INTRODUCTION
This submission is going to focus on the nursing care that I gave on two placement simulations and one shift on placement, placing emphasis on oral care, bed bathing and medication management. It will outline the fundamental aspects of clinical nursing skills that have taken place in my setting. This will also highlight the learning process taken place and how it helped me to enhance my knowledge, and ethical values in order to deliver quality and safety of care. Using other sources of current literature, I will use a reflective model to discuss how I have achieved the necessary level of learning outcome. By utilising this model I hope to demonstrate my knowledge and understanding in relation to these skills as well as identifying areas with scope for learning.
Reflection is the process of reviewing an experience in order to describe analyse, evaluate and so inform learning about practice (Reid 1993).
Gibbs (1988) model of reflection will be used as a framework, because it focuses on different aspects of an experience and allows revisiting the event fully. By contemplating it thus, I am able to appreciate it and guided to where future development work is required.
For confidentiality purposes the patient’s real names will not be used and will be referred to patients as B and R where appropriate. This is in line with the (NMC, 2008) requirements to maintain confidentiality at all times.
Skill 1: Oral Care
The care of a patient’s mouth forms an important component of assisting hygiene needs and yet is a nursing skill which is not always afforded the attention it fully deserves (Evans, 2001)
Description
I was part of a placement simulation group which went to the multi-skills laboratory to practice deliv...
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Sturdy, D. (2007) Indignity in care: are you responsible? Nurs Older People. 2007; 19(9): 9.
The National Institute for Health and Clinical Excellence (2009), information on medication management available from http//: www.nice.org.uk (accessed on 14th February 2011)
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World health Organisation (2010) ‘Oral Health’, at http://www.who.int/topics/oral_health/en/ (Accessed 19/11/2010
Charalambous, A. (2010). Good communication in end of life care. Journal of Community Nursing, 24(6), 12-14. Retrieved from EBSCOhost.
I am going to use Gibbs (1988) Reflective Cycle. This because Gibbs is clear and precise allowing for description, analysis and evaluation of the experience helping the reflective practitioner to make sense of experiences and examine their practice. Taking action is the key; Gibbs prompts to formulate an action plan. This enables the reflective practitioner to look at their practice and see what they would change in the future, how they would develop/improve their practice.
On the 1st of November 2013, I performed my first simulation on the module, Foundation Skills for Nursing. This simulation was on checking for vital signs in patients particularly, measuring the blood pressure (BP) which is the force of blood vessels against the walls of the vessels (Marieb and Hoehn, 2010). We also measured the temperature, pulse and respiratory (TPR) rates of a patient. This simulation’s objective was to engage us in practising some basic observation techniques taken on patients in and out of hospitals and to familiarise us on some of the tasks we will be performing when in practise. I will be applying the “What”, “So what”, and “Now what” model of reflection in nursing by Driscoll (2000).
One reason for Reflection being used is to give practitioners the chance to change an aspect within their setting, which they feel can be improved in order to help the development of children within their practice. Reflective practice is about improving practice and coming up with theories to support the improvement (Holmes, 2011, p.7). Reflective practice using critical reflection will allow the practitioners to identify what they do well and what they need to improve on within their Early Years settings. It can also give practitioners the opportunity to develop their professional identity, and work at improving their working environment (Forde et al, 2006, p.65, 66). By allowing practitioners the chance to improve their working environment, it can have a huge influence on the children and their development within the Early Years. For example, a teacher looking back and being reflective over their lesson, will allow them to make amelioration for when they teach that lesson again, thus leading to further learning development of the
I aim to use Gibbs’ reflective model (1988 cited in Peate 2013) to reflect on the three skills because it is simple to use and understand. It will also enable me to reflect on how I felt whilst undertaken each skill.
Utilising John’s model of structured reflection I will reflect on the care I instigated to a patient with complex needs. The patient in question was admitted to the Emergency Assessment Unit for surgical patients then transferred to the ward where I work as a staff nurse.
