Recently I reflected with an action that made changes in my medical knowledge and practice. AS I was working as a staff in an aged care within the high care unit, I took place to witness a situation in which I acquired involved. Most of the residents in the high health care unit were utilizing continent pads. While on my day alter I realised there have been no adequate bed linens or linen for the residents. ONCE I experienced to do bed making for the residents I came across that there is no linen kept. Normally there is always extra linen stored in the linen rack, such that it can be employed by the nurses for bed making. This is strange. I examined with all possible locations to see if there is extra linen, but could not find any. I searched if there was linen in the laundry. On the other hand I found that there was increase range of soiled linen for cleaning in the laundry. The laundry in the aged care that I functioned was from 7am to 4pm. Then i inspected with the might work personnel, why so many soiled linen was there in the laundry. They suggested that it was because of the use of inappropriate size of continent pads. Because of the unacceptable continent pads used for the residents, bed wetting was occurring at regular intervals during nights. This in turn increased the staff's workload. This increases the need for personnel time to keep carefully the residents dry looked after increased laundry cost because of more repeated bed changes. Bed wetting also causes foul odour on residents clothing. These are serious issues when it comes to quality of good care, dignity and patient's satisfaction. Poor sizing of continent pads is a potential for skin problems, and can lead to waste material of product. For instance, if the citizen is using large pad instead of medium, it s a misuse of the merchandise and escalates the cost.
During my night shifts, I occurred to note work insert was extensive. I found that residents were wetting their mattresses frequently. Because of this, linen needed to be changed many times during the night. It afflicted the sleep and dignity of the residents. It was when I modified the linen, I pointed out that the pads of the incorrect size, which the residents were putting on. Nurses are accountable for their practice. Usually the evening staffs, changes the resident's pads before they go to sleep. Normally the pads for evening are of large size that can take large amount of urine for long time. Due to insufficient knowledge, consciousness and neglectfulness, staffs were utilizing the improper size pads. WHENEVER I enquired about the consumption of inappropriate size pads, I found that it was credited to unavailability of that particular size of continent pads. It had been because there was no delivery of the pads when it was sold-out. The staff didn't inform the administration about the unavailability of large size pads. Research have shown that inappropriate sizing of pads contributes to unhygienic environment, pores and skin breakdown, bad odour and unsatisfied residents. As I was not used to the organization, I was afraid to inform the situation to my supervisor. After my work, when I got time, I reflected on my activities. What happened to me? Am I supplying technical good care or holistic care? Am I simply doing the look after the sake of just concluding my duty or actually for the residents? Why didn't I inform? Am i doing any mechanical work, or whether my activities are justifiable? Could it be predicated on the best available information? I could have done many things, such as inform the approved persons about the unavailability of pads and inappropriate allocation continent helps. I should have reassessment of continental supports and when it was essential to resize their continent pads.
Reference
Binu, T. (2011) Personal Professional Reflective Journal(Unpublished)
Poroch, D. , & McIntosh, W. (1995). Barriers to assertive skills in nurses. Australian & New Zealand Journal of Mental Health Medical, 4(3), 113-123.
Single Loop learning:
What was I attempting to achieve?
I am hoping to find out the cause of lack of adequate linen for the residents as well as to see why there is increased quantity of soiled linens in the laundry. I got also trying to learn the exact issue of foundation wetting with the residents.
Why does I answer as I did so?
I was frightened to see what I then found out, I had not been bold enough, the way I had employed medical before was different, and there is lack of data based mostly practice.
What were the consequences of that for the patient? Others? Myself?
For patient - because of my inappropriate practice, the residents were refused their protection under the law, satisfaction and dignity. Resident's rest was disturbed and they could have developed pressure sores if indeed they rested on soiled lines for very long time.
To Others - EASILY were assertive and assured enough to speak out the truth then it could have been a lessons or motivation for the other staffs.
For Myself - I did so not follow my work of care and attention. I thought guilty. I needed let down my career. I thought bad because I didn't follow the best practice. I sensed bad for my behaviour and actions.
How was the resident(s) sense?
The residents were unsatisfied due to foundation wetting and inappropriate allocation of pads.
How did I understand this?
Through observation and discussion.
Personal - How did Personally i think in this situation?
I could have been unhappy, unfortunate, uncared and being alone
What inside factors were influencing me?
Lack of courage, assurance, assertiveness, type of previous medical experience and lack of evidence structured practice where some of the internal factors influencing me.
Ethics-How performed my actions match with my notion?
My actions did not match with my beliefs because i did not advocate for my patients. It was my responsibility to see to the duty in charge what i had found. I had not been in charge of my values.
What factors made me respond in incongruent ways?
My concerns and uncertainty about my practice with insufficient confidence, having less knowledge and the difference in the manner I practiced nursing were some of the factors that made me respond in incongruent ways.
What knowledge do or must have prepared me?
I should be assertive and really should hold my job high. I should follow the duty of good care.
Reflectivity- How can hook up with the resident's experience?
The reflection about my action helped me to analyse my nursing practice and my knowledge related to praxis
Could I manage this better in a similar situation?
I could deal with the same situation better in the foreseeable future. I should be assertive, responsible and uplift my profession.
What would the result of alternative actions by: the patient, others and myself?
The patient would get best available health care, get satisfaction for the treatment they get.
Myself- I could improve my knowledge and practice that would be predicated on best available practice. I would be assertive.
How should i now feel about this experience?
I am happy because the reflection helps me to change my actions. I am assured and striking enough to do something as a professional nurse.
Can i support myself as well as others as a result?
Yes i could show myself as a best example to improve as per the medical praxis.
Has this modified my ways of knowing?
Yes this practice improved my knowledge through ongoing education, training and books review.
Double loop learning
What do my practices say about my assumption, worth beliefs about medical?
My practice explains to that i will be assertive, proficient, practice nursing on evidence based mostly, uplift my occupation and my duty of care to be sure that we am presenting quality treatment and i will be accountable for my activities.
Where did these ideas come from?
I got these ideas from my modern day medical practice, ongoing training, books review and education.
What social practices are indicated in these ideas?
My practice is patient centred and holistic attention to the patients.
What is it that causes me to keep my theory?
My abreast knowledge in medical practice, ongoing education, training, research and books review helps me to maintain my theory.
What views of electric power do they embody?
It symbolises electricity relation between your personnel, patients and power.
Whose interest seem to be to be dished up by my practice?
My practice is to serve my patients interest.
What is the fact that serves to constrain my views of what is possible in nursing?
Lack of assertiveness and self confidence, the way i practiced medical, insufficient research and no reflection on my action. quit what's possible in medical.
Praxis Statement
Praxis enables visitors to change by pushing self-reflection and a deeper knowledge of those particular situations. Nursing praxis is a mutual process between nurse and consumer with the purpose to help. It focuses on transformation in one point to another. Praxis effect how connections are maintained with patients, people and colleagues in the work configurations. Praxis is the creation art, technology and practice. The nursing praxis helps nurses to reflect on their actions and identify their thoughts during and after the actions in relation to knowledge and skills. It also gives perception to the future development and new practice. This ongoing process assist nurses to reflect on every action they perform. The insights I got from my practice is the fact that i should be assertive, confident update my knowledge, follow the duty of treatment. and uplift my professionalism and reliability.
