The Practice of Orthopedic Practitioners - Case Study Example

The purpose of this essay is to critically evaluate a case study. The paper starts with a brief introduction of the situation at hand and then moves onto the analysis of the issues raised for the people involved under the model of Driscoll and Teh (2001). Further, it takes into account many scenarios and generally demonstrates the potential for reflective practice for orthopedic practitioners. Thesis Statement and Research Methodology In this essay I will demonstrate through the use of a case study the need for ethics, values, and also the nature of knowledge that is required for the practice of orthopedic practitioners, be they doctors or nurses. For the purpose of research, I have analyzed many literature reviews so that the arguments can be substantiated by thorough evidence. The Situation The case study is about a student nurse (me in this case) who is talking to her patient about the issues faced by the patient at her home before she is discharged the next day. At the same time, another nurse from a ward turns up and asks the student nurse to make use of her free time in helping the ward nurse clean up other beds. The student joins the ward nurse, leaving her patient alone. When she returns to talk to the patient about her issues, the patient does not want to talk to her. It is obvious that the patient does feel ignored by the student nurse. The reaction of the patient clearly demonstrates this fact. The reason for this attitude may be that the patient may have wanted to discuss something and thought that a nurse could be a good listener. However, the patient was obviously greatly disappointed by the attitude of the student nurse. The student nurse could also not have done anything. This was because she was a junior nurse and it might have been hard for her to say no to the ward nurse. The need for reflective practice Reflective practice, according to Bolton (2001), refers to a scenario where a certain person is required to use his/her set of abilities to take a decision in a critical situation. For Brookfield (1990), these situations may be different for each person but whoever the person or whatever the situation, the way the person analyses the situation and deals with the problem at hand is important. Cowan’s (1999) study also argues that learners are more reflective when they attempt to evaluate one or more personal experiences and apply the same thinking to other situations. Hence, reflective practice may be understood as something that enhances the capabilities of the person concerned in such a way that it promotes autonomous learning. Through reflective practice, as a result, the person is more aware and experienced about the situation at hand and is in a better position to deal with it, as Atkins and Murphy (1994) relate. It is important that the practitioners in every profession are able to assess their strengths and weaknesses through reflective practices and are able to distinguish the areas where they may need to improve, according to Dewey (1933). The case study that is discussed above shows that the student nurse has to chose between the ward nurse and the patient. At one hand it is her duty to care for the patient through self reflection, as Freshwater (2002) discusses, while on the other hand it is important that the student nurse listens to the senior one. In such a situation, the potential for the reflective practice of nurses is greatly felt as Driscoll and Teh (2001) relate. Reflective practice is important for nurses in such scenarios because it helps them determine what should be done so that neither the patient nor the seniors are disappointed. Since reflective practice helps the people to assess the pros and cons of a decision, it can help the people (nurse in this case) to assess the situation in a better way. Here is where the ethics and values of the person may also step in. According to Egan (2002), the reflective practice can help the doctors and the nurses to consider the ethics and the values related to a certain decision. The importance of ethics and knowledge in the patient-nurse relation Before arriving at a critical decision, there is a need for people to consider the ethics and the values and also the knowledge related. For example, in the example above the student nurse should have been more knowledgeable about what the patient was going through. In accordance with a report by the Health Department (2003) relates, the discharging time can be very disturbing for individuals and their families. The patients may be depressed because they may have lost something as Ribbens (2006) relates, or they may be people who are discharged because no cures can be found for their diseases as NHS West Midlands (2008) argue. It is therefore pertinent that the nurse (or anyone else that is accountable for that care) is aware of the problems that the patients might face while moving back to their old lifestyles, as Baille et al. (2008) state. For a nurse, the potential for the acquiring of such knowledge is higher because any actions of the nurse can directly affect the patient. This was also observed in the example where the decision of the nurse to leave caused the patient to be disappointed. In accordance with another report generated by the Health Department (2003), the dignity of the patient is highly important and there should be no compromise on it. Especially for the patients being discharged and for those that are terminal, the Department of Health has jotted down many points according to which the hospital practitioners should work. According to the report different measures should be taken like improving the discharge system, coordinating with the patients and trying to make sure that they are right and satisfied with the decisions of the doctors, and assessing their needs. The Health Department (2003) further acknowledges that a nurse (or the care-taker) should make certain