Reflective Clinical Journal: , Health Sciences and Medicine - Personal Statement Example

Reflective Clinical Journal: Personal ment, Health sciences and medicine Year 2: Level 5 xxx June 24 Introduction Learning isa continuous process, and it must follow a structured method, where experiences are documented and the student reflects on these experiences. This work is influenced by Kolbs experiential learning model, and I have tried to adopt all the four roles of Accommodators, Converger, Diverger and Assimilator, recommended in the model (Kolb, 1984). The document is written as per the structure provided by the Gibb reflective framework (Gibbs, 1988). The document presents three main entries and each entry has different sections, which indicate the learning I have undertaken. My Background: I am a mother and my journey into homeopathy practice started about 14 years ago when I gave birth to my first son. Due to the complications of the pregnancy, I was asked to visit a homeopath and my subsequent treatment and interactions with the practitioner, formed a new perspective about homeopathy. Since then, I have been fascinated and curious about the subject, and I then decided to join a college, and make a career as a homeopath. I hope to use this opportunity to increase my knowledge about the subject, treat patients, and help them to lead a better life, free from excessively powerful drugs. I like to help people, share my experiences, and knowledge with someone who will benefit from them, and it is the best gift for me. I believe in being honest and sincere with myself this very important about my experiences. Through this reflective statement, I want, through my practice, to show to people I come across with, how important it is, and simple it is, be honest with you. 2. Entry 1 Description: Our school uses video clinics where the patient is consulted in a separate room with a camera. The camera transmits the entire treatment process to another room where we students sit and watch the proceedings on a large, flat TV screen. The camera is placed in such a manner, that it captures all the questions asked by the student homeopath and the questions posed by the senior practitioner in attendance. The sessions are very interesting since we can see the manner in which homeopath interact with the patient, their initial inhibition at opening up and while some people are hesitant to speak about their illness, others are voluble and it is difficult to actually get them to quieten down. I had a chance to sit in as an observer in the clinic with one of the students who was already quiet advanced, and she was very confident in her work. Our patient was an old woman suffering from leukaemia, and she was looking for help to go though chemotherapy and side effects of all the prescribed drugs she was taking. My student partner took her case and I witnessed the follow up. Feelings: My problem is that I wear my feelings on my sleeve and in this case, forgot that I was a practitioner and the clinical dispassionate and disassociation expected in a practitioner-patient relation was almost set aside. I felt sorry for the woman during the entire consultation. I wanted to ask her thousands of questions that I was not allowed to do as an observer. It is difficult for me not to be able not to speak out what I want. I am “tubercular” when it comes to any sort of restrictions. I felt like giving her a big long loving hug when she broke in tears, and once I was even smiling imagining the reaction it may cause in our class if I did that. I did feel close to a patient I worked with, and I did feel her suffering, I do try to hold back my tears sometimes and feel sorry and compassionate. I have realised that maybe it is because I need someone who will be the same to me. I do treat people the way I would like to be treated. I need love and care, and that is why I always think that people who came to see me suffering from lack of love and attention. Analysis: I realised that my problem comes from my concern for the patient as a human being, and not as an object, that requires medical attention. Such an approach becomes unhealthy and certainly unwelcome since the practitioner needs to look at the ailments from a clinical point of view, while I attempt to consider the psychological aspects of the case. I realise that over burdening myself with such feelings would only slow down my work and make me less efficient. Caring for the patient, analysing their illness, and prescribing the required treatment are the only processes that must be followed. In the above case, I realise that the woman, who was suffering from Leukaemia, needed medication to reduce her suffering. She did not need my sympathy or my tears. While a homeopath needs to feel, and understand the patients suffering, bonding at the pain and distress level is certainly not needed. I really wonder, what the patient would have felt, if I had tried to hug her? I feel a bit different from my classroom mates. Sometimes I feel I am being like an eyesore for some of them. I am often, talk too much, pass comments, ask too many questions and argue with our lecturer trying to prove my point of view, I can feel the vibes of irritability in the air, but I cannot help it. I am an attention seeker and seek the positive attention, understanding, and acceptance. I am depending on people kindness, forgiveness, and patience towards me. I love my classmates; all of them and each of them are so special. I am anxious sometimes when I think that eventually we