Personal experience at a community healthcare facility - Essay Example

? Reflective essay on personal experience at a community healthcare facility College Lecturer Introduction Feeding the elderly patients at St. Cecilia Nursing Home (fictitious name) was one encounter like none other. It shaped my attitude and feelings about the nursing profession. It is at St. Cecilia Nursing Home that I got to internalize the concept of Gibbs Model in a practical way and in accordance with the tenets of the NMC guidelines (NMC 2008). Thus, the following essay is a reflective chronology of my practical experience at St. Cecilia with respect to ethical issues of informed consent, confidentiality, professional conduct, and empathy as well as respect and dignity for patients (see Appendix 1). Reflective Practice When I joined St. Cecilia as a student and assigned to Ward X (fictitious for purposes of confidentiality), I thought I knew everything ranging from protocol adherence to professional conduct. It seemed to me that I could work on my own and deliver the best services to the elderly patients afflicted with dementia. I wanted to exude confidence in my nursing skills and for the first time my attitude was a little rigid. What I did not actually think of was the fact that I was outside an ordinary classroom and that my work at St. Cecilia required a great deal of teamwork, patience and commitment as postulated by Miranda and Best (2005, p.51) and Suzie (2001, p.1209). With time, the interaction with my patient (let us call him Uncle Richard) helped me develop the right momentum for doing the right thing through reflective nursing practice in accordance with the Gibbs Model of reflective practice as disused hereafter. My assignment in Ward X was to feed an elderly patient herein referred to as Uncle Richard (fictitious name). The patient was diagnosed with Parkinson’s disease dementia. Clinically, this dementia is characterized by declining memory and inability to make sound judgment or concentration (Cormac et al. 2004). This type of dementia resulting from the Parkinson’s disease also affects the cognition ability of patients resulting in delusion, depression, irritability, sleep disturbances and anxiety. While my patient could hardly interpret visual information, his condition was also accompanied by muffle speech. To make it worse, the patient had a hearing problem, his right arm amputated and he was a poor eater. It was important to explain some nursing issues to the patient almost daily and at times it forced me to pester the patient for several minutes before he could accept to eat. In terms of describing my feelings in of the experiences in Ward X, it would be prudent to uphold honesty as highlighted in the Gibbs Model (Gibbs 1988). Initially, it was difficult feeding the patient and staying with him was a little boring because of his memory problems, muffled speech and irritability. The patient was troublesome when it comes to eating, and occasionally I felt pissed off. At some point, empathic seeing that the patient could not even interpret a picture of his favourite dish. Once in a while, the routines made felt inadequate and out of place having to deal with a patient that seemed so difficult. Forcing my patient to eat was not a viable option especially that he still reserved the ethical right of patient autonomy (Cormac et al 2004, p.108; Guido 2006). It was however imperative to exercise some patience and understanding so as to cope with his condition and anxieties as required by NMC 2008. Learning to communicate with my patient was a breakthrough as time passed. Somehow, we became friends and the daily encounters with the patient became a normal practice after all. In his light moods, he would tell me a few things he could remember including a bit of his family life. Of course the stories were juggled up and some did not even make much sense. In some way, a few of his narrations were emotional and quite informative. For instance, one afternoon I felt remorseful when Uncle Richard told me how his wife abandoned him with a ten-year-old daughter after their family doctor diagnosed him with Parkinson’s disease. Like many other cases, it was required of me as member of the nursing profession to accord the sincere listening, continued encouragement and utmost courtesy. Being an adult patient and person of age, it was a matter of professional prudence and moral ethics to always treat the patient with respect and dignity as recommended by Gibbs (1988) and NMC (2008, p.17). Across the daily routines with my patient, each moment was special and my interaction with the patient was transforming indeed (Hargreaves 2004; Tauber 2005). The experience taught me to be tolerant, diligent and thoughtful of every decision that would impact the life of the patient or the image of the profession. While the patient later confided in me, professional conscience enabled me to honour such trust and assure the