For the goal of this essay, I am going to use Gibbs (1988) Reflective Learning Pattern to think about an aspect of individual professional practice, which requires development in planning for my role as a Registered Nurse. Gibbs (1988) Reflective Learning Routine encourages an obvious description of a predicament, analysis of thoughts, evaluation of the knowledge and examination to make sense of the experience to examine what you will do if the problem arose again.
To keep within the Nursing and Midwifery Council (NMC) Code of Professional Do guidelines (2008a) and also to maintain confidentiality the use of names or places will not be used throughout this essay.
Description
Whilst on positioning working on a general ward during my third year I was asked to research a drug I got uncertain about by my coach. On my way to analyze the drug I was approached by way of a health care assistant who asked me if I could assist her with an individual who was laying in a soiled foundation. I chose to help medical care assistant when i thought this was priority as I could research the medicine at any point in your day as it was for my own learning and development and wasn't immediate. After I had helped the health care helper, my coach asked if I had investigated the drug. I explained i had opted to help medical care helper and would now research the drug, which I then do. My coach then told me that I needed to improve on my time management, as I had not looked up the drug when she asked me to. She carried on explaining that when I turn into a Registered Nurse I'd need to know drugs and what they are used for. This example left me questioning that was the top priority, the patient's needs or my very own professional learning and development.
Feelings
I automatically helped the health health care assistant in making the individual comfortable when i felt that was the goal over researching the medication. I remember thinking that I could do this at home if the ward became active. I felt irritated with myself for not speaking up to my mentor about the issue as I got thought I put made the right decision to help the patient. I was worried about the patients comfort and believed I could not justify giving the patient lying in a soiled foundation because I had fashioned to analyze a medicine. Nurses need to be able to justify the decisions they make (NMC 2008a).
After the incident, being advised by my mentor that I had a need to improve on my time management skills because I chose to assist medical care assistant baffled me just a little. This practice experience made me feel as if I had a need to learn and develop more regarding my time management skills. I determined I'd have to research into the so this means of 'time management' as I thought that my time management skills were fine. I had been always promptly for my change and I'd make a list of the jobs I needed to do and prioritise them. This experience made me question by domain flipping was prioritising my workload at the moment.
Evaluation
I thought we would assist the health care associate in ensuring the individual was clean and comfortable and noticed that was the main concern in this example. As an accountable practitioner the NMC (2008a) areas 'you must make the care and attention of people your first concern, dealing with them as individuals and respecting their dignity' that i did. I possibly could know very well what my mentor was trying to explain to me, that as a RN I must have the ability to know very well what different drugs are and what they are used for. As an responsible practitioner, I must have the data and skills for safe and effective practice when working without direct supervision, acknowledge, and work within the boundaries of my competence. I have to also keep my knowledge and skills up to date throughout my working life and I must be a part of appropriate learning and practice activities that maintain and develop my competence and performance (NMC 2008a). Post-registration education and practice (Prep) is a couple of Medical & Midwifery Council requirements and instruction, which was created to help you provide a high standard of practice and health care. Prep allows you to keep up as of yet with new trends used and encourages you to believe and reflect yourself. It also enables you to show to the people in your treatment, your co-workers and yourself that you will be keeping up up to now and expanding your practice. Prep provides a great framework for your carrying on professional development (CPD), which, although not a assurance of competence, but is a key component of professional medical governance (NMC 2008b). Following this experience my matter was which is the priority and that was not which if I experienced have researched the drug I would have been departing the patient in a soiled foundation until I had done it.
Analysis
As Individuals, we do not invent the idea of time, but we learn about it, both as a concept and a communal institution, from years as a child onwards. In the Western world, time has been designed around devices of way of measuring, such as clocks, calendars and schedules (Elias 1992). A study by Waterworth (1995) explored the worthiness of nursing practice from the viewpoint of experts, she identified that time with patients is important, but increases the question of how nurses control their time.
The importance of time management will strike me sooner or later in my job as a RN. I will be inundated with work and I am going to need to evaluate how to manage my time effectively. Time management is a active process. It really is constant activities and communications between you and your goals and dealing with changing situations (Brumm 2000). Time management will go together with good prioritisation skills, which suggest managing your time and effort, deciding upon priorities and planning consequently, this can be one of the most difficult skills to obtain (Hole 2009). Taking care of time appropriately will reduce stress and increase production.
