Personal Development - Essay Example

?Nursing - Personal Development Reflection is a vital skill in nursing practice because it allows nurses to be able to process al the events that have taken place and the different reactions to them. Patricia Benner came up with a comprehensive model in the description of the benefits of reflection in nursing practice (Jasper 2003). She stated that making correct medical judgments as well as providing the right care for patients is all dependent on the correct reflection done by the nurses. Indeed, in my term as a student nurse I found that leadership and providing appropriate care for patients is something that is dependent on the relationships between nurses and patients as well as between the nurses themselves. This means that nurses have to be in possession of more than passable communication skills in order to be able to provide the right care for their patients. In the medical facility in which I served as a student nurse in my first week of placement, there were no permanent doctors. It was up to the nurses to conduct medical procedures such as CPR or shock treatment for cardiac arrest whenever the need arose. The physicians would come in for only three everyday during which they would check on the progress of all patients. There were different wards and there had to be good relationships between the nurses catering for the needs of patients in each ward for work to progress smoothly. The nurses would also update the doctors, when they came, of any important developments in the cases of different patients. The nurses also served as a type of link between the doctors and patients because the patients were more accustomed to them- and thus more comfortable with their ministrations. In this medical facility, nurses were not only responsible for checking the daily progress of patients, but they also ensured that the patients had all their personal needs catered to. For extremely weak or debilitated patients this would mean helping them in using the bathroom and in bathing. These are sensitive subjects that call for nurses to use their best communication skills so as to put the patients at rest or ease their anxiety at having lost the power to oversee their own personal hygiene. People in general tend to experience a sense of disempowerment when they lose their capacity to take care of such basic functions (White, Fook, and Gardner, 2006). This feeling of helplessness can further exacerbate their physical symptoms if it is not adequately dealt with. The ministrations of an empathetic and considerate nurse can put the patient at ease so that he or she does not feel too vulnerable. In this medical facility, the nurses were also responsible for administering medications to patients and monitoring blood sugar in the case of diabetic patients. I made the decision to prioritise my work in the morning in order to make as efficient a schedule as was possible for each day. Having reflected on the needs of each patient, I would then arrange them according to the cases of most importance before doing the rounds. Reflecting allowed me to be able to closely study the symptoms exhibited by each of my patients, thus allowing me to come up with the best ways of assisting their recoveries. For instance, I would accord more time for an anxious or discouraged patient in order to be able to speak more with them about their interests and family. This would help the patient to feel appreciated and less alienated. There are different theories on the importance of reflection and its basic benefits in a healthcare setting. Donald Schon believed that all reflective practices can be divided into reflection on action and reflection in action (Johns, 2011). Reflection on action basically describes the process of reconsidering an event that already took place while reflection in action is more concerned with processing an event even as it takes place (Redmond, 2006). In my first week of placement, reflection-on-action allowed me to be able to recount the actions of other nurses whom I had accompanied on rounds in order to understand the knowledge that was used in treating patients by examining and absorbing the information that I remembered. In making use of reflection-in-action to understand nursing processes, I had to be conscious of what the nurses were doing when they did it in order to learn from it. In using reflection-on-action, I was able to keep journals on the different treatments used for different patients who suffered from the same disease and also engaged in role play before I was allowed to treat actual patients. Reflection-on-action was different because all that was required of me was to be mindful whenever I accompanied other nurses on rounds to administer to the needs of patients. David Kolb and Patricia Benner came up with different theories on the importance of reflection that both utilise experiential (Lyons, 2010). David Kolb believed that learning becomes more consequential when it takes place through actual experience. According to Kolb’s learning cycle, learning through experience can only occur through four stages. These are the concrete experience stage, where something is done, the reflective observation stage, where the person reviews the accuracy or significance of what has just been done, the abstract conceptualisation stage, where the individual takes lessons from the experience, and the active experimentation stage where the person tests the learned experience to see if he or she mastered the lessons that were presumably learnt (Johns, 2011). I underwent all these stages during my first week of placement as a student nurse. Concrete experience: I did not arrive on time at the medical facility to which I had been assigned as I was not conversant with that part of the city. When I finally arrived there, I got a bit lost as I went to different rooms of patients until one patient directed me to the nurses’ lounge. I was quite embarrassed at having a patient direct me and mentally memorised the names of corridors so as not to get lost again. At the nurses’ lounge, I found that the meeting had not