and pushed the tray away and began to get more upset, with that I left. I went to discuss this situation with my mentor, Hawatson-jones (2016) recognizes that only by seeking feedback from others, can you understand if you made the correct decision. My mentor had also noticed these periods of agitation and outbursts and decided to start her on a behavior chart. (Quote in escalating concerns).nmc ?
I felt helpless and lost as to what to say or do for Mrs Ross, our communication was limited, I was aware that it was me that had to ask the Right questions, closed questions are ideal for eliciting specific pieces of information (Egan,1998). Unfortunately I didn’t feel that I did, I had asked Mrs Ross if she had felt sick, but other than that I couldn’t understand what was upsetting her. I could sense Mrs Ross was getting frustarated and when I asked her a question she began to get even more distraught.
I feel looking back on the experience, I could have comforted Mrs Ross, even if I just sat with her, however due to her aggression and shouting I didn’t feel confident to do so. Dowling (2006) state student nurses lack the ability to respond in the correct manner during complex situations, this is due to lack of nursing experience. I felt a lot of empathy towards Mrs Ross as I could sense her helplessness in not being able to express what was upsetting her. Due to inhability to express her thoughts and feelings verbally, it is important to remember that mrs Ross is still able to understand what is being communicated to her and avoid assumptions that she cannot understand what is being said to her (Brink and Skott 2013) . I felt speaking to my mentor and expressing how distressed Mrs Ross was helped understand what the trigger for her upset was. Staff noticed through the aid of the behavior chart ( Quote on behavior chart ) that when Mrs Ross husband visited there was a change in her behavior, this allowed staff to ask closed questions regarding her husband and how she felt about living with him. Mrs Ross then expressed an undesired to return home with her husband as he would shout at her. (quote on career burnout/stress and taking a non-judgmental approach.
Although I have had a lot of experience in home care, I found this particular situation difficult as I did not know Mrs Ross and her husband well. My previous jobs included working with people over a long period of time so I was aware of what was normal for certain individuals and their behavior ( quote on building relationships ) whereas in hospitals or ward settings many patients are admitted and you do not know what is normal behavior for them. something to consider is that Mrs Ross and her husband’s relationship was amicable, often it is taken for granted that people will care for the loved ones, although not all people are natural careers. Mrs Ross situation is a life changing event especially for her and her husband, this adjustment might have made the husband angry or frustrated with his new career role.*** I also found watching the health care support workers helpful ( everyone can be a mentor ). I learnt how they communicated with Mrs Ross during personal care and found out what she liked and wanted by asking closed questions, I watched how open and happy Mrs Ross was when talked to and involved in general conversation. It is important to treat everyone as an individual with their own sets of values and needs (Taylor et al 2008). I also noticed that when Mrs Ross was upset I was asking the wrong questions but in hindsight I wasn’t to know the issue was her husband but by discussing my concerns it helped in the process of finding out what was wrong.
In conclusion I have come to realise that without this event taking place It would not have led me to reflect on my actions, through situations and problems arising it leads you to think on what you could have done differently. As future practitioner I feel I could have been more sympathetic to Mrs Ross’s needs maybe in time I will feel more comfortable if a situation like this arises again , it has taught me a lot regarding communication, empathy and self awareness, Bulman and Schutz (2004) express that self awareness is the basis in which reflective practice is developed on . I may have also had a preconception that Mrs Ross could not communicate effectively, leading me to believe she couldn’t understand me correctly, Brink and Skott(2013) highlight that some diagnoses lead to preconceptions on individuals. Communication is the basis of all life, as humans we are able to communicatie not just verbally but through facial expression and body language, kozier et al (2004) express that we need to be aware of what we are saying by how we carry ourselves, communication is the most important feature of nurse and patient relationship (Taylor et al (2008). It was also something that kept replaying in my mind that Mrs Ross had had a previous suicide attempt, I wanted Mrs Ross to feel that I listened to her and that she mattered however, I felt annoyed that I couldn’t console her. Ouzouni and Nakakis (2013) state that some patients who slef harm may portray negative emotions such as anxiety.