There are three basic steps to time management. The first step requires a chance to be set aside for planning and establishing priorities. The second step requires doing the highest top priority task whenever possible and finishing one task before you start another. In the ultimate step the nurse must reprioritise what jobs will be completed predicated on new information received (Marquis and Huston 2009).
We use planning in all aspects of our lives. In medical, we often call it a 'care plan, ' and nurse's utilize this process to guide their practice. The medical process, or 'Assess, Plan, Use and evaluate (APIE), ' can be used successfully as a time management tool. 'APIE' is a organized, rational approach to planning and providing treatment but if you change, this is to read this can be a systematic, rational approach to planning and accomplishing a workable time management plan this can be a great tool for nurses to utilize to control their time effectively (Brumm 2000).
Assess/Analyze - Gather and organise data and form a assertion of actual or potential time management needs.
Plan/Prioritize - Formulate your plan. This involves devising goals and expected results, establishing priorities, and identifying interventions to help reach the goals.
Implement/Intervene - Put your plan into action.
Evaluate - Assess your outcomes and observe how you measure up against your targets.
There will be continuous requirements on my time and attention and it might be difficult to identify precisely what my priorities should be. In patient treatment, priorities can transform rapidly and I will need to be able to constantly re-assess situations and respond properly. Priority setting up is the procedure of creating a preferential collection for addressing medical interventions. The nurse commences planning by deciding which involvement requires attention first, which second and so on. Rather than rank-ordering interventions, nurses can group them as having high, medium, and low goal. Life threatening problems such as loss of respiratory or cardiac function are designated as high top priority. Health-threatening problems, such as serious illness and lowered coping ability, are allocated medium goal because they may result in postponed development or cause destructive physical or mental changes. A low-priority problem is one that comes from normal developmental needs or that requires only minimal nursing support (Kozier et al 2008).
The assumption is that priorities can be decided, and decisions made as to what is most important, and that can be followed by appropriate nursing activities. To determine priorities is to question what will be the result if this is not done immediately.
During this experience questioning 'what would be the consequence of not assisting the health care assistant?'
The patient could have had to wait whilst I explored the medication and would have been left lying in urine and faeces. This could cause skin excoriation to the patient and they could have been left uneasy and undignified. I'd not have been providing a higher standard of practice and health care as stated in the NMC (2008a) and I could be held in charge of this as a Registered Nurse. Bladder control problems and faecal incontinence should be handled in a manner that is unobtrusive, reliable, and comfortable. The patient should be taken care of quickly, in order to prevent skin surface damage, relieve irritation and restore dignity. Nurses have to be aware of the potential skin issues that may derive from incontinence (Baillie 2005). The existence of moisture content from urine and sweat boosts friction and shear, skin area permeability and microbial load (Jeter and Lutz 1996). If an individual has been incontinent of urine and faeces, their connection can bring about the forming of ammonia, leading to a rise in pH and an increase in the activity of faecal enzymes that harm your skin (Baillie 2005). The importance of changing a soiled product rapidly in conditions of faecal incontinence to prevent skin excoriation in addition has been emphasised by Gibbons (1996). I have to act all the time to identify and minimise risk to patients and clients (NMC 2008a).
A research article and reports story about student nurses and bedside attention produced a phenomenal response on nursingtimes. net. The study writers Helen Allan and Pam Smith (2010) speak out stating that given the existing pressures, experienced nurses are unable to deliver bedside treatment. The perception is the fact technical treatment is valued in addition to bedside care as a way to obtain learning for students' future assignments, leaving them sensing unprepared to be recorded nurses. Their research proved that students conceptualize nursing in another way to qualified personnel because of an intensified section of labour between listed and non-registered medical personnel. As students, we often notice health care assistants doing bedside good care and recorded nurses undertaking specialized tasks. The absence of clear role models leads students to question bedside health care as part of their learning also to put better value on learning technological skills. With regards to my reflective experience my coach suggested the technological task in exploring the drug was the main concern in relation to the bedside health care of the patient it is therefore unsurprising to realize that college student nurses are unclear in regards to what is a way to obtain learning in preparation for our roles as Registered Nurses. Helping patients with personal health is one of the most fundamental and vital relationship-building skills available to nurses, no matter their seniority and professional medical experience, university student nurses should adopt these opportunities while we don't have the other time stresses and we can then reflect on our activities. These skills will establish invaluable in providing, overseeing and analyzing meaningful, holistic treatment (Bowers 2009).