started because everyone was waiting for me to arrive. I apologised for my lateness and made a mental note to do more than other student nurses. Reflective observation: I got the chance to speak with other student nurses and realised that each of them was nervous. The nurses seemed amused by my excessive apologies and explained that almost all student nurses lost their way when they made their first attempts to reach the medical facility. I noticed that some patients, from whose rooms I had hastily retreated when I was looking for the nurse’s lounge, resented the intrusion and felt I was a bit haughty because I had rambled into their rooms and swiftly left with mumbled apologies which were not heard by most. Abstract conceptualisation: I am quite bashful and usually experience intense anxiety in some social situations. Even though I had read about body language and the importance of good communication skills when handling patients, I found it hard to ask patients to expose themselves when I first administered injections to patients. This was especially hard when dealing with patients who thought I was unsocial after my foray into their rooms on my first day as a student nurse. I think that i may have to develop more people skills in order to deal more effectively with my timidity. Active experimentation: In all future placements I shall make sure that I visit the medical facility I am sent to before the actual stipulated day of arrival. I will also make sure that my nervousness about how I will perform does not cause me to appear to be forbidding to the very patients I am supposed to develop a warm relationship with. I will also always keep a smile on my face and establish eye contact in order to seem amicable to others. If I should ‘freeze-up’ again for any reason, I will force myself to return to the patient to whom I might have seemed curt instead of begging another student nurse to cater for that particular patient on my behalf. In dealing with how to inform a patient’s family about the deterioration of an elderly patient’s health, Kolb’s learning cycle was often utilised. My preferred way to do this is through convergence; where I create a number of small tasks that will result in the objective being met. This theoretical hemisphere will also be typified by considering alternatives on how to say what needs to be said to the waiting relatives (Maarof, 2007). Next, in the learning cycle’s “practical hemisphere”, I will then first speak with a standardised patient (SP) and ask for feedback about the communication skills used to divulge the news before finally breaking it to the sick patient’s family. Patricia Benner's theory of reflection, the Novice to Expert model, is concerned with how nurses develop their expertise in different responsibilities (Peden-McAlpine, Tomlinson, Forneris, Genck and Meiers, 2005). Benner’s theory was gained from practice. Benner’s theory holds that a nurse moves from seeing the differentiated parts of a whole situation to being able to view it as the sum of its parts (Reed, 2006). It is only through reflection that the nurse will be able to perceive the situation as being whole. According to Benner’s theory on reflection, student nurses like me take time to know or understand how to view situations as a whole and not simply as separate parts. The first stage of the Benner theory involves the experience of student nurses who are inexperienced about hospital settings and do not know how to assess medical situations (Roffey-Barentsen and Malthouse, 2009). Owing to their inexperience, they are more likely to observe every rule and depend on medical texts for the determination of treatments. Having never worked in a medical setting before, I can attest to the truth of this statement. In my second week of placement, I strived to learn more communication skills which would help in my ability to relate well with patients. I began to understand that planning was vital in ensuring that each patient received the correct treatment. I was able to make plans to deal with the tasks necessary for each patient I was assigned to with the help of my mentor. This not only allowed me to be able to serve all patients on time, but it also pleased my working colleagues such as physiotherapists who were then able to start working with the patients on time. However, I also noticed that I often confused my patients and their illnesses, which seemed almost identical to me. I had to begin writing a journal in which I described my perceptions of the symptoms of different patients so as not to confuse them. Not only can the novice nurse, according to Benner, not be able to tell between different patients and situations, he or she is also not able to use any past real life experiences to improve their attempts at patient care. Still, I had more time, after finishing my assigned duties, to talk at length with other medical practitioners such as physiotherapists and other nurses about the different patients. Holding such discussions can actually be quite beneficial because a nurse is able to hear different opinions on the best way to treat a patient. A nurse will also be able to ask questions about hard subjects and generally share with other medical practitioners (Jasper, 2003). Such discussions foment high-quality relationships between medical personnel, resulting in the mutual respect that greatly improves working conditions in a medical facility. Benner’s reflection model names the advance beginner’s stage as the phase where, due to having attained basic skills when functioning in medical settings, the novice nurse has marginally improved in his or her duties. In this stage, a student nurse perceives the medical cases in the clinical setting as activities that exist to test his or her capabilities. The student nurse therefore still is not in a position to perceive the patient’s requirements as being the main thing of importance. Even though the student nurse can successfully diagnose different symptoms, he or she still needs the supervision of the mentor. In my second week of placement, I encountered Jane, an 85 years old patient who