The reflective model I have chosen to use is Gibbs model (Gibbs 1988). Gibbs model of reflection incorporates the following: description, feelings, evaluation, and ...
It is important that students have the ability of being competent in a clinical setting. To be deemed competent in skills according to nursing regulations and requirements. This is a challenging factor for many students, as they enter transition period. This is due to students feel they do not have the desired clinical competency that promotes the skills and authorities of a registered nurse (Harsin, Soroor & Soodabeh, 2012). Clinical research studies have found that students do have the required expected levels of knowledge, attitude and behaviour’s. However, the range of practical skills aren’t sufficient for the range of practice settings (Evans, 2008). This research has also found that other evidenced based studies found that competency in nursing skills is still lacking (Evans, 2008). These skills are lacked by students and newly graduated nursing how are in the first or second year of
Sturdy, D. (2007) Indignity in care: are you responsible? Nurs Older People. 2007; 19(9): 9.
Reflection has its importance in clinical practice; we always seek to be successful and that can be achieved by learning every day of our life through experiences we encounter. In that way we can reconsider and rethink our previous knowledge and add new learning to our knowledge base so as to inform our practice. Learning new skills does not stop upon qualifying; this should become second nature to thinking professionals as they continue their professional development throughout their careers (Jasper, 2006). According to Rolfe et al. (2001), reflection does not merely add to our knowledge, it also challenges the concepts and theories by which we try to make sense of that knowledge. Acquiring knowledge through reflection is modern way of learning from practice that can be traced back at least to the 1930s and the work of John Dewey, an American philosopher and educator who was the instigator of what might be called ''discovery learning'' or learning from experience. He claimed that we learn by doing and that appreciating what results from what we do leads to a process of developing knowledge, the nature and importance of which then we must seek to interpret (Rolfe et al., 2001).
In this reflective essay, I will be using the Driscoll’s model of reflection to talk about how my knowledge of quality nursing care has improved since the commencement of this module. Quality nursing care has helped me develop various nursing strategies that will guide me in my first placement and throughout my career in nursing. Furthermore, it has taught me about communicating effectively with patients, I have learnt about verbal communication such as paraphrasing when communicating with patients to ensure that what said is properly understood. I have learnt not to make assumptions about patients and putting them in the middle of their care, taking into account their preferences.
As it mentioned above this reflective essay is based on the main theory on Reflection, which is the Honey and Mumford’s learning styles that was developed from Kolb’s work. This is based on four stages of specific styles of learning:
Reflection within early year’s settings and schools allows for the practitioner to think about the work that is being completed either whilst doing it or after it has occurred, the reflection allows for seeing how the work has gone or whether it needs to be changed for future practice. Schön is a key writer about reflection and illustrates the differences between reflection in action, reflection on action and reflection whilst completing the task. The above critical skills help all practitioners to develop understanding as they hugely impact on others lives, if this skill is not engaged in then practice could be effected (Leeson, 2004).
The intention of reflective practice is to help the teacher/learning coach evolve and develop the quality of their teaching by the continuation of personal development. Although most teachers have done this for years, reflective modelling or methods have formulized a structure which can be followed and adapted to best suit their methods. It is an ongoing process which takes feelings and emotions into consideration and so it will not always have a definitive answer/ending. Since most models of reflection require subjective and objective thinking then there is a willingness to be honest to engage constant self appraisal. It asks that the teacher become flexible analytical and socially aware when addressing their chosen model of reflection.
The reflective dimension is the journey of self-development through a critical analysis of one’s thoughts, behaviours and values. Reflection allows you to relate your inner self to the environment around you. It encourages social responsibility and constant improvement as you learn from experience and acknowledge success. (Olckers, Gibbs & Duncan 2007: 3-4) Reflection can boost learning by stimulating awareness of our feelings and practices. This allows health professionals to cope with unfamiliar circumstances and conflicts.