Development of the Professional Role - Essay Example

Development of the professional role Introduction This paper seeks to discuss a reflective account of one of my year 3 placements in which I negotiated with my mentor on the opportunity to develop my professional role and reflect on the episode of my practice. This reflective account will utilize Gibbs Reflective Cycle to reflect on my episode of practice in which I was involved in a person centred practice or individualized care. The main focus of this paper is the circumstance I found myself in during my placement and the lessons I learned from the experience and how I developed my professional role during this practice. I have selected this episode of practice, individualized care, because it is the section I took most of my time learning and had a vast experienced and involvement with other practitioners. I will use Gibbs Reflective Cycle to discuss this episode, my experiences, my actions, and lessons learned during the practice. Through the use of Gibbs Reflective Model, I will address clinical decision making, management, leadership and teamwork, delegation and supervision of others, quality assurance, and continuing professional development. I will address the above mentioned themes in relation to Gibbs Reflective Cycle of how I have developed in these areas during my training to date. I will also use Gibbs Reflective Cycle to demonstrate my fitness to practice and reflect on my personal and professional development, and the skills needed to be utilized in order to enhance my practice. The Gibbs Reflective Model is a six step cycle structured method which enables the students to explore their feelings and thoughts and encourages an action plan and analysis with the aim of challenging practice and improving knowledge (Brown 2007). The aim of this reflection will focus on individualized care for a patient of a man, who I will not mention the name in order to protect his anonymity. The reflection will equally examine my feelings and thoughts, evaluations, and critical appraisal of the care given to the patient in line with the National Health Service. Description While on placement in Emergency and Accident Department, I was assigned a patient under individualized care, to record his follow-up vital signs and document my findings on a chart. I was supposed to observe any deterioration and report and discharge or recommend referrals where possible as a health professional in charge of ensuring safe and effective discharge of patients from the hospital to their homes. This reflection is aligned with the policies established by the 2010 Quality Health Framework. The reflective framework used is Gibbs Reflective Model based on clues such as; description of the experience, reflection, factors that influenced my decision and other choices available that could influence my decision and lessons learnt from the experience (Bishop 2009). I was in the discharge planning team during my placement. The role of discharge planning team involves coordinating transition of a patient from the Hospital to their homes. This is due to the fact that safe transition to their homes is an important process in the recovery of a patient. As a member of the discharge team, it is my responsibility to advise the patient on the importance of recovering in a rehabilitation facility or at home. For example, on a reflection of what happened in the past while I was on placement in Emergency and Accident Department. I was asked to recommend treatment for an old diabetic man who just finished his treatment at the hospital. As a member of the discharge team, I recommended that the patient looks for a home care so that he may effectively respond the treatment administered, this recommendation was however overruled by the family of the old man, in spite of the assertions by Geriatric professionals that the patient has the capability of a quick recovery if enrolled in a care home, as opposed to his house (Caulfield 2005). Feelings On reflection, this was a very unpleasant experience that occurred in my life in my duties. It may have been both unprofessional and unethical to suggest to the old man that he attends a care home for his quick recovery, without prior consultations (Department of Health 2008). In order to achieve the goals set by the National Health Service, it was my responsibility to use the knowledge and tools provided effectively and accurately to prevent deterioration and recommend further treatment. However as a 3nd year student it is also about building my profession and confidence in my ability and understanding my limitations. This is why I recommended transfer to a place where the patient could recover without distraction and with intense care from professionals. I am aware of the importance to consult and make decisions in order to ensure I accurately justify my recommendation for a transfer, however I questioned my ability to make such decision and judgement as my mentor and I had completely different judgement of where the patient could recover well. It would have been prudent to have consultations made with other professionals and families members who were concerned with the health condition of the old man. This is because the process of recovery involves various stakeholders including; doctors, the patient her/himself, nurses, family members, social workers, and geriatric professionals (Department of Health 2000). Through this experience, I realized the importance of communication in effective provision of medical and health care services. This is because communication is one of the guiding factors for the development of the Scottish 2010 Quality Strategy Framework. Proper communication can result in efficiency in the provision of health care. This is because it creates an aspect of collaboration based on information amongst different stakeholders involved in the health care process of a patient (Department of Health 1999). Evaluation Current national guidance such as NICE, recommends that all patients in acute hospitals should have individualized care and constant monitoring from their initial assessment. They also recommend recording the variables of a patient such as rate of respiration, level of consciousness, oxygen saturation, blood pressure, pulse rate, and temperature. Recording such variables and ensuring that they are taken care of properly improves patient safety with key communication and observation tools (Drucker 1995). Implementing evidence based care and promoting patient safety is a fundamental principle with the National Health Service. The National Health Service aims are to apply interventions that are evidence based to every patient every time. This ensures that adverse events are reduced through standardising their approach to care. This is as well co-ordinated by the National Health Service. The focus is on 5 key leadership area, general ward, critical care, preoperative care, and medicine management. Building on this is to ensure early interventions for deteriorating patients (Girvin1998). The decision to give recommendation was founded on the three goals contained in the National Health Service Strategy on Health. These goals included: to create an association which is advantageous to the patient, their families, and any person in charge of delivering health care services. In my own opinion, through the services of a care home, the old man would recover quickly. This is so because his health would improve and his family would have incurred less health care expenditures (Fry 2008). I also intended to have the person recover quickly from his condition because of the clean environment around care homes, which the environment at their home could not