will go separate ways in life. Conclusion: I can conclude from the above incident, that it would perhaps be better if I focussed more on clinical approaches and medication, rather than try to get involved emotionally with my patients. While good bedside manners are essential to help the patient overcome fears and reassure them about their illness, excessive involvement is unwanted. Such involvement makes the practitioner to ignore the symptoms and illness of the patient and proper diagnosis, and treatment become secondary. Action Plan: I have decided to take up more video clinics and get more involved in examining patients. I have decided to take up mental conditioning and ignore all possible misplaced sympathy that can create barriers in the treatment. I have some friends who are allopathic, and homeopaths and I have decided to visit them, take part in the consultation of vulnerable subjects such as young children, whose illness would move anyone to tears. I will also involve myself in the clinic run by my college and learn to be clinically detached while having sessions with the patients. Outcome: The approach I have adopted helped me in treating my son and my mother, when they fell sick. It was simple flu like symptoms, which started with a sudden sore throat, tiredness, and increased temperature. If I had not conditioned myself to be dispassionate and be observant, I would have driven myself into a tizzy, and worried myself. However, I used clinical analysis and asked simple questions such as How do you feel today? Are you tired more than usual? Is your throat sore? How was your appetite? This attitude and approach helped me to diagnose the illness correctly and I gave him a dose of Aconite 30C. By next morning, the cold and sore throat had disappeared. I have realised that since homeopathy is very precise and sensitive, when it comes to choosing the remedy, I have also be sensitive in order to be precise, and set aside personal feelings. Another outcome worth mentioning occurred when I was travelling with my family and was accompanied by my mother who suffers from haemorrhoids, a chronic back pain, and constipation. Many times she was bedridden, lost her appetite, feeling depressed and tired. We were travelling abroad, and I purchased some medicines, hoping they would help her, but the modern medicines and treatment was not effective. I was still a student, and was not very confident about my treatment, but decided to try. After, analysing her symptoms and complaints, for half an hour, I decided to give her some homeopathic medicines from my stock of Murphy’s repertory and Prisma and the Ainsworth Homeopathy kit. I gave her a dose of Sepia 30C, and I am thrilled to say that my mother was cured. 3. Entry 2 Description: My first patient, who came to see me, as a student-homeopath was a very famous Russian actor, well known in her circle. Someone recommended her my name and I was surprised to get a call in a foreign accent, asking for an appointment. I had made a resolve of not getting emotionally involved with my patients and to assume a clinical dissociation with the. I was worried that she would inadvertently give out some personal information. However, my initial fears were proved false and she talked freely about everything I needed and even more. In this entry, I will speak about how I initially let the session be hijacked by the patient who seemed to talk about inane matters, all the while forgetting the reason as to why she had come to visit me. Feelings: The consultation took place in my home in London, in my main room with a big sofa and a big table with many books on it, mostly related to a homeopathy. I had taken care to ensure that the setting for the sessions would be relaxing and had placed flowers and paintings, to create a relaxed atmosphere. I offered her a cup of tea or coffee and she opted for coffee, mentioning, saying that she never refused a cup of coffee. The patient was garrulous and extremely talkative, and it was difficult to get her to speak about her illness. In fact, my fingers felt sore from taking down notes rapidly since she talked so much and so quickly. A couple of times I had to direct her flow into more structured conversation. It was initially difficult, but after halting her midway in her rendering of some dialog from one of her plays, she got down to describing her problem. I felt this lady was going into needless details of her acting career and while this was very interesting, I realised that this was not a tea party but a consultation. I felt she spoke to me like a friend, maybe because of my friendly appearance, maybe because the consultation was in my personal space. However, for a practitioner-patient relation to be successful all feelings of friendship must be set aside, and we have to focus on the illness and the malady. The session was very tiring and while I got the information needed for the diagnosis, I realised the importance of being brusque, but not impolite and of learning how to make the patient stay in line with the consultation. I also realised that informal settings such as homes, flowers, sofas, books and tables, perhaps relax the patient and they do not take the session seriously. I have realised that consultation would perhaps seem more official, if the sessions were held in a clinic or a doctors office, where the patients seem overwhelmed. It is important to stop the patient waste the practitioners time talking about irrelevant stuff because the surroundings will remind them about the reason