Posted at 10.13.2018
In this reflective profile I will relate to a substantial event, demonstrating how I've developed in my opinion and professionally, focusing on the implementation of care and attention and support. Rodgers (2002) implies from Dewey (1933) that reflection is the process of "reconstruction and reorganisation of experience which increases the meaning of experience". Therefore analysing an experience, to develop your present knowledge, by looking at your actions and assessing the knowledge to develop your own personal and professional skills in future practice. Hamill (1999) recommends writing representation in first person using Driscoll's style of representation (Driscoll 2000).
The situation I have chosen to think about is an interaction with an individual who was simply given a terminal medical diagnosis and had been educated the prognosis was limited. I've chosen to reflect on this account as it engaged difficult communication which made me question my competency as a student and prior to the event I thought I'd not anticipate to offer with it. (See Appendix)
As I had previously interacted with the patient on her admission, I have already communicated and developed a marriage with her. Groogan (1999) declares that communication creates a romance, with communication providing a holistic approach to caring for the individual to meet their mental health, social, spiritual and physical needs. I got therefore able to recognise that something was incorrect and determined that she needed somebody to talk to. Forrest (1989) recognized core elements of nursing as picking up on cues and the importance of "being there".
Jarrett and Payne (1995) researched books on nurse-patient communication and concluded that there's a dependence on nurses to make an evaluation of each individual situation, so that they know about whether the patient desires the info. Associated with the analysis I manufactured from the situation I got aware the individual wanted to talk and realised that she had not been requesting information but desired someone to talk to.
During the event I felt anxious and nervous about how to behave and talk to the patient when i had never experienced that situation before. Buckman (1998) recognized health care pros experience concern with the untaught and fear of saying "I have no idea", the knowledge of showing emotions was also discovered and throughout the situation I felt empathy towards her. Empathy is thought as the mental capacity to understand another person's sense without becoming a member of them, understanding patients experience. (Hojat et al 2001).
Sieh et al (1994) declares that special emphasis is located on tuning in and empathy skills in the training of nurses. However, in the problem I questioned my competencies within my communication skills when i thought I used to be unequipped in my training to supply the attention and support the patient required. On reflection, I identified which i worked in my role and constraints as a student to assess the problem and act as appropriate.
Reflecting on the situation I have determined that non-verbal communication played out a large part of the experience. Non-verbal communication includes the utilization of eye contact, flexibility of facial expressions, the utilization of gestures, use of touch, pausing to permit a reply timing and body posture (Purnell 2000). This description relates to the problem when i was sat at her bedside when she started to cry, and then she thought to me "I am dying aren't I?" She put her hand out and I just comforted her by positioning her palm.
The appearance and discussion of emotions of reduction and grief can be quite problematic for patients with incurable disease and their families (Clements- Cortes 2004) When she asked me the question "I am dying aren't I?" my first thoughts were to ask a Staff Nurse to come and talk with her, but I sensed as if she got chosen me to talk to and this I couldn't have strolled away to get someone. Although I didn't answer her question, I believed as though I got supporting her when you are with her and as I understood she grasped her prognosis and experienced that the question didn't need an answer.
On reflection, the function straight impacted on the individual, me and my role as a student and my mentor. I feel that the patient was able to express her feeling and emotions and I was able to provide care and support in my role. I discovered that I evaluated the situation and made decisions to provide the best possible health care and support for the individual at the time. The situation made me question my capacity nonetheless it developed my communication skills that happen to be transferable to all aspects of nursing.
To enable me to think about the situation I used books as part of the reflective process to read around conversing in palliative care, the nurse-patient romantic relationship to carrying on development and promote learning as Glaze (2001) studies the utilization of literature is utilized within reflection to promote learning by reading around this issue.
Following the event, I up to date my mentor what had occurred and she said she was aware of the situation and felt which i had dealt with it perfectly. We reflected on the event and I thought as though at the time somebody might have came to make certain the problem was fine but following a discussion my coach was alert to the situation and this she'd have intervened if required. Following the discourse I felt supported by my coach, although the function was emotional and sensitive I feel it was a positive learning experience.
Benner (1984) explains phases of practice from beginner to expert, at this stage in my training, I am working towards an advanced rookie, although I recognise this in this situation I had no connection with connecting in difficult situations and for that reason I felt such as a novice. For this reason I feel as though my mentor would have discovered my weakness in this area and at the time and acted quicker. The role of the mentor is to evaluate and support the pupil used (NMC 2008) at this juncture I experienced my mentor satisfied their role after the discussion following the event, however through the event I believed it was just me and the individual, and I acted within my role.
In conclusion, I have recognised the value of the nurse-patient marriage and feel the knowledge at that time and reflecting on the knowledge has had a positive impact on my personal and professional development. Knowing that within the role of a nurse, communication is not only about information provision but about adapting your own skill to assess situations and take action appropriately. With regards to implementation of care and support this experience highlights the nurse role to provide mental support to continue to talk effectively.