Reflective Account

8 August 2016

This is assessment is a reflective account using Gibb’s (1998) reflective cycle. It provides me with the structure to follow when reflecting (Brooker, 2013). The cycle has 6 steps which include; Description, feelings, evaluation, analysis, conclusion and action plan. In order to comply with the NMC Code of Confidentiality (NMC, 2013) and Data Protection Act 1998, I will call the service user Mrs M in order to maintain confidentiality. Description On Thursday in my placement I was asked to assist Mrs M with her lunch. Mrs M is 90 years old and has dementia.

She has barriers to her communication due to her dementia and physically she can’t walk without support. The two care workers, Mrs X and Mrs Z were to escort Mrs M through to the dining area using a wheelchair. The both put an arm through her armpits and put her on the wheelchair before wheeling her away. Mrs M was then taken out of the wheelchair in the same way and put onto a seat at the table and pushed in, to be close to the table. I then took over from the care workers. I told Mrs M that I was going to put a protector around her neck, in order for her to have her lunch.

Reflective Account Essay Example

Mrs M’s table is called the ‘assisted table’. I assisted her with her starter, which was soup. Staff then gave me her main meal, which I encouraged Mrs M to participate on eating on her own. Mrs M seemed to enjoy her lunch and ate it all. Mrs X and Mrs Z then escorted Mrs M back to the lounge. Feelings I will now discuss my thought and feelings throughout this account. I observed that the care workers did not communicate with Mrs M when elevating her to and from the chair. I thought that she seemed fretful (unhappy, nervous).

I was feeling a bit angry that Mrs M was not communicated with, I thought that surely they can explain what they are about to do and why. When given the soup, I wondered how hot it was, as steam was rising from it and I have to admit I was tempted to stick a finger in it to test before I fed Mrs M. I knew that due to infection control and respect for Mrs M I would not be able to do this. I was scared already, of burning her mouth and I hadn’t even started to assist with feeding. I thought that I should wait a few moments, and give the soup a chance to cool.

I spoke to Mrs M about her soup and asked if she liked soup etc. She responded by “yes” and enjoyed her soup. When saying “that’s good” I felt that she was enjoying her meal. When Mrs M main meal arrived I thought it was be good for Mrs M to try and participate in her own feeding. I felt that there would be no harm done if there was spillage, as she had a protector on which would protect from burns. Observing Mrs M feed herself enabled me to see that although her hand eye co-ordination was not great, she was able to finish her meal on her own.

I was given a beaker of milk to give, I asked her if she would like a drink and she said “oh yes”. I put the beaker into her hand but she could not get it to her mouth without my assistance. I felt that through spending one on one interaction with Mrs M I was able to get to know her better. Evaluation I shall discuss what went well and what didn’t go well. I feel that the Mrs X and Mrs Z did not have effective communication with Mrs M. Mrs M was clearly showing signs of unhappiness when being elevated.

It could have been carried out much more effectively through communication, a positive attitude and care. During my time with Mrs M, I felt that she was happy and comfortable. However, it felt difficult to feed her the soup as the spoon seemed too big for her mouth. Encouraging Mrs M to participate in her own feeding enabled her to be independent and help promote hand eye co-ordination which she seemed to be lacking at the start of her meal. Spending time with Mrs M has helped me to understand her and her capabilities better, which in turn will enable us to work towards a therapeutic relationship.

Analysis I feel that my communication skills were effective in the end. During our time I observed that she was unable to communicate with an open question. I then used closed questions which Mrs M replied to, for example; “Mrs M, are you enjoying your soup”. Mrs M was able to filter this question and respond with “yes, and very nice”. I communicated non-verbally also with Mrs M, through smiling, holding up beaker for her to see. I showed a positive attitude towards Mrs M. I’m a positive person, and enjoyed the opportunity to assist with eating. Conclusion

“A Therapeutic relationship relies on specific components being in place, including rapport, empathy, trust, geniuses, warmth and positive regard” (Brooker, 2013) Having compassion, empathy, caring and spending time with the user will promote a therapeutic relationship with a service user. Trust is also a component of a therapeutic relationship. According the NMC code (NMC, 2013), people in our care must be able to trust us with their health and wellbeing. Care workers are required to be effective communicator’s with a diverse range of service users.

It is vital to have effective communication in order for the message we are giving to be understood. However, there are many barriers within health care setting to effective communication, such as; conflict (not sharing common ground), internal noise (mental/emotional distress), difficulty with speech and hearing, medication and different language etc… (Brooker, 2013) There are many forms of communication which we use on a daily basis, for example; verbal and non-verbal communication.

Verbal communication is spoken words, non-verbal is when no spoken words are used, such as; gesture, touch, smile, eye contact, stance, body language, facial expression, writing and signs. Models of communication such as the “blueprint of behaviour, which is a tool to help health care workers understand how people comprehend the world around them, how this influences the person’s communication and therefore how others responds” (Brooker, 2013) It states that we are all individual and unique in how the world affects us and our understanding.

Mrs M has a barrier to her communication due to her dementia. Therefore it is essential that efforts are made to enhance communication in order for her to filter the information she is receiving, in turn enabling her to respond. This knowledge is useful for myself and other health care staff. “People make errors when communicating. Practitioners who do not communicate effectively with the individual may cause anxiety, or fear which can in turn negatively affect patient’s health” (Brooker, 2013).

This seemed to be the case in Mrs M’s experience when being elevated to her wheelchair, without communication. This brings me to ‘person-centred care’. In order for a person-centred approach to be carried out successfully, relationships between health care workers and service users must be established. Person-centeredness involves; the person being the heart of care, communication will be open and honest, and presented in a way that’s understood, staff presenting a positive attitude, respecting individual rights, values and beliefs.

Action Plan If I have the opportunity to assist Mrs M again, I will hopefully be able to escort her (with another care worker) to the dining area myself. Communicating effectively to avoid any anxiety that Mrs M encountered on Thursday. I will also encourage Mrs M to participate in eating all of her lunch, with my assistance if required. If I was to feed Mrs M with soup again, I would prefer to use a smaller spoon or maybe even a dessert spoon. The Soup spoon was too big for her mouth.

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