Empathy Education in Nursing - Essay Example

?Reflection Introduction This is a critical reflection on the skills applied during my clinical placement. The communication and interpersonal skill,especially how it was applied during the handover during the multidisciplinary meetings were a significant part of this essay. With the assistance of the mentor, I was able to manage this communication skill, including other clinical skills. Before signing off on how well I have learned this skill, a review on the application of my skill was necessary. The mentor gave me feedback on my performance throughout the placement. She also gave me pointers on how I could improve in my next placement. The mentor also provided feedback from the patients, and through such feedback, I found out that the patients liked me talking to them and smiling at them. In general therefore, I performed well. Part 1: Gibbs Reflective cycle Description (What happened?) The incident involved my clinical placement with a community hospital which houses 19 inpatient beds, an A & E Department, Physiotherapy, and X-Ray/Ultrasound facilities. Their services include rehabilitation for patients having gone through accidents or minor injuries with a team of professionals including doctors, nurses, physiotherapists, occupational therapists, and social workers/case managers. During this placement, I was able to apply various skills and take part in various nursing interventions. One of the activities I was able to participate in is the handover during multidisciplinary team meetings. The meeting comprised of various nurses and other health professionals caring for different patients. To protect patients’ confidentiality in accordance with the NMC Code of Conduct, patients’ consent for care were sought before any essential nursing services were offered (NMC Code of Conduct Domain 2.8). I administered care to patients in the ward, assisting in wound cleaning and vital signs monitoring. The handover multidisciplinary meetings were done weekly with nurses bringing all the folders for the patients in the bay and giving a handover to everyone attending the meeting. I participated in giving handovers to about two patients a week. Members of the team ask questions about the patients I would be handing over, and I would explain what I can about each patient. At times, my mentor would help me explain further about each patient. The patients’ attending physicians, physiotherapists, occupational therapists, nurses, dieticians, and social workers were present in the meeting. I reported about the patients’ vital signs, oftentimes indicating possible changes and unstable levels for patients. I also expressed that some patients had a low threshold for pain. The Gibbs reflection style was used for this paper because it provides an orderly and detailed process of reflection. It also allows for an in-depth assessment of details and interventions used during the incident being evaluated. Feelings (What I was thinking and feeling) I felt like my contribution to the team was an important contribution and I was also assured with the fact that the other members of the team listened and welcomed my comments and contribution to the handover meetings. I also listened to them as they shared their expertise on patient care. At times however, I found the discussion intimidating because the members of the team are experts in their field. I felt however, that I needed to be more assertive during these discussions in order to ensure that my contributions to the discussion would be heard. Evaluation (What was good and bad about the incident) What was good about the incident was that it taught me that the contributions of the team in the care of a patient are effective means by which improved patient outcomes can be gained. By attending the handover multidisciplinary meetings, I was able to endorse the patient and communicate their essential needs based on my assessment. With the assistance of my mentor, I was also able to be effective during the handover meetings. What was bad about the experience was that there were times when I felt too intimidated amidst the company of the team, that I often opted to keep my silence instead of being more assertive and contributory during the discussion. Analysis (What sense I can make of the situation) Participating in the handover multidisciplinary team meetings is an important aspect of the nursing practice because it ensures that the contribution and the evaluation of the nurse in relation to the patients’ care are expressed to the rest of the team (Nagi, et.al., 2012). Attending such meetings also helps inform the nurse about the contributions and opinions of the other health professionals on various aspects of the patients’ care. Through such handover meetings, a more holistic evaluation of the patients were secured as the assessment and expert opinions of the yielded relevant details on the patients’ care (Propp, et.al., 2010). The doctors provided their medical opinion on the patients, the nurses expressed the nursing care needs of the patients, the therapists expressed the patients’ physical and rehabilitative needs, and the social workers expressed their community and personal needs. Each member of the team could express what the patients’ needs were and each member of the team could evaluate how well the interventions fit into the patients’ life without making their conditions worse (Propp, et.al., 2010). Through these handover team