Clinical Practice 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)

Reflection is a process of exploring and examining ourselves, our perspectives, attributes, experiences and actions / interactions. It helps us gain insight and see how to move forward (Nursing Times 2018). I believe reflection is particularly important when it comes to Nursing, as medicine is constantly changing/ improving and us ourselves medical professionals must adapt with the changes in medicine. I find that reflection is extremely useful in doing this as we can look over procedures or experiences that we have had, how that made us feel, whether we would change anything, then in the future we can see the changes that may have been made, whether this has changed our feelings and opinions on medical practice.

Reflection is described as a way of reviewing experiences from practice so that it can be described and analysed and used to change future practice (Bulman and Schutz, 2004).

My course of study at the University of Mary is the Master of Science in Nursing, Nurse Educator track. My level of experience in education is limited to the time I have spent educating patients within the various positions I have held since becoming a nurse. Pre- and post-op instructions, educating patients during their labor and delivery experience, as well as educating patients on medications, treatments and options in their care include some of the ways I've interacted with patients in providing education. I do not have any experience in the development or implementation of research of evidence-based projects (EBP) studies.

Being able to communicate both verbally and non-verbally is a key factor in creating a therapeutic relationship with the client. Throughout the nurse-client interaction the nurse showed verbal and non-verbal behaviors that did not follow the guideline that The College of Nurses of Ontario (2006) has laid out for nurses to follow. A few of the guide lines are; trust, empathy, and power. From the moment the nurse entered the room she did not look at the client at all and never introduced herself or told him why she was there. The client had to ask “No doctor?” (Video, 2008) for her to finally say anything. By her not introducing herself she has already diminished the first impression that the client has of her and has lost his trust. Introducing themselves to the client by name and category is one the most effective communication

Communication is an activity that most people partake in on a daily basis. Learning to communicate in a therapeutic setting can be a challenge to any new nursing student. With verbal and nonverbal communication being seen as valuable and needed in psychiatric nursing. Learning to master such skills is an important step in guiding patient care. This writer believes that with discovering one’s own beliefs, setting up for a successful one to one relationship, and learning effective forms of verbal and non-verbal communication, psychiatric nurses can provide patients with the therapeutic opportunity that is needed for truly understanding patient needs. This writer will review and discuss relevant evidenced based research to support this claim.

In the last four weeks, I have been attending Oak Hill Hospital as my second clinical rotation. During this period, I noticed distinguished qualities in myself. Some skills I have strengthened over time are informing the patient what I am doing before, during, and after the exam, how to position using verbal commands, and giving the patient time and attention while in my care. These attributes may seem subtle, but they have improved my attitude in the working field and gave off a positive atmosphere around patients and co-workers alike. On the other hand, I have automatically sought out to improve on several obstacles I came to face at Oak Hill Hospital. One of the weaknesses is confidently operating the portable x-ray machines, especially knowing the correct tube angulation for the portable or wheelchair chest exams. Another struggle I faced at the beginning of this clinical rotation is transporting patients by stretcher and occasionally wheelchair. The body mechanics I have used are poor with transporting the patient, which risks the quality of the patient’s care (Bontrager, 2014). Lastly, marker placement for fluoroscopic overheads and timed studies have been an extreme struggle to battle against. With countless action plans from my clinical coordinator and instructor, I have found several action plans to change my weaknesses into additional strengths.

In this video, Professor David Austin introduces the concept of "therapeutic communication" which refers to the process in which the therapist consciously helps the client to a better understanding through verbal or nonverbal communication. Therapeutic communication should be purposeful and goal directed to meet patient’s needs. Austin elaborated on how important it is to have effective therapeutic communication skills. Throughout this video, I have learned that therapeutic communication the key to developing a helping relationship. The lack of effective communication is one of the major problems faced in healthcare (Therapeutic Communication, 2015).

Today, Jessica, Laura, and I met with Holly to discuss concerns about clinical projects and hours. This meeting went well; we will be working on our projects, in clinical only. I also observed Holly teach 3- first grade classrooms, and 1- 2nd grade class room about nutrition. This was a great experience, and I learned a lot of great techniques for teaching. I was also able to interact with the kids, and they were a lot of fun. As well as, I had an hour- where I worked on my PSE project, and developed a plan for organizing a health fair that would occur sometime in March- I am very excited about this. Jessica and I also met with Katie- the foster teen program coordinator, that is overseeing our nutrition classes that we will be teaching 02/14

Kolb (1984), describes learning as an activity as a relatively change in behavior due to experience whereby knowledge is gain through the conversion of experiences. Learning thorough reflection is an essential tool in practice based on personal professional learning setting where learning took place from the individual own professional experiences, (Bolton, 2010). Therefore this reflection essay aims to critically evaluate my clinical practice learning experiences and my current higher education learning process and how effectively lifelong learning was managed towards my own personal professional development. After completing my high school, I choose nursing as professions in my career pathway because I prefer to be involving myself in developing

My earliest patient contact was in Confucius-Mannings Pharmacy and Surgical supplies. From this experience, I was able to learn how to provide better care through maximizing my resources. We were frequently overrun with patients and tensions can get high especially with the small size of the store. Maintaining good communication among patients and co-workers, frequent checkups on waiting patients allowed us to provide care to a large number of patients everyday.

Therapeutic communication is the first communication tool Hawthorn discusses. Hawthorn explains that therapeutic communication allows care providers to get a better understanding of how patients convey thoughts, emotions, ideas and anxieties. By doing this provider must be able to as-sess a patient’s perception, obtain a patient’s invitation, and respond to a patient by expressing empa-thy. Hawthorn believes that this process should be done verbally and non-verbally, allowing patients to better understand themselves and their situation. Therapeutic communication skills for health pro-fessionals are important because it allows patients the opportunities to communicate openly and al-lows them to feel less anxiety and more hopeful during their time of needs.

This weeks clinical was more of learning about specific medical procedures and observing the inter-professional collaboration in the healthcare environment, rather than rendering hands-on patient care. Disappointing. The feedback from the previous group of nursing students who observed the week prior were somewhat dismal. Thus, this was one of those clinical rotation I was not really excited about. I was assigned to observe the cardiac catheterization laboratory, where they conduct various diagnostics and interventional cardiac procedures. The extent of my previous knowledge about the cardiac catheterization procedure was limited to those learned from the book, thus, my would be experience was somewhat influenced by and overshadowed by negative experiences by those assigned there before me. However, my experience was completely different from theirs, it was fascinating. I was utterly surprised to find out how facile what I thought was going to be a complicated procedure, yet it was. This was, of course, mainly because of the efficiency and cohesiveness of the inter-professional team; knowing and performing their role, to achieve

Communication is such a crucial concept when it comes to providing the best care for clients in need. In order to have a good conversation with a client there are special techniques to use. The client may be stressed or uncomfortable while carrying the conversation so it is important to use therapeutic techniques to ensure comfort and relaxation for the client. Therapeutic communication involve verbal and nonverbal skills in order to have a successful discussion with the client as a healthcare worker.

Each clinical day, I am constantly thinking about what is evidence based; what have I learned for lecture. To be honest, I never thought I would be thinking so much about evidence based practice, but I feel it’s essential that each and every single one of my patients gets the best possible care that they deserve. Some ways that I’ve incorporated EVP into my clinical is having discussions with employees about the correct needle length size, observing employees do certain procedure and reflect back, as well as, if I see something that doesn’t seem right, I’ll ask the nurse a question. For example, the nurse and I were doing a postpartum assessment and I noticed when the nurse was assessing the patient’s lochia, that she didn’t have the patient turn to see if any blood was pooled under her.