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Reflective practice : Use Gibbs reflective model as a framework to reflect on an experience you have had as an undergraduate registered nurse that has impacted on your philosophy of practice. Essay Example

  • Category:
    Nursing
  • Document type:
    Assignment
  • Level:
    Undergraduate
  • Page:
    3
  • Words:
    1881

Introduction

Nursing practice takes place in a dynamic environment characterised by unprecedented challenges and experiences that are likely to impact nurses’ philosophy of practice. As nurses transition from learning to practice, they are likely to face increased pressure due to the ambiguity of their roles and the increased demands and responsibilities imposed by their professional (Chang & Hancock 2003). Nevertheless, when nurses prepare effectively, they can competently and effectively care for patients while continuing to develop skills throughout their professional. In order for nurses to effectively meet the demands of their profession and engage in continuous learning, reflection is a vital skill that they need to develop. Critical reflection is a valuable tool that helps nurses to learn and improve their philosophy of practice by offering them insight on their day to day practice and experiences. Nurses reflect since it offers a mechanism or tool that they can used to communicate and evaluate their practice (Daly et al, 2010).

Using Gibbs reflective model, this paper will provide a reflection on an experience that I had as an undergraduate registered nurse that has impacted on my philosophy of practice. Gibbs reflective cycle is a framework that entails six stages that are used to enable nurses improve their nursing practice in the coming days. The cycle begins with a description of an experience or situation. The next stage is feelings’ analysis followed by the experience’s evaluation. The fourth stage involves analysis of making sense out of the experience followed by a conclusion of what could have been done differently. The last stage is a plan of action to prepare once the incidence came again (Daly et al, 2010).

Stage 1 : Description of experience

My reflection revolves around an elderly female patient aged 75 years who was admitted in the general ward following a fall. Since it is imperative to keep the patient’s information confidential, the patient herein is referred to as Mrs. A. I was concerned that Mrs. A was not ready to mobilize and that a couple of nurses had neglected to talk to her about the significance of mobilizing. She later informed me that she was afraid of walking due to fear of falling again. With regards to the context with my patient, it is essential for me to develop therapeutic relationship that is the patient-nurse relationship. In therapeutic relationship, a rapport should be established from a mutual understanding and a sense of trust between a patient and a nurse so as to create a special connection of the relationship (Stein-Parbury, 2009).

In order to build a therapeutic patient-nurse relationship, a nurse ought to demonstrate sincerity, trustworthiness care, and empathy. These attitudes may possibly be expressed through promotion of effective communication as well as interaction by interpersonal skills’ implementation (Stein-Parbury, 2009). Interpersonal skills entail the total capacity to effectively communicate with others. These can be verbal, which is about speech or talking, or non verbal, which involves postures, gestures and facial expression.

Stage 2: Feelings and thoughts

The second stage in Gibbs reflection model requires one to analyze their feelings and thoughts. While attending to Mrs A, I felt that there was lack of connection and trust in the way in which she interacted with her caregivers. I thought it was important to introduce myself to Mrs. A. prior to offering any help. Therefore I tried to create a good rapport with the patient because I did not want her to be uncomfortable knowing I was not her family member and the fact that I was just from school. With her permission, I asked her if I would be of help in walking her around hence making her mobilize. She looked at me with much pleasure and I was delighted that indeed I would be of help to her. I listened to her as she expressed her fear of not wanting to walk around because she thought she might fall again. I reassured her that mobilizing is very crucial for her and that it helps in the healing process. I felt that in order to address Mrs A’s mobility issues, it was important to foremost build a therapeutic patient-nurse relationship characterised by sincerity, trustworthiness care and empathy.

Functional mobility is regarded as the ability to move from position one to another (standing sitting and lying down), to facilitate participation in regular day to day activities and routines. Functional mobility entails transfers, wheelchair mobility, bed mobility, and walking. Having autonomy in the tasks of functional mobility decreases the degree of long-term care needed by a person with a disability and enables a person to take part in a variety of self-care (Stevens, 2013). Functional decline that is age-related indicates that aged people are more vulnerable to de-conditioning (Hindle et al, 2011). In Australia, falls, associated injuries and confidence loss because of fear of falling are leading causes of morbidity (Gray & Heinsch, 2009). The capacity to walk, shower, toilet and dress, are connected to an aged individual’s degree of strength, endurance and balance. Maintaining strength, endurance and balance in the course of hospital stay is significant to improve or maintain independence. It also prevents de-conditioning that can lead to functional decline as a result of physiological changes after a period of low activity or inactivity (Hindle et al, 2011).

Stage 3: Evaluation

In my evaluation, I think I made the correct decision addressing Mrs. A’s functional mobility issue by mainly focusing on developing an effective patient-nurse relationship. I believe my practice was in line with the National competency standards for the RN. The National competency standards for the RN call for provision and organization of care (ANMC, 2006). Element 7 of the national competency standards for the RN states that RNs should provide comprehensive, effective and safe evidence-based nursing care to attain individual health outcome. Element 7.1 further elaborates that by stating that RNs should provide education as well as support to help development and preservation of independent skills of living (ANMC, 2006). This is also supported by 1.2, which stipulates that RNs should fulfill the responsibility of care (ANMC, 2006). I believe that I effectively adhered to these standards. I executed suitable interventions according to the acknowledged practice standards. Additionally, according to the nursing code, I executed my practice in a manner that is safe and competent (ANMC, 2008). My practice in this case generally exemplified a collaborative and patient-centered approach which is essential in promoting patients’ health care outcomes.