meetings, the nurse communicated with the other members of the team. These meetings also provide a means to “coordinate fragmented care” (Van Houdt, et.al., 2011, p. 72). Where various health professionals are caring for a particular patient, these meetings help to establish a more congealed and coherent care, one which would not contradict each other, would not cause repetition of care, or would not create complications in care (Holleman, et.al., 2009). Through these meetings, possible blind spots in the patient’s care were also discovered, essentially securing better structure to the overall patient care. These meetings also provided an avenue whereby the different members of the team could share information, knowledge, goals, and secure mutual respect for each other. Conclusion In general, based on this reflection, it is apparent to note that the handover multidisciplinary team meetings provided an opportunity for me to improve and apply my communication and interpersonal skills. There were gaps in how I communicated, however, by securing more confidence and knowledge, I believe I would be able to improve my communication skills during these meetings. Action Plan (If it arose again, what would I do?) In order to resolve gaps seen during the incident, I am resolved to improve my communication skills, especially in terms of clearly providing handover details to the other members of the team. I need therefore to be more prepared during each handover process, especially in relation to each patient I would be handing over (Holleman, et.al., 2009). Such preparation however has to be based on accurate knowledge. In effect, arming myself with the right information regarding patients’ care would help provide me with the confidence I most need to contribute what I can during the handover meetings. During the handover meetings it is also important for me to listen to what my colleagues want to share, valuing their opinion and taking notes in order to ensure that the essential data regarding the patient’s care would be ironed out and clarified. Part 2: I expect to use this skill in different practice areas with different patients. I know that I would be communicating numerous times with the patients and their family and that I would need to have the right skills in order to ensure effective communication (Buljac-Samardzic, et.al., 2010). While caring for the patients, I know that I would have to communicate with them, asking them how they are feeling, asking them to turn this way or that, or asking them to take their medications. In the process of communication, I know I would have to use my communication and interpersonal skills by listening to the patients (Buljac-Samardzic, et.al., 2010). Listening to the patients involve looking at them when they are talking, and acknowledging their feelings and emotions (NMC Domain 2, 2008). It involves active listening and being an encouraging presence to the patients. Interpersonal skills involved the ability to relax the patients and to establish rapport with them (NMC Domain 2, 2008). By establishing rapport, I would likely be able to ease into the more serious elements of the communication. In applying my communication and interpersonal skills in patient care, I am also aware of the importance of reading non-verbal gestures from the patients. Patients may not always express what they are actually feeling, but it is possible to observe their non-verbal cues in order to determine pain levels, stress levels, and other symptoms (NMC D.3, 2008). Communication skills include the ability to observe the patient, and to match the tone, the expressions, and the emotions to the actual words being expressed. Communication and interpersonal skills also includes the ability to express empathy towards the patient (Ward, et.al., 2012). Where the patient can feel the empathy from the nurse, he would be more open about his feelings and be more cooperative in his care. Empathy fills in emotional voids for the patients which they may feel in relation to their illness (NMC D 2.A). Where nurses are able to speak in empathetic tones, the patient would also be more likely to believe in what the nurse is trying to say and feel less alone in his illness and pain. Empathy can be expressed in various ways, and for the nurse, it is important to understand where one’s boundaries are (Brunero, et.al., 2010). Patients have a personal space where they which they may not want to be invaded. The nurse has to stay outside such parameters, which is usually within a foot or two of the patient. Talking at patient level, sitting at his bedside, or on a chair beside the bed would help make the communication process less intimidating or threatening to the patient (Rice, 2006). Standing over the patient may often be too intimidating and can put the patient at a defensive. For each patient, effective communication processes may be different. It is therefore important for the nurse to evaluate the patient, how he feels and which styles of communication he prefers. Part 3 Proficiency in this skill contributed to effective nursing care because communication skills are one of the strong determinants of securing improved outcomes (Bernard and Gill, 2008). Communication and nursing are inseparable. Communication is as essential to nursing as nursing care and health services delivery are. Therapeutic nursing skills include the establishment of a strong nurse-patient relationship (Bernard and Gill, 2008). The application