Critical Exploration and Analysis of an Incident that Occurred in Clinical Practice
Introduction
Within this discourse, I will employ Gibbs’ (1988) reflective cycle to meticulously scrutinize and dissect an incident that transpired within clinical practice, profoundly impacting my learning and professional growth. Using Gibbs’ cycle will facilitate deep reflection by discerning emotions that may have influenced my practice, evaluating both strengths and weaknesses in performance, and delving into the ramifications within the practice setting.
Reflection constitutes a pivotal component of nursing, fostering continual professional advancement by examining the impact of personal practice on the quality of care provision (Kiron et al., 2017). The focal point of this reflective endeavor will be adapting communication while tending to a patient with Dementia. This particular area of practice has been singled out for scrutiny as Handley et al. (2017) underscore the escalating prevalence of patients with Dementia receiving treatment in hospital settings, attributable to an aging population and diminishing social care services. It is imperative for practitioners to tailor their approach to communication to ensure its effectiveness, especially for patients with diverse needs (Murphy and Maidens, 2016).
In adherence to the guidelines outlined by the Nursing and Midwifery Council (NMC, 2015: The Code), all identifying details of the individuals involved have been altered, and the specific location of the clinical placement has been omitted. The patient’s pseudonym has been designated as Margaret, and likewise, my mentor has been anonymized as Helen.
Description
Upon receiving the handover at the commencement of my shift, I was apprised of a forthcoming admission from the community—a new patient suspected to have a urinary tract infection (UTI) following a fall. Upon Margaret’s arrival, it was immediately apparent that she was disoriented, exhibiting signs of confusion and a lack of spatial and temporal awareness. Her demeanor was marked by verbal aggression toward transferring staff, coupled with evident distress. Handover revealed that Margaret had been diagnosed with Alzheimer’s Disease seven months prior, and the current exacerbation of symptoms was attributed to a suspected untreated UTI. To ensure comprehensive awareness among the multi-disciplinary team (MDT) regarding Margaret’s condition, the ‘Butterfly Scheme’ was implemented, symbolized by a logo at her bedside to signify her Dementia diagnosis and the potential need for adapted care.
Effective communication with patients is a cornerstone of the Nurse’s role, as Fakr-Movahedi et al. (2016) emphasize. When faced with communication barriers, practitioners must adeptly navigate and surmount them to uphold the quality of care. The adaptation of communication strategies by both Helen and me will be a focal point of this narrative, underscoring its pivotal role in delivering person-centered care.
Feelings
I must confess to feeling somewhat apprehensive upon witnessing Margaret’s pronounced disorientation upon admission to the ward. Given the reduced staffing due to sickness, I harbored concerns regarding the timely and safe care delivery, particularly considering Margaret’s evident distress and heightened need for individualized support.
However, Helen’s composed demeanor served as a source of reassurance, instilling in me a sense of confidence that I could draw from her wealth of experience in nursing patients with Dementia. Aware of her specialized interest in this domain, I was determined to provide person-centered care for Margaret. I approached the situation with eagerness, eager to glean insights into various methods of adapting communication to cater to her unique needs effectively.
Evaluation
A notable strength of this incident lies in the implementation of the Butterfly Scheme, which effectively heightened staff awareness of Margaret’s Dementia status throughout her hospitalization. This heightened awareness facilitated improved communication among staff, leading to observable adaptations in Margaret’s care to suit her needs better, underscoring the significance of transparency in care provision.
Furthermore, the proficiency and experience exhibited by Helen in adapting care for individuals with communication difficulties served as another significant strength. My exposure to Helen’s approach aligned with evidence-based, best practice guidelines and provided invaluable learning opportunities, as I am inclined to learn effectively through observation. Helen’s role modeling within the practice context was instrumental in shaping my nursing skills.
However, it was evident that staffing constraints sometimes resulted in rushed communication during ward rounds, adversely affecting Margaret’s well-being. Witnessing Margaret’s distress highlighted the imperative of refining communication approaches and underscored the importance of utilizing nonverbal communication to convey empathy and warmth. Incorporating Egan’s ‘SOLER’ principles into our interactions with Margaret, including maintaining eye contact and employing appropriate touch, proved effective in fostering a sense of comfort and reassurance.