that he/she is better connected with the patient, and is willing to discuss the problems and the future concerns of the patients. Also, as Egan (2002) and Collins (2009) argue, the nurse should be knowledgeable about the future planning and treatment of the individual patients. This way, through the acquirement of the knowledge of the needs of the patient, both the patient and the carers can develop a better and a well coordinated relationship, as Clark and Seymour (1998) relate and also improve the communication between the patient and the nurse according to McCabe and Timmings (2006). The acquisition of the right knowledge about the patient is one thing. In accordance with Baille (2008), another challenge that is faced by the nurses usually is to decide between right and wrong. In the example, the nurse was faced with the same problem. Benner’s (1984) study shows that in order to be a successful employee, it is important to make the right decision. Nurses are generally hired for the extra care of the individuals. The diagnoses and the treatment can be carried out by the doctors alone but the need for nurses arises when the patients that have undergone mental stress or trauma are to be looked after consistently. Collins (2009) believes that the prime job for the nurses is to understand the problems of the patients and help and care for them when they need it the most. The relationship of the patient with the nurse should be such that the patient can rely on the nurse in all circumstances as Williams and Iruita (2004) argue. The patients, especially dying ones, should feel that there is someone who can take care and give him/her attention any time, according to Sinclair (2007). This was not what happened in the case study and therefore the lack of concern of the nurse towards the problems of the patient made her lose confidence in the nurse. Therefore, practitioners generally should put in their maximum effort to consider the ethics associated with a certain decision. For example in the case study the student nurse should have respected the dignity and the integrity of the patient, as Lothian and Philip (2001) deduce, rather than fearing the bullying of a ward nurse. What is right is right and the patient had more rights over the nurse at that time especially when she wanted to discuss something very important related to her life before being discharged. Now that the paper has discussed the importance of the ethics and knowledge related to the student nurse, it is important to analyze the situation of the ward nurse. The indifferent attitude of the ward nurse According to a report by the Registered Nurses’ Association of Ontario (RNAO) (2008) workplace violence and bullying is very common in the health related departments. Nurses, however, suffer the most because they are constantly bullied by doctors and other head nurses. The journey for becoming a ‘novice’ to an ‘expert’ nurse takes a lot of time as Gibbs (1988) and Melia (1987) argue. Therefore, the nurses are exposed to a greater risk of bullying. The risk to the nurses is also analyzed by Godwin (2009) who argues that the hospital ward routine is such that the head nurses exercise a greater amount of authority. This authority makes them think that they are superior to the other nurses. In such circumstances, as Fretwell (1998) discusses, it is difficult for the nurses to not listen to the head nurses even when they do not want to. In the case study that is being discussed, one may observe the indifferent attitude of the ward nurse towards the student nurse. The ward nurse knew that the student nurse was busy with a patient. Still, she intervened and assigned a task to the student nurse knowing that she was actually doing one job i.e. taking care of the patient. It is important for the betterment of the patients and the nurses alike that such an attitude by the seniors is discouraged as a report by the RNAO (2008) states. The nurses, be they student nurses or the head nurses, should realize that the patient comes first as Kitwood (1997) demonstrates. While the importance of the relation of the patient/nurse relation has been discussed in detail it is also pertinent to focus on the relations of the nurses and their seniors. In accordance with Langer (2008), the seniors in a certain profession should also make use of reflective practice so that they can assess their strengths and weaknesses better and not exercise their authority in the wrong way. Rather, as Boud et al. (1998) discuss, the primary concern of the seniors should be that the subordinates work in a more comfortable environment. This way the efficiency of the subordinates can be improved (as there are greater incentives to work) without compromising on the dignity of the patients, as Booth and Booth (1998) recount. The seniors should also take into account the knowledge associated with their nurses and their respective practices. If the head nurses are willing to understand the problems associated with the nurses or the tasks already assigned to them, then the junior nurses would not feel as isolated as they normally feel, as Randle (2003) argues. Conclusion To conclude, the nursing profession has a great potential for the reflective practices. The nurse/patient relation and the nurse/nurse relation are two very important aspects of the nursing profession. To make the environment comfortable for all the parties, it is important that ethics be considered before taking a decision. A certain kind of knowledge also needs to be present with the respective parties so that the problems of all are better dealt with as Bulman and Schultz (2004) relate. References Atkins S. and Murphy K. (1994). Reflective Practice. UK. Nursing Standard.   Baille L. Gallagher A. and Wainwright P. (2008). Defending Dignity: Challenges and Opportunities for Nursing. London. RCN.   Benner P. (1984). From Novice to Expert. Menlo Park. 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