for their visit. Analysis: My nature and attitude is such that I cannot be firm and abrupt towards others, especially for patients, who come for consultations. I have the compulsion to make their misery as my own and wallow in their pain and suffering. I realise that such behaviour is highly unwanted, unrealistic, and non-productive. It is acceptable for the practitioner to make some amount of small talk, to place the patient at ease. However, there is no need to listen to the detailed life story of the patients, especially when the story has nothing to do with the treatment or illness. Another problem that I realised was the setting where the initial session was conducted. The hall of my home is suitable for entertainment of guests and friends, and it is not suited for consultation. I realised the importance of having a separate clinic, complete with examination table, chairs, charts and other literature that creates the correct ambience for a consultation. By inviting the patient to my home and offering her coffee, I realised that the patient lost the seriousness of the occasion. To a certain extent, I was awed that a Russian actress had come to me for consultation and this created a certain barriers, and I let her lead the consultation, whereas, it should have been the other way round. My analysis indicates that during the session, I had a difficult time getting the actress to speak about her illness and this was a tragedy, since the main goals of my profession and my personal objectives are healing the patient. Conclusion: My feelings and tendency to become too much involved in the patients life and career is unwarranted. A patient is just that, and her personal achievement, popularity or achievements in her career are of no concern, unless the lifestyle is such that medical advice and intervention needs to be given. I also realised the importance of having a formal clinic for consultation, since it creates the correct ambience, and deters the patient from being over communicative. Action Plan: I plan to join a senior practitioner and understand the manner in which they deal with patients, and the manner in which they keep the consultation on track. I also plan to join and see more video clinics and see recordings of consultations, analyse the body language and nature of conservations between the patient and the homeopath. I am also considering joining some business communication courses to understand the manner in which consultants deal with their customers. I feel that other than my homeopathic skills, I must also develop good conversations skills, where the conversation does not veer into sidelines, but remains focussed on the research subject. I also plan to ask my friend to video shoot my consultation, show the movies to my seniors and ask them for advice. Outcome: I completed some of items, listed in the action plan and now see a change in my attitude, bearing and approach towards treatment. My attitude and approach is more professional, I am direct without seeming abrupt and rude. While I do listen to the patients problems and discuss the background, I change the topic when they start talking about their personal problems. My videos, where I recorded my sessions with my customers, indicated the areas of my improvement. I seem to laugh and smile a lot and while a grim attitude must be avoided, at the same time, a jocular and merry attitude must be avoided. I realised that the settings for the consultation is important and have converted one of the garages at my home, into a clinic, complete with examination table, charts and other equipment, that inspires the patient and lends a professional attitude. These changes impress my patients much more than a casual and friendly attitude. 4. Entry 3 Description: An important entry that I wish to include in this journal is the case, where three people came for consultation, at the same time. I had an appointment with a women but she came along with her daughter, and her husband. I ended up consulting for the woman and her husband, and the setting was the hall of my home. I was surprised to see how similar and connected people within one family are, how they can reflect each other emotions and symptoms, and at the same time how misleading it can be someone who is so worried about their children that they cannot really see through the reasons and make so many assumptions according to their personal negative experience. The problem arose when the woman started to speak about her problems with the husband and daughter joining in and prompting the woman. I realised that the woman was not really telling me about her problems, but speaking of the problems that the husband, and daughter wanted her to speak about. In fact, they were interpreting the problems she faced, and giving reasons for her behaviour. It was very confusing, since I could not force myself to ask the others to keep quiet. I should have asked the others to leave the room and wait outside, but reticence and bad judgement forced me to continue with this group consultation. After probing and asking a few pointed questions, it became apparent that the basic cause of distress was stress. Faced with the constant barrage of helpful prompts from the husband and daughter, the woman finally broke down into tears. I calmed her down and asked the other to keep quiet, and further requested them to move to a corner of the hall, where the woman could speak about her problems in relative seclusion. After seeing that the woman had calmed down and appeared