Nursing Reflection

Throughout my time on the Mother Baby Care Unit, I have faced many instances in which I have been able to reflect on both my patients and the care that I was providing them. One situation in particular that I found myself critically reflecting upon involved a new mother who was feeling slightly stressed about being discharged as her newborn son would not be going home with her. For confidentiality reasons, this patient will be given the pseudonym of Kayla for the remainder of this reflection.

In October 2005 the Quality and Safety Education for Nursing program was established. This program is funded by the Robert Wood Johnson Foundation. QSEN was developed specifically for future nurses to understand and be aware of key challenges such as the knowledge, skills, and attitudes that are essential to constantly advance the quality and safety of the way healthcare systems work. The goal for QSEN is to reshape the identity of nursing so it includes the recommendations by the Institute of Medicine so there is a commitment to the quality and safety proficiency (Dycus, 2009).

Quality and Safety Education in Nursing (QSEN) was started around 2005 by the Robert Wood Johnson Foundation. QSEN's main goal is to “prepare future nurses with knowledge, skills and attitudes (or KSAs) necessary to continuously improve the quality and safety of the healthcare system,” (QSEN, 2017). “Integration of clinical skills with the intellectual capacity to safely manage the complexity of nursing work in key to quality care in a time of diminishing resources,” ( Dolansky, 2013). “It is vital for schools of nursing to meet the needs of today's complex health care systems by including principles of quality and safety throughout the curriculum,” (Lewis, 2016). Within the KSAs are six main categories; patient-centered care, teamwork

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.

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.

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

In the article “What Do Nurses Really Do?”, Suzanne Gordon explores what nurses truly do. She concludes that nurses “save lives, prevent complications, prevent suffering, and save money” (Gordon 2006). Nurses provide care for their patients in the physical and emotional sense. Emotionally caring for a patient and being sensitive to his or her needs result from interacting with patients while performing the skills and using the knowledge that nurses learned in school. Nurses grow in their skills, knowledge, and attitudes through practice. Quality and safety education for nursing incorporates competencies that all nurses must use in their practice. These nursing competencies include evidence-based nursing practice, quality improvement, safety, teamwork and collaboration, patient-centered care, and informatics.

The overall goal through all phases of The Quality and Safety Education for Nurses (QSEN) is to address the challenge of preparing future nurses with the knowledge, skills and attitudes necessary to continuously improve the quality and safety of the healthcare systems in which they work. In order to accomplish this goal, six competencies were defined. These competencies from the Institute of Medicine (IOM) are patient centered care, teamwork and collaboration, evidence-based practice, quality improvement, informatics and safety. Over a decade has passed since the Institute of Medicine’s reports on the need to improve the American healthcare system. The Quality and Safety Education for Nurses

Over time the health care industry has become more complex. Health care is rapidly evolving and continuing to complicate our delivery of care, which in turn has the same effect on quality of care. This steady evolution and change results in nursing shortages and an increase in the prevalence of errors being made. In hopes of preventing these errors and creating safe and high quality patient care, with the focus on new and improved ways of thinking, The Quality and Safety Education for Nurses (QSEN) initiative was developed. The QSEN focuses on the following competencies: patient-centered care, quality improvement, safety, and teamwork and collaboration. Their initiatives work to prepare and develop the knowledge, skills, and attitudes that are necessary to make improvements in the quality and safety of health care systems (Qsen.org, 2014).

The following essay is a reflective account on an event that I, a student nurse encountered whilst on my second clinical placement in my first year of study. The event took place in a Fountain Nursing Home in Granite City. I have chosen to give thought to the event described in this essay as I feel that it highlights the need for nurses to have effective communication skills especially when treating patients that are suffering with a mental illness. Upon arriving to the Nursing home for the second time on Thursday November 14,2013; assigned the same patient as before. On meeting my patient the first thing I noticed myself doing without even thinking about it was giving her a visual inspection. Before nursing school I never really looked at

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.

The five core competencies identified by IOM and the sixth added by QSEN, safety, are believed to be necessary to improve both quality and safety of the healthcare system within which nurses work (Multimethod teaching). The six core competencies outlined are patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, informatics, and safety (Diffusing Qsen). While all competencies are significant to the healthcare system, patient centered care is vital to positive patient outcomes and focuses on the patient’s perspective within the healthcare system.

Errors pervade in our lives whether it is our home, in our workplace, or in our society. The effects of healthcare errors have impacted all our lives either directly or indirectly. Patient safety and quality care are at the core of healthcare system which strongly depends upon nurses. “To achieve goals in patient safety and quality, thereby improve healthcare, nurses must assume the leadership role. Nurses need to ensure that they and other healthcare providers center healthcare on patients and their families. Even though the quality and safety of healthcare is heavily influenced by the complex nature

As higher standards expected are from the public and higher patient safety demands are expected from health boards, therefore, there is a need for a way of measuring standards of practice which can be achieved through active thinking in a clinical environment brought about by critical reflection (Rolfe, Jasper & Freshwater 2011). Reflection has become such a key component in the role of a nurse that the Nursing and Midwifery Council (NMC) have seen it fit to include it in their professional code of conduct the Code: Professional Standards of Practice and Behaviour for Nurses and Midwives, hereafter referred to as the Code (Nursing & Midwifery Council [NMC], 2015). With reflection being a vital skill for nurses to continue their professional development (Parrish & Crookes, 2013), an analysis of what it means to reflect within nursing is needed by all who intend to enter the profession to ensure its effective use is applied.

Learning goals I have set for myself during the course of this class are to gain an understanding and foundation of nursing theories, gain and understand the impacts of nursing practice as it relates the theories, and how to apply nursing theories to practices as appropriate and necessary. These goals were chosen because they will help set a foundation in nursing theories. Looking at the different topics to be discussed the two most interesting are (1) Theory of Cultural Care Diversity and Universality and (2) Nightingale’s Environmental Model (George, 2011). The two topics that are the least interesting are (1) Child Health Assessment Interaction Model and (2) Maternal Role Attainment/Becoming a Mother (George, 2011).