Clinical Nurse Meeting Reflection

This essay will demonstrate my reflective abilities within an episode of care in which I have been involved with during my practice placement. It will discuss several issues binding nursing practice with issues of ethics and the model of reflection which provided me with a good structure and which I found most appropriate, is Gibbs model (Gibbs 1988). This particular model incorporates - description, feelings, evaluation, analysis, conclusion and the action plan.

In this essay, I will reflect on taking a patient; whom I shall call Bethany; to and from the theatre. This experience has helped me to understand the importance of parent’s participation in their child’s care. I have also gained a better insight into the type of nurse I will pursue to be. To help structure this essay I am using the framework described by Gibbs (1988). Using this framework, I have provided a strong reflection on the experience and focused on a more child-centred approach.

The objective of this reflection is to explore and reflect upon a situation from a clinical placement on an orthopedic unit. The incident showed that I did not provide safe, timely and competent care for my patient when the oxygen saturation was low. Furthermore, this reflection will include a description of the incident, and I will conclude with explaining what I have learned from the experience and how it will change my future actions.

I watched all the videos and chose to comment on video # 1 nurse-patient interview (leaton25). When Linda Davis (the nurse) started the interview she appeared professional, she was dressed well, introduced herself, made eye contact with Mrs. Eaton (the patient), shook Mrs. Eaton’s hand, and explained what she was there to do. Linda provided information and showed a knowledge of professionalism and effective communication techniques; however, Linda was not therapeutic, nor did she act in a professional manner for the remainder of the interview. Linda did not maintain eye contact with Mrs. Eaton, she was rushed with her closed-ended questioning method, looked at her watch, purposely ignored Mrs. Eaton’s complaints of pain, did not acknowledge Mrs. Eaton’s social issues, and she offered false reassurance for Mrs. Eaton’s verbalization that

The final stage in the Gibbs cycle is what I have learned from this incident and the action plans (Gibbs, 1988). From this group work, I have identified my skills and I know that, how it helped me to take part in the team work. For this Belbibns theory (1988) helped me identify my strength and recognize my role in the team. I am aware that in order to improve the collaborative working as a nurse; I need to improve my knowledge and skills about patient care. I have read through few books regarding team work for this assignment and it helped to improve my knowledge in collaborative practices. I am also understands that the collaborative practices are very important in health care to ensure a safe, high quality and evidence based nursing care

This essay will discuss a clinical skill in which I have become competent in practicing as a student nurse.

Skin integrity is an important concept that’s nurses assess on their patients. A key skill in nursing practice is to frequently assess the skin for possible breakdown or decreased skin integrity. Skin assessments should be conducted thoroughly once a shift and frequently reassessed for any signs of change. Skin discrepancies may be the first sign of an underlying issue. Early detection of any breakdown can help to implement interventions sooner. Unfortunately, unless there is a major skin discrepancy, skin issues can easily get overlooked, specifically in documentation and report. The focus of this paper is to research new skin integrity assessments to improve documentation effect and accuracy, resulting in decreased prevalence of skin breakdown in hospitalized patients. Topics discussed include reviewing current practices and new skin assessment techniques that decrease the prevalence of skin breakdown and pressure ulcers.

I met with my nurse manager, Stephanie Jones on Thursday November 10, 2011 at 1:00 pm. Stephanie is the nurse manager for cardiology services at the hospital that I am employed. She attends many meetings and is on multiple committees and is quite involved with the facility. The three activities that I will be shadowing her on are the Staffing Committee for which she is the chair, on Monday November 14, 2011 at 1:00 pm, Readmissions meeting (regarding reducing CHF readmissions), on Wednesday November 16, 2011 at 2:00 pm, and CV Case Conference (where cardiology care is discussed with other members of administration and physicians), Thursday November 17th at 7:30 am. My roles as an observer will be to just observe. There are multiple people involved with these committees and I will probably not have much input to add. It is possible that I will be included

Compassion: Doanne & Varcoe refers to Compassion not only means sharing in the moment, but additionally, “offers a way of being and orienting relationally in the midst of discomfort and angst/ to join and be in our ‘common suffering’” Through engaging to what seemed to be a flurry of discourse and to being present I was able to demonstrate this compassion as evidenced by active involvement, or listening. Adding along with the nuances of small expression revealed through my relaxed posture and face of concern.

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.

At our staff meeting held yesterday, I was granted permission by my Unit Manager to record the meeting. All nursing staff and other disciplinary were present at the meeting. The Manager facilitated the meeting with the help of the Nurse Practitioner. Discussion was based around staffing, job security and patient workload. There were spirited exchanges between the manager, two other nurses and myself. The meeting was scheduled for 45 minutes but it lasted for an hour with some question not being fully address.

In this reflection, I am going to use Gibb's reflective cycle (Gibbs, 1988). On the first day of our placement, the nurse and I went to try gaining consent from a resident to become my patient/resident for my portfolio and nursing care plan. The nurse and I managed to gain consent from Mrs. A to become my patient/resident for my portfolio. With the help of the nurse, I explained to the resident about the portfolio and that I am going through her medical notes and details for me to complete my nursing care plan and to gather her objective data. After our conversation with the resident about the portfolio, the nurse asked me to spend time and talk to Mrs. A to gain her trust so that she will cooperate with me. When the nurse left us, I notice that Mrs. A is nervous of me being there, so I tried to comfort her by spending one hour talking to Mrs. A about her past experiences as a nurse aid. She also mentioned that sometimes she is getting depress because of her regrets in the past, I listened to her stories and regrets carefully and attentively for me to get some details on how to comfort her.

The simulation exercise presented a complex situation when Charge Nurse Janice didn’t have enough nurses in her unit and the VP of Support Services called and her about the scheduled meeting. At the start of the shift, she responded unprofessionally to the situation by giving directions to the staff while on a personal call and reacting negatively to any patient update provided by the staff. Janice also created a bad impression to Elise, the new nurse, when she asked about her assignment. Janice addressed the patients’ names with the procedures they had. Knowing that there was a situational problem, Janice should have communicated properly and emphasized to the staff about teamwork to facilitate the workflow in the unit. Elise is new and inexperienced, but Janice could have utilized her help with basic tasks as long as she had been directed and coached properly.

Prior to this discussion with Ms. Forks two nurses had been discussing how busy the ward is and how they needed extra beds.

On Monday April 3 2017, I spoke with Claudia via text messaging about splitting her a Monday shift with Dana as she did jot have the hours she was promised full time. Claudia stated she would let her work the last part of the shift. I explained to her that Dana had testing for certification the next day and could work the first half. She declined letting her work that shift. Stated she could work her Sunday. I declined as Dana was all ready working that Sunday. This seemed to upset Claudia and she stated umm no she doesn't. She never did let me explain to her that Dana works weekends in Atlanta which she would not see on the sch. This evidently brought up a very sore subject for her as she was upset that she works two weekends a month while