much better after the consultation, the husband also wanted to consult with me. This was a surprise, and I am afraid, I was unprepared to treat a male patient. The questions I asked did not make him or me feel uncomfortable. After a detailed enquiry, I found that the problem was of a large drug layer and suppression. It took a while for him to open up about his problems and emotions, and he could not see the point of discussing his feelings that he was experiencing at the time. I did not insist on talking about issues that he felt uncomfortable with, since his wife and daughter were sitting nearby and they could overhear our conversation. I was not sure if I did the right thing, and while wife consults regularly with me, he never scheduled for an appointment and follow up. I dont know if my treatment was ineffective or if my gender and manners were not acceptable. I feel disappointed, and feel like I failed this case. I realised that along with homeopathy, I had to learn about psychology, since understating the patients psyche is important in the consultation. Feelings: I have mixed feelings about this case and began with the realisation that the hall in my house is an inappropriate place for consultation. Another realisation is that group consultation is the wrong approach, when we are consulting adults. If a group of people come for examination then it is better to treat them separately rather than both, at the same time. I realised that again my feelings for the women lacked a professional attitude. When I realised that she was stressed and when she started crying, I fought the urge to breakdown in tears, since I feel stressed out on many occasions. While speaking alone with the husband during the consultation, I realised that he was not the brusque and overbearing person, I had imagined he was. He kindly trusted me his health issues and he had problems of anxiety, irregular bowel movement, brought on by stress. I found that the experience was not different from the consultation with a woman, except for the emotional aspect. Men do not express their emotions the way women do. Initially, I had troubles to understand his mental and emotional status. Analysis: I realised now that I made a number of errors in this case. The first was to consult the women with her husband and daughter looking on and prompting the woman. This was unacceptable, and I realise that I should have isolated her from her family, and given her an opportunity to speak about her problems in privacy. The same reasoning also applies for the male patient, husband of the woman. I also realised the need to have a separate room, with all the facilitates to keep the sessions private. Conclusion: The main conclusions from this entry are that privacy of patients, during consultation is important, even when they are accompanied by family members. In addition, adult patients, even if they come in groups, must be taken as individual cases. I also realised that males have certain reservations and do not open up easily. For such individuals, the best solution is to be very professional, handle the cases individually, provide professional advices, and one should not ask probing questions, not related to the treatment and illness. Action Plan: I have decided to take some courses in psychology and in handling people, who are stressed out and those that are reticent. I realise the homeopathy and belief are closely interlinked and individuals that come for examination must be handled very professionally. I have also decided to join senior homeopaths and pay special attention to understand the manner in which they handle disturbed patients who are under stress. Close family members play a role in the healing process and I would like to examine the possibility of including them in the post examination phase, and explain to them about the role they can play in helping the patient. I have also decided to open a new clinic by converting the garages. Outcome: The psychology courses have helped me to understand patients better. I find that in addition to medication, mental healing also helps. I have developed a better perspective in handling cases and about 30 percent of the cases I handle are males. 5. Conclusions The three journal entries in the document, present my passage from a novice student homeopath to an advanced student homeopath. In the first entry, I spoke about the use of video clinics and my habit of excessive emotional bonding with the patients. I realise that while good relations with the patients is important, excessive bonding mars the patient-homeopath relation. In the second entry, was about a Russian actress and I spoke about the manner in which the actress hijacked the session, leaving me in awe of her. This type of relation is not productive to the patient-homeopath relation. In the third entry, I discussed the problems I faced when I treated a family member with other close relatives giving advice and prompting the patient. In all these three entries, I realised the importance of a healthy patient-practitioner relation, the need to adopt a professional attitude and avoid being casual and the need to use an adequately appointed clinic. I hope these lessons will make me a better practitioner. References Gibbs, G., 1988. Learning by doing: A guide to teaching and learning methods, Oxford Centre for Staff and Learning Development. London: Oxford Polytechnic Kolb, D., 1984. Experiential learning: Experience as the source of learning and development. Englewood Cliffs: Prentice-Hall Read More