Care Delivery

Throughout personal professional development reflection is essential, allowing health care professionals to self-develop by revisiting events and analysing areas in which improvements and learning would ensure a positive impact on their future practice. The Nursing and Midwifery Council, (NMC, 2010) notes that all health care practitioners must be self-aware in their own values and principles which could affect their practice. Ensuring they maintain personal and professional development while learning through supervision, feedback and reflection.

Reflecting on the situation that had taken place during my second placement working in the community. This will give me the perfect opportunity to develop and utilise my commutation skills in order to maintain the relationships with my patient. In this reflection, I am going to use Gibbs (1988) Reflective Cycle. This model is a recognised framework for my reflection. Gibbs (1988). Baird and Winter (2005,) give some reasons why reflection is require in the reflective practice. They state that a reflect is to generate the practice knowledge, assist an ability to adapt new situations, develop self-esteem and satisfaction as well as to value, develop and professionalizing practice. However, Siviter (2004)

Burns, S. Bulman, C. Palmer, A. (1997) Reflective Practice in Nursing - The growth of the professional practitioner. London: Blackwell Science.

Reflective practice in nursing is the process where we examine our nursing ability’s and practice in order to critically think and analyze the way we work and think about the views of others in our practice, what we could have done and we could have achieved a greater result by doing this also allows us as nurses to include best practice and use our own judgment in patient care to show the factors that either aid and hinder nurse to patient relationship. (Lowenstein, Bradshaw and Fuszard, 2001) described reflecting in nursing practice “the nurse must first come to understand what he or she defines as ideal practice”.

During my clinical placement, I have done the nursing standard 2 which is engaging in therapeutic and professional relationships. An example of one event in my placement where I have done this standard is when doing interviews in my two-week community placement at the Community Rehabilitation in Armadale Hospital. For my reflection, I will be using the Gibbs’ Reflective Cycle (1988).

In this assignment I am going to reflect on a clinical situation that has taken place during my placement. I will be using the Gibbs’ reflective cycle which will include the skills of assessment, planning, implementation and evaluation of care and link it to the registered nurse standards for practice – standard 4 , comprehensively conducts and assessments (nursing and Midwifery Board of Australia [NMBA], 2016). The Gibbs’ reflective cycle consists of 6 stages which starts with a description of the situation and what I observed, the second stage is to describe what were my feelings and thoughts were at the time, third stage is an evaluation to explain what worked well and what was good, fourth is an analysis to link the incident to what we have been learning , fifth stage is the conclusion to talk about what else could have been done and the final stage is an action plan to set out next steps for if it was to happen again (Gibbs' Reflective Cycle, 2014).

The Gibbs reflective cycle (Bulamn & Shutz,2008), is a framework for reflective practice entailing six stages. Stage one is the description of the event that occurred, inclusive of where the nurse was; who else was present; the reason why the nurse or persons were present; what the nurse was doing in relation to the context of the event; what was their part, what parts did others present play and finally, what was the outcome of the event. In the second stage,

The assignment is a reflective account of how I overcame communication barriers to achieve a high standard of care, using the Gibbs reflection cycle, learning by doing. Gibbs, 1989. I will try to explain what happened, my feelings of what was good and how I can try to improve the experience both for me and the patient.

Preparing new specialists, therapeutic orderlies, and other social insurance specialists take years, and on occasion decades. Without more graduated class from nursing and restorative schools and extended improvement in shared parts and commitments among masters, chaperons, and other helpful specialists, individuals and families will go up against longer hold up times, more unmistakable inconvenience getting to providers, shortened time with providers, extended costs, and new disillusionments with mind transport (Anderson, 2014).

There are so many trends inside and outside of health care that initiated the innovative care delivery models. Rapidly increasing health care costs and insurance premiums resulted in expanding uninsured and underinsured population, resulting in increased emergency departments and greater use of community clinics. A persistent nurse shortage made the problem worse. These factors, and other changes in health care such as the rise of health care consumers led to the development of new care delivery models. One new model is the role of nurses and other non-physician health professionals. "In 2008, The white paper sponsored by the Robert wood Johnson Foundation identified the following common characteristics among a variety of new care delivery

Healthcare is forward moving, and remains in a constant state of change. There are multiple opportunities to improve the quality of delivery of care given. These opportunities shape and develop the visions and goals that healthcare organizations intend to achieve long and short term. Healthcare organizations of all sizes are responsible for establishing innovative practices that address patient’s needs within the community, and their service areas. Becoming a choice provider requires developing patient relationships that produce desirable outcomes.

The introduction of the Gibbs reflective cycle helped the nurses to have a systematic thinking about the different activity phases (Huston, 2014). These logical elements of the procedure are describing the problem, feelings identification, evaluation, analysis, conclusion, and an action plan. Every stage is essential in carrying out the reflective processes for nurses.

Reflection is a tool used by many healthcare professionals. It is a method of critically analysing ones practice with the aim to see where changes or improvements can be made (Johns, 2004). Both the Nursing and Midwifery Council (NMC) and the Royal College of Midwives (RCM) recognise reflection as a way of developing practice. Demonstrating an ability to learn from practice is seen as part of Continual Professional Development (CPD).

This is a reflective essay based on my experience whilst on my external placement in one of the local community hospital. I have chosen this incident specially as I used my communication skills and interpersonal skills when caring for a patient who is suffering from advanced dementia. I will be using Gibbs (1988) reflective model to structure my essay by allowing me to look at the incident from a number of perspectives. Reflection is concerned with consciously looking at, thinking about the experience, actions, feelings and responses and then interpreting or analysing them in order to learn from them (Atkins and Murphy, 1994). Reflection helps me to think about, plan and deliver high quality and safe care to my patients as a nursing associate (RCN website).

Self-assessment is a principal of learning; it enhances a student’s achievement, awareness, and reflection on the learning process. It is a student’s reflection on his or her progress to determine if they are meeting the concepts and criteria of the course (Al-Kadri, et al. 2012). The purpose of this paper is to reflect on past clinical experiences and evaluations to identify three areas of personal strengths to maintain and weaknesses to address, along with three clinical skills to obtain prior completing the program. Additionally, the history and role of nurse practitioners will be discussed, along with personal contributions to the profession of advanced practice nursing.