patient was confidentiality (Cowen & Moorhead 2011; Cormac et al 2004, p.113). Ward X became my second home and the interactions offered the patient moral support in the course of monitoring his health, feeding and giving the associated nursing however challenging it was. In that light, the practice enabled me to learn how to keep good records and report my observations to the immediate supervisor as required by the code of practice (NMC 2008, p.15; Thorpe 2004, p.329). Perhaps the experiences in Ward X could have been better in one way or the other. For instance, it would have been wise to seek help from my senior colleges whenever necessary. Being overconfidence can at time worsen one’s attitude towards service it happened to me at St. Cecilia. The situation calls for teamwork, collaboration and a great deal of patience (Ekebergh 2007). On the other hand, the nursing officer in-charge always encouraged nursing students to seek clarification whenever in doubt and ask for an extra hand when needful. These were open doors that I could have explored much often to enhance the quality of my professional duties relating to caring for dementia patient. It also could have prudent to seek guidance on how to administer dementia medications such as Cholinesterase inhibitors, L-dopa or other prescription antipsychotics as per the directives of qualified personnel to help my patient improve (John 1995; Howatson 2010, p.83; Howse 2007). Based on the challenging experience with the dementia patient, it would suitable for healthcare facilities dealing with adult dementia patients to develop reflective program for orientation of nursing students as postulated by Ely and Scott (2007). Each student should be well informed about what to expect and the nature of their respective duties. In addition, the facility should assign specialists to always monitor and assist nursing students to learn how to handle difficult patients. These actions would cushion nursing students from potential breach of professional ethics or code of conduct in line with the NMC 2008 guidelines. Conclusion The experience at St. Cecilia enhanced my practice skills of the nursing practice with specific regard to confidentiality and professional conduct in line with the Gibbs Model (see Appendix 2). Besides, the interaction with my patient and other professionals thereon shaped my personal attitude towards service. Despite the fact that nursing students are required to take practical lessons at local healthcare facilities, the whole experience provides us the opportunity to apply the ethical principles of consent, empathy as well as respect and dignity for our patients as recommended by the NMC (2008). References Cormac, I, Martins, D & Ferriter, M 2004, ‘Improving the physical health of long-stay psychiatric in-patients’, Advances in Psychiatric Treatment, vol.10, no.2, pp.107-115. Cowen, S & Moorhead, S 2011, Current Issues in Nursing Practice, Mosby Elsevier Publishing Group, St. Louis, MO. Ekebergh, M 2007, ‘Lifeworld-based reflection and learning: Contribution to the reflective practice in nursing and nursing education’, Reflective Practice, vol.8, no.3, pp.331-343. Ely, C & Scott, I 2007, Essential Study Skills for Nursing, Elsevier Health Sciences. Gibbs, G 1988, Learning by Doing: A guide to Teaching and Learning Methods, Further Education Unit, London. Guido, W 2006, Legal and Ethical Issues in Nursing, Pearson/Prentice Hall, Upper Saddle River, NJ. Hargreaves, J 2004, ‘So how do you feel about that: Assessing reflective practice’, Nurse Education Today, vol.23, no.3, pp.196-201. Howatson, JL 2010, Reflective Practice in Nursing: Transforming Nursing Practice, Learning Matters, London. Howse, K 2007, Health and social care for older people in the UK: A snapshot view, Working Paper No. 607, Oxford Institute of Ageing, Oxford. John, C 1995, ‘The value of reflective practice for nursing’, Journal of Clinical Nursing, vol.4, no.1, pp.23–30. Miguel, JA & Killaspy, H 2011, Long-term mental health care for people with severe mental disorders, Accessed March 1, 2013: Miranda, R & Best, D 2005, Transforming Practice through Clinical Education, Professional Supervision and Mentoring, Elsevier Health Sciences, Hoboken, NJ. NMC 2008, Guide on Professional Conduct: For Nursing and Midwifery Students, Accessed March 1, 2013: Suzie, HK 2001, ‘Critical reflective inquiry for knowledge development in nursing practice’, Journal of Advanced Nursing, vol.29, no.5, pp.1205–1212. Tauber, I 2005, Patient Autonomy and the Ethics of Responsibility, MIT Press, Cambridge. Taylor, B 2004, Reflective practice: A guide for nurses and midwifes, Open University Press, Maidenhead. Thorpe, K 2004, ‘Reflective Practice: International and Multidisciplinary Perspectives’ Journals of Reflective Learning, vol.5, no.3, pp. 327-343. Appendix 1: Ethical Issues in Nursing Practice with reference to NMC 2008 Appendix 2: Gibbs Model of Reflective Practice (1988) Read More