Stage 4: Analysis

A critical analysis of my involvement with Mrs. A, it is apparent that this event helped me to exercise my communication skills that play a fundamental role in establishing a nurse-patient relationship. Nurse-patient relationship later helps in promoting patient outcome since the patient is able to comply with whatever therapy, medication or intervention that is presented before him or her (Daly et al, 2010). Patients that are not attended to properly are likely to have longer hospital stay since their conditions may get worse or take long to improve. Effective communication particularly in aged care is, hence, more than providing quality care that is patient-centered (Bedin et al, 2013). It is considered the vehicle via which involvement of a patient is optimized as well.

As a patient navigates the psychological, lifestyle, economic, social, and physical changes linked to aging, one relationship that might remain a significant source of encouragement and support is the relationship with his or her health care provider (Bedin et al, 2013). Hence, this explains why effective communication between the nurse and the patient should be upheld as the development of a trusting relationship that is therapeutic can be vital to the elder patients’ health care (Stein-Parbury, 2009). Active participation of patients in their treatment and their preferences’ voicing for various elements of their care can be significant to both patient adherence and patient satisfaction (Bedin et al, 2013). Active communication raises knowledge of patient about their condition, enables them to convey essential information to the nurses, and enhance care process. Studies indicate that participation of patients is controlled by characteristics of the patient; higher participation is provided to patients that are active partakers themselves (Stevens, 2013).

Stage 5: Conclusion

In conclusion, it is evident that building effective patient-nurse relationship can promote positive health outcomes amongst patients. In order to build such a relationship communication is essential. Effective communication between a nurse and a patient is directly connected to reliable and safe patient care (Stein-Parbury, 2009). On the other hand, skills of communication are underdeveloped for a lot of nurses as well as nurse leaders (Bedin et al, 2013). For instance, some of the barriers to effective communication in nursing include and not limited to: anything that alters the desired message can be deemed as noise that stops the receiver from proper interpretation of the message (Daly et al, 2010). Psychological and physical barriers can make a patient not understand a nurse or reacting to a request (Bedin et al, 2013). This is why it is essential to be aware of nonverbal cues like eye movements, facial expressions, body postures, hand gestures and uncontrolled reactions like respiration rates and pulse. In potential situations of conflict, the nurse should avoid unpleasant, hasty retorts (Daly et al, 2010).

Stage 6: Action Plan

My action plan from this experience is that patients should be assessed comprehensively and their needs discussed so that every patient receives the desired nursing care. Preparing to handle such incidences is important. This will involve being armored with effective skills of communication because every care giver wants the best for their patient despite the situation. From the experience, communication is indeed a fundamental element in developing a good nurse/patient relationship. Broad research evidence shows that the nurse-patient relationship on its own can provide therapeutic care to the patients. A nurse’s attention, concern, practical assistance, caring, and warmth, as well as open and accurate communication, can bring about an incredible difference to older patients’ health. Through collaboration in patient care, nurses can considerably improve the health outcomes of their aged patients through effective assessment and noting concerns in addition to supporting them in their management of condition, their emotional coping, and their adherence to care plan.

Reference

Australian Nursing and Midwifery Council (ANMC). (2006). National competency standards for the registered nurse. Canberra: Australian Nursing andMidwifery Council.

Australian Nursing and Midwifery Council (ANMC). (2008). Code of Professional Conduct for Nurses in Australia. Canberra: Australian Nursing andMidwifery Council.

Bedin, M. G., Droz-Mendelzweig, M., & Chappuis, M. (2013). Caring for elders: the role of registered nurses in nursing homes. Nursing Inquiry, 20, 2, 111-20.

Chang, E., & Hancock, K. (2003). Role stress and role ambiguity in new nursing graduates in Australia. Nursing and Health Science 5(2):155-163.

Daly, J., Speedy, S., & Jackson D. (Ed.) (2010). Contexts of Nursing: An Introduction, Chatwood, NSW: Churchill-Livingstone Elsevier.

Gray, M. & Heinsch, M. (2009). Ageing in Australia and the Increased Need for Care. Ageing International. ISSN 0163-5158, 09. Vol. 34, Issue 3, pp. 102 – 118.

. Oxford: Oxford University Press. Nursing Care of Older PeopleHindle, A., Coates, A. & Kingston, P. (2011).

Stein-Parbury, J. (2009). Patient and Person: Interpersonal skills for nurses. (4th ed.). Churchill-Livingstone, Sydney, Australia.

Stevens, K. (2013). The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas OJIN: The Online Journal of Issues in Nursing, 18(2), Manuscript 4. 25(32), 35-37.