- Lorna Bennett
The Assertive Medical Student
In this representation paper, I'll relate my experience of an event that helped me to become more assertive, compassionate, and self-confident in my skills. I will be using the Gibbs style of reflection to write this newspaper. Gibbs model (1988) identifies the key techniques within reflection itself, rather than as representation as an activity within basic learning. The cyclical model, or more accurately an operating platform for reflective study, assumes recurring experiential contexts and it is put into six key areas. These areas are event explanation, sense, and thoughts; analysis, analysis; finish and action plan (Gibbs, 1988)
Event Description
In my second specialized medical placement, I used to be working in an over-all medicine device of Gray Nuns Hospital. I had been assigned to care for Karl (pseudonym). Karl was a wonderful 82-year-old male, admitted with AECOPD (Acute Exacerbations of Chronic Obstructive Pulmonary Disease). Karl's eldest child, Lisa (pseudonym) acquired devote her life to execute the tasks of the principal caregiver and can be an dynamic participant with health care and planning his daily needs. Both Karl and Lisa acquired no hesitation in welcoming me as students to participate in Karl's treatment.
During my head to toe diagnosis, Lisa was constantly commenting on what she feels was the "best way" to execute nursing responsibilities for Karl. That remaining me being bullied and distraught, as Lisa was always questioning my head to toe diagnosis and nursing care. She didn't let me perform my assessment and nursing treatment because she was always intervening by directing negative feedback about my skill and offered clues on how it should be performed instead. I tried out to explain to her my role and the importance of the head to toe analysis, but she placed telling me a specialist such as a Doctor or RN and not students Nurse in his second calendar year must do the diagnosis. This sense of inadequacy arose partly because of Lisa's strong assertion of being the patient's little princess and sole major treatment giver.
Feeling and Thoughts
Nurses are in charge of providing safe, competent, and ethical medical care and attention to patients, when issue arises between people and nurses; building trust through relational practice way becomes difficult in producing the nurse-patient romantic relationship. I found it difficult to provide attention as my values and values were tested, I felt as if I did not belong in that situation which nursing had not been the profession for me. Mitchell (2001) suggests that nurses need to look at their own moral development and the ideas that guide their practice. She further talks about that whenever nurses choose theories that improve their moral practice, "the self-assurance that originates from that choosing will help nurses have the courage to act in line with the realities that every person and family brings to the problem" (p. 113).
I advised my pal nurse about Lisa's assertive and demanding behavior. My pal nurse also talked to Lisa about my concerns and told her that I should be cared for with respect equally as everyone in medical team which I used to be of great help Karl. I also spoke to my teacher on what possessed transpired during my first meeting with the patient, and how Lisa made me feel as if I lack self-confidence in my level of skill. She suggested that people talk with Lisa about any of it together. My teacher spoken to Lisa quietly in Karl's room, and asked her why she was so uncomfortable with me doing the examination and providing look after her daddy. Lisa appeared quite annoyed, she said she seems a second year medical student should not conduct such an assessment, as we are not experienced to identify certain medical issues. My instructor reviewed the value of the head to toe evaluation with her, and told her I was proficient to perform the assessment, when i was informed in school to take action. I also strived to include a holistic method of the patient, in which the health care team, family, and the individual can benefit from the best nursing treatment possible. However, for once in my own nursing profession, I felt as though my practice had not been safe, skilled and welcomed.
Evaluations.
The incident was extremely challenging for me personally. I thought that I should have acted on my critical thinking skills previously. However, I am delighted that Lisa got partially agreed with me to perform the skills. This incident has educated me the value of behaving assertively rather than to be bullied into one's beliefs and values and concentrate more on the patient's concerns. After some consideration, I understood that I was doing from the stance of my nursing skills, while at the same time concentrating on not making mistakes; I strayed from my relational reference to Karl and Lisa. Though I tried out my better to make a rapport with Lisa, I find it challenging to pursue as she was focused on her values and values as opposed to the good care myself and medical team are providing.
She commented adversely on every part of nursing care performed without any help. I realize that her negativity stems from her insufficient knowledge of medical conditions, AECOPD, and the rationale on why care and attention has been provided. Valentine (1995) claims, "This disappointment and vulnerability can be especially severe when bullying is included, and the patients of bullying need high degrees of assertiveness so they can withstand the associated stress. Hence, generally nurses use conciliation and escape as methods of dealing with bullying and issues (p. 145).
Analysis
During that week of practicum, I felt that we became more confident in my evaluation. However, after i was confronted during my first head to analysis with Lisa, I was unable to give a clear rationale on why I had been performing my analysis the way it was, despite being skilled in my skills. This affected my self-assurance because I had been centered on doing my analysis appropriately and lacked assertiveness when it mattered. Lisa was constantly critical of my head to toe assessment. I had sought out both my pal nurse and teacher to verify that my level of skill was appropriate. I came to the realization that insufficient confidence had not been skill related, but my inability to converse the evidence-based reason to perform my assesment skill under regular pressure from Lisa. That positioned me into a posture where I looked like I was incompetent to perform my head to toes and other medical care.
Conclusion
During, this ordeal, I was able to reflect on my practice, identify my weakness in self-assurance, and become proactive to search out the help of my friend nurse and trainer in allowing me to develop my level of skill as a student. I got also in a position to become more assertive when confronting Lisa. Assertiveness is a way, which may be used to work against bullying, improve nerve-racking situations, and enhance empowerment (Fulton, 1997). Through the collaborative effort with my pal nurse and teacher, I could clarify that my assertiveness, not my examination level of skill or knowledge bottom was not the reason why rather my inability to effectively communicate when put under great pressure, which in turn led to too little confidence in my own skill and knowledge.
Action Plan
I notice that assertiveness can be an important aspect of nursing practice and has an enormous impact on ensuring the well-being of the patient is maintained. It really is evident that my insufficient confidence in my own capacity when pressured by Lisa contributed to my emotions of being bullied and incompetentence. I've learned to be more assertive after that incident by putting into action critical thinking and effective communication. That experience has made me more assertive when interacting with staff, patients, and individuals in this current rotation in Nurs 277.
References
Fulton, Y. , 1997. Nurses' views on empowerment: a crucial social theory perspective. Journal of Advanced Nursing 26 (3), 529-536.
Gibbs, G. (1988) Learning by doing: Helpful information to educating and learning methods. Oxford Further Education Device, Oxford.
Mitchell, G. J. (2001). Attempting in change: From the original method of Parse's theory- based practice. Nursing Knowledge Quarterly, 3 (4), 110-116.
Valentine, P. E. , 1995. Management of conflict: do nurses/women take care of it in a different way? Journal of Advanced Medical 22 (1), 142-149.