offer. In addition, there would be an appropriate intervention in support of the old man in case he experiences any challenges and difficulties during the recovery period. This is because in a care home, there are professional health care workers who have the capability of diagnosing health care problems and providing solutions. Another influencing factor that led to care home recommendation was the idea that care homes are professionally managed, and aged people in these institutions are properly taken care of (Griffith 2010). At the discharge planning team, there were other options that could be considered in this scenario. The first option would have been consulting other stake holders involved in the treatment of the old man and to find out the best place where he could recover. During this process, his family would be the main decision-makers on the place where the old man should recover. This is because other people would prefer taking care of their patient during the recovery process (Neil and Galloway 2009). Other stake holders such as nurses, doctors, social workers, and geriatric professionals would offer professional advice. May be there would have been no conflict between discharge team and the family of the old man if we adopted this option. Through this approach, I would have learned the special needs of the patient and therefore plan his discharge based on satisfying these needs. On this note, this approach is an effective way of creating a good relationship between the patient, the members of his family, and the medical staff. This relationship has an effect of respecting the specific needs of the patient and therefore depicting continuity and compassion (Hood 2006). Analysis This reflection changed my perception on the importance of working as a team and effectively communicating within the team. I learnt that in the medical arena, the contributions of every member are important. There are high chances of achieving success by implementing an idea that is discussed and agreed by members of a team (Handy 1993). The 2010 Quality Strategy of Health by the National Health Service advocates for collaboration amongst health care professionals for purposes of satisfying the health needs of a patient. In addition, I learned the importance of developing a nursing care plan. This is an important step in the treatment of the patient and his subsequent recovery. The plan can also improve the recovery process of a patient. The National Health Service Strategy of Health advocates for creation of such plans as it would assist in the diagnoses, treatment and recovery of a patient (Jasper 2006). The objective of the National Health Service is to steadily improve the safety of hospital care across the country. In order to achieve this, evidence-based techniques and tools are implemented for their safety and reliability. One particular aim of the National Health Service is to ensure early interventions and continuous monitoring to recovery for deteriorating patients. Clinical effectiveness is dependent on the wealth of knowledge, expertise, and skill of the medical practitioners or those taking care of the patients. The health care providers are expected to deliver high quality care to their patients by the National Health Service (Jasper 2003). Student nurses are also encouraged to consult and ask questions in order to be part of a culture of critical enquiry, this is one reason Communication is an essential component in providing effective and safe nursing care; a handover may be seen as the transfer of accountability and responsibility for the patient. As a student nurse in placement, my role is to observe, listen, ask and then communicate this information to a qualified nurse. In line with the National Health Service aims on improving safety of the patient, the hospital has adopted key communication and observation tools such as (MEWS) & (GCS) which ensured that the stalemate between my judgement and the perspective of the patient’s family was resolved quickly (Johns 2004). I intended that guidance and continuity of care be assured to the patient under recovery, and that is one of the reasons I recommended home care. I was however asked to consult by the in charges before making such medical decision. The National Health Service aims to ensure early intervention and treatment for deteriorating patients; this is an important communication aspect in health care delivery. I should have communicated to my mentor before passing judgement and therefore failed to observe this critical aspect (Marquis 1998). When a patient is being transferred to a home care institution or to another hospital, it is vital to communicate between the transfer planning team and other multi-disciplinary team including nurses, medical doctors, the paramedics transporting the patient, and the whole medical staff at the hospital in which the patient was admitted. This would allow them to plan, assess, implement and evaluate a care plan for the patient. As medical professionals, we have a moral, legal and ethical duty to care for the patient, on reflection I noted that nursing stems majorly from principles of beneficence and ethics to provide care and do well to the patient, non maleficence not to harm the patient through listening and supporting the patient through recovery (Marquis 2009). Conclusion In summary, the National Health Service should initiate the registration of organizations that have the capability of further improving the skills of seamless health care professionals. This will provide health care institutions with highly skilled manpower which has the capability of efficiently and effectively providing seamless care services (Bishop 2006). A plan for effective discharge of a patient is pivotal in recovery process. Therefore involving all the stakeholders in decision making is very important in the diagnoses, treatment and recovery of the patient. The aim of the National Health Service for safer care for every patient, every time, was generally not effectively met, and this could have had a detrimental impact on the wellbeing of the patient (McKimm 2009). The patient had a right to be treated with dignity and respect and dignity. Therefore this reflection emphasized on the need for student nurses to be hyper vigilant, and ensure they do not lose the ability to use their intuition. As a student nurse under placement, I felt confident that at this stage in my training, I had carried out my duties effectively and though may have made a mistake; I learned really well the procedures involved. Action Plan Communication and patient safety are two of the most fundamental issues in health care. Reflecting on this situation, I am aware of the significance of the role of communication when nursing patients and the family concern. I plan and intend to apply and use the experience I gained on this placement in order to ensure that I look at the possible implications in the future for the patient and family when taking into account their issues and concerns. I have also learned as I reflect on this particular case not to question my intuition just because I am a student, but I will consult and seek a second opinion from doctors or in charges or another qualified nurse before making any medical decision concerning patient recovery and treatment in case of any doubt concerning the health of the patient or a concern by the family. I now have a greater understanding of the kind of care that should be given to a patient with signs of deteriorating. Through self directed learning, I have acquired a greater understanding of the patient’s condition and the reason why the family was hard on me. 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