Reflective Essay Essay

The aim of this rise is to prove an catch of my perception of rumination and how reflective practice impacts on the clinical environment and the encyclopaedism process. The essay is based on my practice and training in the cardiac ward during my Foundation degree in Health and Social C ar. I obligate selected 5 extracts from my thoughtful Journal concerning a patient experiencing shortness of breath which led to a cardiac come. In order to be able to use this pip for my reflective process the patient impart be referred to as Jane for the maintaining of confidentiality according to the Nursery and midwifery Council (NMC, 2008).I cast off chosen to discuss on the case of Jane as the situation I was confronted with at the time make me reflect on issues of decision and the importance of communication and interper word of honoral skills in the relationship with the patient. I will be using the What? Model of Structured Reflection (Driscoll, 2007) a framework that uses three sim ple questions as guidance in reflective practice, namely What? So what? Now what? I pitch chosen this mould as I retrieve is a practical solution that shag be applied by wellness care professionals in a rapid and efficient manner. It stimulates an in depth meaningful reflective process that leads to an actual plan for future actions. check to Johns (2013) reflection weed be viewed as a window through and through which a practitioner can see himself in the context of his practice and have a clear view of his/her experience, organism able to make an analysis between what should be wear upone and the actual practice.Searching for a darksomeer understanding of the decisions and actions interpreted 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 and the details it comprises. Therefore reflection can be made in a deep and me aningful manner that considers totally aspects of the situation or in a superficial manner that leads to solving problems based on factors such as usance or work pressure (Lowe et.al, 2007). Another downfall of reflection can be the focusing on the negative aspects of the way a situation has been managed or else 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 include the description of the situation, stepings experienced during the situation, an evaluation regarding the positive and negative aspects, an analysis process followed by a conclusion which should include what could have been through with(p) in the situation and an action plan for future actions if a similar situation occurs (Gibbs, 1988, cite d 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 practitioner and his/her work colleagues. Johns (2013) also 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 numerous reflective frameworks, none of them should be used as a rigid tool which asks questions that need to be answered.They are all intended to offer a certain structure of the reflective process and take the practitioner towards deeper understanding (Lowe et.al, 2007). I have chosen Driscolls model as I believe it is a practical tool that allows free view and rapid understanding of the situation. Coward (2011) states that following a rigid model of reflection limits the thinking process and undermines the reflective process. Throughout my reflective process I have chosen to discuss also on the subject of decision making as the Code of Professional Conduct (NMC, 2008) underlines the fact that nursing practitioners are responsible for their decisions. During a working twenty-four hour period in a hospital there are numerous clinical decisions that need to be made and as Dowie (1993, cited in Raynor, 2005) states, the decisional process is manly a choice between several alternatives. According to Burns 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 thinking about the actions I take in opposite situations helps me evaluate my work and un derstand what further knowledge I need in order to become a professional.Writing a journal that detail 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 shopping centre disease. She has been submitted in the hospital several times before as she experienced shortness of breath and released from the hospital when her condition stabilised. On that day I was helping the maintain observing the patients, taking vital signs and recording blood results. Her observations on that day were within normal limits, but even so she complained about shortness of breath. Her preserve had just visited half an hour before and the breathing problems appeared after he left. The nurse asked her if she received any unsettling news show from her husband because her state changed suddenly after he left. She told us that one of her sons was in town 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 nurse told Jane that her son will be fine and probably will come back to visit very soon. However, I could see that Jane was feeling anxious and had a dread(a) look in her eyes.She repeated several times that she couldnt breathe and the nurse told her that she will be exquisitely if she tried 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 wonder if this is more than the observations capability show. She took my hand and asked me not leave, because she needed someone by her side. At first I told her I would be there for as grand 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 quickly and time came for me to go home. Before I left, I asked the nurse who was attending 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 next 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 heard 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 that I am accountable for my actions and omissions even if I follow the advice of other professionals. This is what bechanceed in this situation as well, as I felt and thought that there skill be more than unsettling news that could be disturbing Jane. Even so, it is well-known the fact that stress influences the medical condition of patients with heart diseases and this could have been a contact 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 talk to her and by chance 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 warm and appearing involuntary to listen and talk to the patients can sometimes make a big difference in someones medical condition. I believe that the deprivation 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 perhaps wouldnt have triggered the cardiac arrest. I think that at that time assuring her that it will all be alright and that feeling better was the most important thing for her and her son as well was the best 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 mind 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 compassion as I believe this would 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 most of the times it is the individuals certificate of indebtedness 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 mind international 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. outcomeReflection can vary from deep and meaningful to superficial inquiry. As I stated above the care for patients can b e 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 find 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 patients.ReferencesBenner, P., 2001. From Novice to expert Excellence and Power in Clinical nursing Practice. London Prentice Hall Basford, L., 2003. T heory and Practice of care for An Integrated Approach to Caring Practice. 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