Nursing Reflection

7 July 2016

In the context of professional practices reflection is defined as the examination of personal thoughts and actions (David, 2004). In this essay I am reflecting on an incident that happened in my earlier years of working as a professional nurse. The incident I am sharing and the subsequent learning I have gained by reflecting it helped me in the later years of my nursing career. During my career as a professional nurse I have worked in several hospitals also attended several cases and those provided me with lot of insights and leanings.

As per NMC 2002 guidelines, for protecting identify of the patient, names have been replaced with pseudo names. For structuring my experience and the subsequent reflection I am using Gibbs (1998) model of reflection as a framework. By using Gibbs (1998) model the practitioner and also take emotions into account. As shown in the below diagram, this model for reflection consists of six stages. Figure : Gibbs reflective cycle.

Nursing Reflection Essay Example

Source : Oxford Brookes University Gibbs reflection starts with describing the incident, analysing the feeling, evaluation of the experience, analysis of the experience, conclusion, what else can be done as the final step also it analyse about the future plan how to approach a similar situation in the future. The incident I want to describe happened during the third year when I was working. When I was working in the causality ward, and an 11 year old named Maria was admitted.

From the first sight I figured out that Maria was in great deal of pain and I came to know that she met with an accident. She was conscious and was bleeding profusely. We have done the preliminary examination and found out that one of her legs were fractured. The people who brought her to the causality already left, she was alone and her parents or relatives were not yet reached the hospital. In that stage along with keeping her conscious I was also trying to establish a therapeutic relationship with Maria to create trust and confidence.

As a medical professional it is important to build trust and confidence of the patient because it will increase the self-esteem of the patient and helps in diagnosis of the situation and in the process of healing (Hark reader & Hogan, 2004). During that time I have noticed that Maria was not responding to my voice and not screaming and shouting like any other children do. For a short time I was wondering the reason for that and I immediately realised that her speaking and hearing was impaired. The

situation was much more complicated than I was initially thought, in short I was dealing with a half conscious deaf and dumb girl, having multiple fractures also the possibility of internal bleeding. However as the biggest challenge I felt was her corporation. I can feel from her face that she was very nervous and in pain and also helpless to convey the difficulty she was facing. Feelings For taking the case forward and working with Maria, it is very critical to establish a good connection and communication between us.

I remembered that communication could be established not only by verbal exchange but also means such as non-verbal exchange also (Black & Chitty, 2007). In Maria’s case non-verbal communication using hand signals was the only way of communication that possible. I have stated completing the essential medical procedures, alongside I was trying to create a rapport with her by showing some hand signals which expresses sympathy and care. When I was with her I always tried to keep an eye contact so that she gets a feeling that I am interested and wanted to help her.

According to Caris (1999) eye contact is a good way to communicate the sense of interest in the person one is conversing with. From Marisa’s reaction I figured out that my efforts were giving me good results, she started pointing where all she was feeling pain. Also she tried to tell me the whole chain of events happened using hand gestures. Evaluation From the experience with Maria, spending time with a patient to understand the situation she was actually in one of the critical factors in analysing a medical situation.

Also I have developed a patient centric relationship between Maria rather than a task centric relationship. This relationship helped me in gaining the confidence of Maria and gave the best to treat her. Even in my later nursing experiences I have learned that most of the Nurse Patient communication is task centric relationship rather than patient centric relationship. On the contrary Maria and me developed a warm, genuine and empathic relationship as mentioned by Burnard (1990). Analysis I realised that for a patient like Maria adaptive communication skills are important.

The establishment of interpersonal communication – communication that exists between two individuals(Funnel, 2005), have played an important role in get to know the situation of Maria better. My attempt to communicate with Maria through non verbal and hand signals helped me in handling and understanding the situation more effectively. White (2005), recommends that a professional nurse should learn alternative languages and methods to communicate with the patient so that she / he could handle the situation better. Further analysing the incident, when a patient is alone away from his / her family they feel insecure.

In such situation it is difficult for a nurse or for a doctor to have the confidence of the patient. In the case of Maria also in the beginning she was a bit scared with the hospital environment and me, and I could like any other personal made her cooperate with me continue my work. However, instead I have tried to better understand her situation and build her trust in me. Hence I got an overview of the situation and full corporation from Maria and gained her trust. Furthermore, reflecting on the incident, I felt my approach of being patient centric rather than task centric helped me in giving better treatment to her.

Generally many of nurses working with me that time given more preference to task centric approach. I reckon the task centric approach will touch only the surface and many a times using this approach medical professionals only scratch the surface by the guess work and experience rather than getting the inputs from the patient and looking into the matter more deeply. In short, as a conclusion I could effectively give adequate medical attention to Maria by establishing a therapeutic relationship. I realised that patients are different and the ways to handle each of them differently in order to gain the trust and confidence of each other.

Also I learned that the practitioner should effectively communicate with the patient both ways such as patient centric communication and task centric communication (McCabe, 2004). In the case of Maria I can conclude that I effectively handled the situation by demonstration various skills such as my approach toward the patient, getting relavent answers, being an active listener, support the emtions of the patient and showing empathy towards the situation of the patient (Walsh, 2005). Action Plan The action plan I have prepared based on the case of Maria is mentioned below.

Improving my communication skills : I have learned that communication is the foundation of the relationship (Wood, 2006). So I have decided to improve my communication skills, both verbal and non verbal communication skills and also decided to learn some additional languages. Improve my listening skills: I realised that listening skills are also important as the communication skills. I am trying to improve my listening skills especially I am listening to patients with out making notions or judgements. Handling different kind of patients: This part I consider one of the most critical part I have to take care of.

Equip to handle any kind of patient even if they are visually challenged or mentally challenged. Maintain a diary: I also started writing a daily journal that mentions all the major events happed during my time with patients. By writing down the important events happened in my professional career I can always refer back the successes and failures I have made during my career and think how can I improve them next time. I am concluding that the unique learning experience and the reflection of the incident happened in Maria’s case proved very useful in my professional career.

I have learned a great deal from this one incident and it made me think out of the box to handle the situation. These kind of incidences and the subsequent reflection made me not only a better professional but also a better person. I reckon myself more organised and I started considering more various other possibilities before I making a choice. Also I started using established models to structure my experiences and include all aspects of it with out missing anything. In Maria’s case Gibbs model enabled me to drill down the various aspects of the incident and enhance the understanding of the situation better. Word Count : 1510

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