Furthermore, it was disheartening to observe Margaret’s heightened distress when confronted with medical jargon, despite prior notification to all staff members regarding her condition. The failure of some staff to adapt their communication practices to accommodate Margaret’s needs exacerbated her unease, indicating a shortfall in providing patient-centered care.
In summary, while communication adaptations were largely effective in meeting Margaret’s needs, there were instances where improvements were warranted. The utilization of nonverbal cues significantly enriched the therapeutic relationship and alleviated Margaret’s anxiety. However, the persistence of medical jargon in communication underscored the importance of consistent adaptation to ensure optimal care delivery and patient comfort.
Analysis
The nationwide implementation of the Butterfly Scheme aligns with the NHS Improvement guidelines for Dementia assessment and improvement framework (2017), and its recognition among staff members largely facilitated improved care provision for Margaret. Early identification and transparency regarding Margaret’s Dementia status allowed for more patient-centered interactions, wherein she was granted additional time for communication and decision-making. Consequently, her involvement in care decisions increased, leading to a notable reduction in anxiety and stress. However, the failure of some staff to recognize and adapt to the Butterfly Scheme underscores the necessity for enhanced training and communication strategies within the ward setting. Fetherstonhaugh, Tarzia, and Nay (2013) stress the importance of inclusive care provision for patients with Dementia, a principle echoed in the NHS Constitution (Department of Health and Social Care, 2015).
Drawing from Bandura’s (1977) social learning theory, I recognized my propensity for vicarious learning early on, making the experience of observing Helen’s interactions with Margaret particularly beneficial. Given our shared personality traits, I naturally modeled my behavior on hers, augmenting my learning process. This insight will undoubtedly inform my approach to future placements as a student and guide my future role as a mentor as my career progresses.
Applying Egan’s (1975) ‘SOLER’ principles complemented the warm approach adopted by both Helen and me when communicating with Margaret. Therapeutic touch, as highlighted by Stonehouse (2017), proved effective in fostering trust and rapport, particularly among patients with Dementia, whose sensory perception may be altered.
However, as observed in Margaret’s case, the detrimental impact of medical jargon on the therapeutic relationship underscores the necessity of patient involvement in decision-making processes to uphold empowerment, dignity, and respect (Truglio-Londrigan and Slyer, 2018). Farrington (2011) underscores the potential intimidation caused by medical terminology, which may impede patients’ inclusion in their care provision, ultimately diminishing the quality of care. While Helen and I ensured the use of appropriate terminology tailored to Margaret’s needs, the failure of some staff members to do so resulted in significant distress for Margaret. Given her Dementia diagnosis, adapting communication strategies to suit her needs, as emphasized by Ellis and Astell (2017), is crucial for enhancing patient care quality, promoting safety, and fostering transparency between staff and patients, ensuring actions are consistently in the patient’s best interests.
Action Plan
To deepen my understanding of Dementia, I will undertake online training to gain insights into the condition and familiarize myself with best practice guidelines for caring for individuals with Dementia. This endeavor aims to enrich my practice by equipping me with the knowledge to deliver safe and person-centered care to those with complex needs. I commit to completing the online training within the next four weeks and will provide the completed certification as evidence of Continuing Professional Development, ensuring readiness for my next placement.
Additionally, to refine my Nursing skills in Dementia care, I will shadow a Specialist Alzheimer’s Disease Nurse to gain firsthand experience and insights into the condition. This opportunity will allow me to learn optimal approaches for adapting care to individual patient needs. I aim to commence this shadowing experience within three weeks of my next placement, contributing to my Continuous Assessment of Practice (CAP) document and advancing towards attaining Specialist Nurse professional learning logs.
Conclusion
Through the lens of Gibbs’ (1988) reflective cycle, I have delved into my experience of adapting communication for a patient admitted to the ward with Dementia. This exploration has underscored the criticality of effective communication as a foundational principle of the Nursing role. Moreover, tailoring communication to meet the unique needs of patients is central to providing compassionate, person-centered care, ultimately enhancing their care experience.