was suffering from a renal tumour and also had pelvic bleeding. She had also suffered three falls in the recent past. Due to her advanced age, surgery was ruled out as a treatment option. In caring for Jane’s personal needs, the physiotherapist and I ensured strove to ensure that she was always comfortable. I was eager to show my mentor that the personal care of a sick patient was something I excelled. The physiotherapist and I also developed a close relationship because we were taking care of the needs of the same patient. In stage three, the nurse will be able to view his or her activities as part of the overall long-term goals. The nurse grows more confident in her or his own abilities to determine an illness without necessarily consulting medical texts. In stage four, the nurse will be more open to considering the symptoms of an illness as the parts of a whole. The nurse improves in terms of decision making and is more interested in engaging in patient-centred care. In the fifth stage, which is the last stage, the nurse uses past experiences to determine different illnesses of patients and does not rely on texts in determining different illnesses. At this stage, the nurse can also easily incorporate the latest medical procedures into patient treatment in order to produce the best outcomes and assist recovery. The experienced nurse, I discovered as a student nurse, is the one who uses patient centred care methods in looking after patients. This, however, is not easily accomplished. Nurses usually have to deal with more frustrations than are found in other professions on a daily basis. These may range from simple disagreements with the families of patients, or the patients themselves, to spats between nurses themselves, or a doctor’s diagnosis and a nurse’s differing analysis on the cause of a patient’s illness. Families such as that of my 85 year old patient, Jane, who agreed to the doctor’s prognosis that surgery would be a worse danger at Jane’s age than even her illness, are actually rare. In addition, nurses are forced to remain on their feet for many hours. Sometimes, due to the shortage of skilled nurses, some nurses are even forced to serve patients in different wards (Gould and Baldwin, 2004). If the nurses are stressed and forget to engage in hygienic practices such as hand-washing every time they cross to different wards, nosocomial infections can erupt among patients. With such cares, it would almost impossible for all nurses to remain sensitive to the needs of all their patients and exhibit empathy when told of the problems of others. As a student nurse, I observed that many times, nurses disengage from their day to day working lives when they do not have appropriate coping strategies to deal with their ever-increasing workloads. Sometimes hospital administrations impose heavy and impractical loads on nurses that actually result in them depersonalising their patients. For instance, when hospital administrations neglect to acknowledge the emotional cost of constantly being exposed to sick and wounded people, some with shocking tales, nurse are left to desensitise themselves from patients in order to continue dispensing treatment without being unduly influenced (Ghaye, 2005). Many hospital administrations also impose improvement proposals that simply serve to worsen the loads on their nurses. I believe that nurses can use reflection as a tool to cope emotionally with the daily challenges presented by nursing. Reflecting on a regular basis will not only improve the quality of services extended to patients, but will also facilitate the personal development of individual nurses. Reflection can be conducted through official channels, such as supervised conferences that allow nurses to express their concerns without fear of censure, or in less formal circumstances like team huddles for ‘decompression’- which was something that was soon to be started where I was serving as a student nurse. While developing a nurse’s ability to confront daily challenges, reflection also seeks to make sure that nurses remain caring towards their patients, and perceptive of their particular needs. Using different reflection models has assisted me in structuring my feelings about my first experiences as a student nurse. I also acquired the habit of critically reflecting on the importance of potential decisions and how they affect future outcomes. I feel that my personal character has also been positively affected by learning about how to cater to the needs of others even when confronted with pressure from other situations. It is evident that reflection is not only a significant tool for nurses in the healthcare sector, but also for combating stress in daily life experiences. References Ghaye, T. (2005) Developing the reflective healthcare team, Wiley, London. Gould, N. & Baldwin, M. (2004) Social work, critical reflection and the learning organization, Ashgate Publishing, London. Jasper, M. (2003) Beginning reflective practice, Nelson Thorne, Tewkesbury. Johns, C. (2011) Guided reflection: a narrative approach to advancing professional practice, John Wiley & Sons, New York. Lyons, N. (2010) Handbook of reflection and reflective inquiry: mapping a way of knowing for professional reflective inquiry, Springer, New York. Maarof, N. (2007) ‘Telling his or her story through reflective journals’, International Education Journal, vol. 8, no. 1, pp. 205-220. Peden-McAlpine, C., Tomlinson, P.S., Forneris, S.G., Genck, G., & Meiers, S. (2005) ‘Evaluation of a reflective practice intervention to enhance family care’, Journal of Advanced Nursing, vol. 49, no .5, pp. 494-501 Redmond, B. (2006) Reflection in action: developing reflective practice in health and social services, Ashgate Publishing, London. Reed, P.G. (2006) ‘The practice turn in nursing epistemology’, Nursing Science Quarterly, vol. 19, no. 1, pp. 36-38. Roffey-Barentsen, J., & Malthouse, R. (2009) Reflective practice in the lifelong learning sector, Learning Matters Ltd, Exeter. White, S., Fook, J., Gardner, F. (2006) Critical reflection in health and social care, McGraw-Hill, New York. Read More