of communication skills were apparent as I changed wound dressings, checked vital signs, administered medications, administered injections, secured personal care, fed the patients, and made ward rounds. All of these skills also require good communication skills for maximum efficacy. The notion of nursing is therefore supported by essential communication skills (McCray, 2009). The therapeutic impact of good and effective communication managed through effective care is secured by evidence. Health care givers who can communicate well emotionally are perceived to be warm, caring, and those who can generate trust from patients (McCray, 2009). Moreover, an informative communication process between the practitioner and the patient helps encourage these patients to be more interested in their care and in their recovery, also to ask the questions they want to ask and to establish a greater interest in their self-management (McCray, 2009). Patients are also able to experience various health benefits when nurses are able to secure a favourable environment, use therapeutic communication, secure accurate information, and ensure positive motivation among patients (Webb, 2011). In effect, good communication within the nurse-patient relationship is on its own very much beneficial and therapeutic for the patient, allowing for a resource of good and effective care. In addition, effective communication also helps secure openness with the patient; it helps the nurses formulate questions about patient care; it allows the patient to have greater control in their decisions about their care and treatment; it engenders trust and confidence between the patient and the nurse; and it can help the nurse reduce pain symptoms, as well as lower stress levels. Nursing and health care is also a constantly changing and dynamic care. With each year, there are numerous developments in treatment and medicine which are being introduced (Arnold and Boggs, 2006). The focus of these treatments and developments has also been on chronic diseases, not acute illnesses. Chronic care requires various interventions and skills from the nurses and other members of the specialist team (NMC Code of Conduct Domain D4.A, 2008). Nurses have to secure holistic skills within the parameters of effective communication and the NMC Code of Conduct, in terms of communication and interpersonal skills, leadership, as well as decision making. In effect, treatment options have become very much based on the effective application of nursing skills and protection of patient preferences. In various circumstances, the patient has now become an expert in their own care. Managing the communication process with these patients has become essential in terms of ensuring that the nurses are able to secure effective and open communication pathways to make these patients understand the importance of self-management. The therapeutic relationship between the nurse and the patient is usually founded on partnership and intimacy. Its goal is not founded on a social relationship, especially as it focused on the welfare of the patient and the nurse and patient do not need to share anything in common (Arnold and Boggs, 2006). Such a relationship can only last for a short duration of time, especially where emergencies or traumatic injuries are experienced. It can also continue for months where chronic care is involved. This relationship can also become personal, especially when bad news is broken to the patient by the nurse; however, it can be light when the nurse is simply instructing a patient what department he would go to in the hospital. In all these situations, nurses work individually as well as in teams (NMC Code of Conduct D4.6, 2008). Such practices indicate that the nurses and the other health professionals value the opinions of their colleagues (Ogden, 2004). As a member of the multidisciplinary team, it is acknowledged that nurses do not work in isolation. They are part of a larger health care team with members having specific roles to play in patient care. These members work best as they coordinate their roles and expertise in order to secure improved patient conditions (NMC Code Domain 2, 2008). In order for students to qualify as nurses, these students must be able to secure their contribution to the team working by understanding how they can move within the team, acknowledging the roles of others, and using the resources made available to them (Webb, 2011). Working with different health professionals and with various roles and priorities can be a trial for most nurses; however, at most times, nurses usually have the leading role in coordinating health care through the process of communication and effective management of holistic care needs (NMC Code of Conduct Domain 2, 2008). Nurses working with different patients will need to understand various specific needs and roles they need to fulfil. Nurses need to administer different types of care and different skills in the practice (McCray, 2009). By securing effective and open communication lines, it is possible for these teams to engage in successful relationships and to improve nursing skills. References Apker, J., Propp, K., and Zabava, W., 2009. Investigating the effect of nurse–team communication on nurse turnover: Relationships among communication processes, identification, and intent to leave. Health Communication, 24(2), pp. 106-114. Arnold, E. and Boggs, K., 2006. 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