As our population ages, nurses increasingly encounter individuals with Dementia in bustling hospital settings. This narrative emphasizes the imperative of adapting care approaches to alleviate distress and elevate the quality of care delivery. Implementing the Butterfly Scheme offered some assistance in this scenario, but it also revealed gaps in practice adaptation among staff. This narrative unveils the intricacies of caring for individuals with communication difficulties, highlighting the considerable influence of personal attitudes and beliefs on care delivery.
Furthermore, this narrative underscores the detriment of using medical jargon when communicating with patients, particularly those with Dementia, as it can heighten confusion and distress. It also underscores the invaluable role of non-verbal communication cues in conveying information and reassuring the patient.
My initial reluctance and apprehension in assuming responsibility for Margaret’s care dissipated with Helen’s guidance. This experience has elucidated my preference for vicarious learning and reinforced the importance of replicating such experiences in future placements and as I advance in my career as a mentor to other staff members. Reflection on this experience has proven invaluable to my learning, illuminating areas for development while bolstering confidence in certain aspects of practice. I am confident that this incident showcases my ability to practice safely and effectively, prioritizing the patient’s well-being and enhancing care delivery through adaptable practice tailored to their needs.
Frequently Asked Questions about Nursing Reflective Practice Essays
What is a Nursing Reflective Practice Essay?
A Nursing Reflective Practice Essay is a written piece that explores a specific incident or experience encountered in clinical practice. It involves reflecting on one’s actions, emotions, and outcomes, with the aim of identifying strengths, weaknesses, and areas for improvement in professional practice.
Why are Nursing Reflective Practice Essays important?
Nursing Reflective Practice Essays promote self-awareness, critical thinking, and continuous professional development among nurses. They allow individuals to assess their actions, learn from experiences, and enhance their practice to provide better patient care.
What is the purpose of using reflective models in Nursing Reflective Practice Essays?
Reflective models, such as Gibbs’ Reflective Cycle or Johns’ Model of Reflection, provide frameworks for organizing thoughts and guiding the reflective process. They help nurses systematically analyze experiences, identify key learning points, and develop action plans for future practice.
How should I structure a Nursing Reflective Practice Essay?
Typically, a Nursing Reflective Practice Essay follows a structured format that includes an introduction, a description of the incident, a reflection on feelings and actions, a critical analysis, an action plan for improvement, and a conclusion. Each section should be clearly outlined to ensure coherence and clarity.
What are the benefits of writing Nursing Reflective Practice Essays?
Writing Nursing Reflective Practice Essays offers numerous benefits, including enhanced self-awareness, improved critical thinking skills, identification of learning needs, and professional growth. Additionally, it encourages nurses to evaluate their practice and strive for continuous improvement.
Can I use personal experiences in Nursing Reflective Practice Essays?
Yes, Nursing Reflective Practice Essays often involve drawing from personal experiences encountered in clinical practice. However, it’s essential to maintain confidentiality and adhere to ethical guidelines when sharing patient-related incidents.
How can Nursing Reflective Practice Essays contribute to professional development?
Nursing Reflective Practice Essays provide opportunities for nurses to reflect on their experiences, identify areas for growth, and develop strategies for improvement. By engaging in reflective practice, nurses can enhance their clinical skills, decision-making abilities, and overall competence in providing patient care.
Are there any resources or tools available to support Nursing Reflective Practice Essays?
Yes, various resources and tools are available to support Nursing Reflective Practice Essays, including reflective models, textbooks on reflective practice in nursing, online courses, and workshops offered by professional nursing organizations.
What should I do if I struggle with writing a Nursing Reflective Practice Essay?
If you encounter difficulties writing a Nursing Reflective Practice Essay, consider seeking assistance from mentors, educators, or peers. Additionally, you can access writing support services provided by academic institutions or utilize online resources for tips and guidance on reflective writing.
How can Nursing Reflective Practice Essays contribute to improving patient care?
By engaging in reflective practice and continuously evaluating their experiences, nurses can identify areas for improvement, leading to enhanced patient care outcomes. Reflective essays encourage nurses to adopt a patient-centered approach, refine communication skills, and implement evidence-based practices, ultimately contributing to a better quality of care.