Registered Nurses maintain a position of responsibility and other folks rely on them. They are professionally responsible to the Medical and Midwifery Council (NMC), as well as using a contractual accountability with their employer and are responsible to the law for their activities. The NMC (2008a) code expresses that 'As a professional, you are personally accountable for activities and omissions in your practice and must always have the ability to justify your decisions'.
The NMC (2008a) code describes the benchmarks that I have to work corresponding to, what's expected of me as a recorded professional by co-workers, employers, and associates of the general public. It also outlines what my professional responsibilities and accountabilities are. I may sometimes be faced with situations, that may require me to issue, and question things they are asking me to do easily feel that these exact things are unsafe or are not in the needs of the individual or organisation. It is well recognised that it could be difficult to handle these issues scheduled to factors such as fear of the consequences, humiliation, and insufficient support like if you ask me as stated above. Semple and Kenkre (2002) point out that the UKCC (2001) [now the NMC] reported the research of Moira Attree, which highlighted that undeniable fact that nurses tend to be reluctant to raise concerns about criteria of health care because they feared either inaction or retribution from employers. Nurses may also be inhibited by concerns to be ostracised by the team if deciding to speak out against poor practice. This is another aspect of my specific professional practice, which requires development, and I'll make an effort to question situations in the foreseeable future if I feel they aren't in the best interests of the patient.
Being overwhelmed by work and time constraints will lead to increased problems, the omission of important responsibilities and general thoughts of stress and ineffectiveness. Time management is a skill, which is learned and improves with practice (Marquis and Huston 2009).
Literature on time management in nursing is mainly unreliable, providing lots of tips about 'how to' manage time, along with information of techniques or strategies. The order for taking into consideration the process varies, ranging from setting objectives as the first rung on the ladder to training how time is being used with aid from time logs (Waterworth 2003). Determining the value of responsibilities or priorities is area of the process, even though the stage of which this should occur varies between authors. The main theme in books is that nurses need to think about their own time management, with the main message being that individual nurses can control their time. The reality of energy management in medical practice has been subject to experimental investigations, although studies on nurses' work business have found time management difficult, with nurses compensating for lack of time by developing strategies so that they can complete their work (Bowers et al. 2001).
Conclusion
Time management is a powerful process and will go together with good prioritising skills. If you fail to prioritise you, will spend your time and be inefficient. This can cause stress to yourself and your fellow associates, as well as creating potential injury to your patients. A competent way to organising your time can be to use the medical process as explained in the article to Analyze, Prioritize, Intervene and evaluate.
After my research into time management and prioritising, I assume that my mentor was incorrect to question my time management skills. I had formed thought about which has been the greater main concern in this example and I still believe the individual was. The individual would have been vulnerable from skin excoriation and could have been left uneasy and undignified. Being a Registered Nurse, I am accountable for my actions and in the future, if the same situation arose again I feel that I would not do anything different apart from to speak up and justify my decisions. I determined and minimised risk compared to that patient as a RN, I will maintain a posture of responsibility and other people will rely on me. Although saying this, my priorities as a RN may be different to people as a student nurse and my continuing professional development will be extremely important. I have to make the care of my patients my first matter at all times, dealing with them as individuals and respecting their dignity (NMC 2008a).
Action Plan
With the increasing emphasis on efficiency and effectiveness in healthcare, how I manage my time will be an important account. Time management is regarded as an important element of work performance and medical practice. As being a newly qualified Registered Nurse, I will need to have excellent time management skills and be able to prioritise care correctly.
To accomplish that I am going to:
Break down my day to learn how long it requires me to do certain responsibilities.
Using the medical process as an instrument, I will write a list in priority order and mix of tasks as they are completed and I will keep assessing my list through the shift.
I will delegate duties to other members of the team where necessary.
Through the representation of this experience, I am now aware that I also need more development to issue and question things that Personally i think aren't in the needs of the patients.
To accomplish that I'll:
I will speak up and justify my activities at all times.
I will research more into assertiveness and self-assurance skills.
