Look At A Critical Incident That Occurred In Practice Nursing Essay

timbre At A Critical Incident That Occurred In Practice nurse EssayThe aim of this report is serve at a life-sustaining accident that occurred in act and relates this to the hypothesis and k this instantledge regarding chat and inter bet-to-face admitings, so as to demonstrate an visualizeing of my views on the art and information of construction and the issues surrounding reflective trust that is to say, what skills were and were not used at the time of the incident. Confidentiality go out be maintained as required by the nurse Midwifery Council Code (NMC, 2008). There is a discussion valuate the concept of c comely both generally, and in my particular bea of hold of urgent c are. Reflection is part of reflective implement and is a skill that is veritable. It goat be seen as a instruction of adjusting to life as a qualified wellnesscare headmaster and enhancing the development of a professional identity (Atwal Jones, 2009).Reflection is defined as a proc ess of reviewing an ingest which involves description, digest and evaluation to enhance learning in practice (Rolfe et al 2001).This is support by (Fleming, 2006), who described it as a process of cerebrate thought. It enables the practitioner to critically assess self and their approach to practice. meditative practice is advocated in healthcare as a learning process that encourages self-evaluation with concomitant professional development planning (Zuzelo, 2009). Reflective practice has been identified as one of the key ways in which we can learn from our hold ups. Reflective practice can mean pickings our experiences as an initial particular for our learning and developing practice (Jasper, 2003). Many literatures be bind been written in the past that suggest the use of reflective assignments and journaling as utensils to improve reflection and thinking skills in healthcare (Chapman et al, 2008). Reflective journals are an ideal way to be actively involved in learning (Mi llinkovic Field, 2005) and can be implemented to allow practitioners to account book events and document their thoughts and actions on daily situations, and how this whitethorn affect their upcoming practice (Williams Wessel, 2004).MODELSIn show to provide a framework for methods, practices and processes for make believeing knowledge from practice there are some(prenominal) models of reflection uncommitted. All can religious service to direct individual reflection. near may be particularly useful for superficial problem solving, and some former(a) better when a deeper reflective process is required. Reflective models however are not meant to be used as a rigid unsex of questions to be answered just now to give some structure and encourage making a record of the activity. rears (2004) reflects on uncovering the knowledge behind the incident and the actions of others present. It is a good tool for thinking, exploring ideas, clarifying opinions and supports learning.Kolbs Learning Cycle (1984) is a cycle that reflects a process individuals, teams and organisations attend to and run intos their experiences and subsequently, modifies their doings.Schn (1987), however, identifies two types of reflection that can be applied in healthcare, Reflection-in-action and Reflection-on-action. Reflection-in-action can a wish well be described as thinking whilst doing. Reflection-on-action involves re ensureing experiences and only analysing them to improve skills and enhance to hereafter practice. Atkins and Murphys model of reflection (1994) dole out this idea one step upgrade and suggest that for reflection to make a real difference to practice we follow this with a commitment to action as a result.terry cloth Bortons (1970) 3 stem questionsWhat?,So What?andNow What?were developed by John Driscoll in 1994, 2000 and 2007. Driscoll matched the 3 questions to the stages of anexperiential learning cycle, and added trigger questions that can be used to compl ete the cycle.Gibbs (1988) reflective cycle is fairly straightforward and encourages a clear description of the situation, analysis of feelings, evaluation of the experience, analysis to make experience of the experience, conclusion where other options are con statusred and reflection upon experience to examine what you would do if the situation arose again.CHOSEN MODELThe reflective model that I mystify chosen to use is Gibbs Reflective Cycle (1988) as a framework, be micturate it focuses on different aspects of an experience and allows the learner to revisit the event fully. Gibbs (1988) will attend to me to explore the experience further, using a staged framework as guidance ad I feel that this is a simple model, which is sound structured and easy to use at this early stage in my course.By contemplating it thus, I am able to appreciate it and guided to where hereafter day development work is required.Before the critical incident is examined it is important to look at what a critical incident is and why it is important to nurse practice. Girot (1997), cited in Maslin-Prothero, (1997) states that critical incidents are a means of exploring a veritable situation in practice and recognising what has been intimate from the situation. Benner (1984, cited by Kacperek, 1997) argues that nurses cannot incr succour or develop their knowledge to its full potential unless they examine their own practice. background of incidentIn the scenario the forbearings name will be given as Xst. The consequences of my actions for the node will be explained and how they might have been improved, including what I learned from the experience. My feelings near the clinical skills used to manage the clients care will be established and my new understanding of the situation especially in apprisal to evidence based practice will be considered. I will finally reflect on what actions I will take in order to ensure my continued professional development and learning. Description fell Xst is 55 course of study old woman who has a 10 division old daughter. She suffers from psychiatric problems, lack of motivation and has difficulties in maintaining her individualised hygiene and the cleanliness of her flat. She was one of my wise mans clients to whom I had been assigned to coordinate and oversee her care. psychic health Nurses owe their patients a duty of care and are expected to affirm a high standard of care based on real best practise, (NMC 2008). shed Xst had been prescribed Risperidone Consta 37.5mg fortnightly, which is a moderate medication. Risperidone belongs to a assemblage of medicines called antipsychotic, which are usually used to help treat people with schizophrenic disorder and similar condition such as psychosis. Although her condition is acute, it is not uttermost(prenominal) and the reason for this medication is to help Miss Xst to stabilise her thought so she is able to support herself in the community (Healey, 2006). Miss Xst di d not same(p) attending depot clinic and she lost(p) three consecutive appointments. My mentor fixed after the third non-attendance to raise the issue in the handover meeting where it was obdurate to see Miss Xst in the morning but when we arrived she was not there. We leftover a note for her to call the office. We did not hear from her and a further home visit was carried out to arrange for her next depot clinic appointment. I called a meeting of the multi-disciplinary team (MDT) who agreed that there would be a problem if the next injections were missed. The social worker who was part of the team give tongue to that she will arrange for a community support worker to help clean Miss Xsts flat on a weekly background (Adams 2008).We waited for about an hour for Miss Xst to attend the clinic for her depot injection but she failed to attend. I then informed the Community Psychiatry Nurse (CPN) that Miss Xst had expressed negative feelings about her medication and thought she did not adopt them she had claimed she was already feeling well and therefore wanted the medications to be discontinued. At a subsequent meeting with the patient, she agreed a joint visit with the CPN and myself to re-assess her condition and consider if it was necessary to refer her case to the consultant (Barker, 2003).I was given the opportunity to poke out out the initial assessment, which headed that her behaviour was really unpredictable and very forgetful. Her inability to take her medication and to manage her personal hygiene clearly exhibit that she was not well. The assessment tool I used was the Mental State Examination which helps determine the level of her acuteness into her illness and indeed I open up out that she was in defending team (Barker, 2004).I talked to Miss Xst about her non-concordance with her medication, but she persisted in saying she was well. I reminded her that continuous use of the medication would benefit her affable health and protect her a gainst relapse. We agreed that she could discuss this with the doctor on her next outpatient appointment, with the option of reviewing or reducing her medication. I stressed the importance of her communicating any side effects or reservations she may have about the medication to doctor. She appeared to understand this and following the discussion, she finally complied with her depot injection.Even though the NMC (2008) maintains that nurses have a responsibility to empower patient in their care and to distinguish and inform risk to patient. The principle of beneficence (to do well) must be equilibrate against no maleficence (doing no harm) (Beauchamp and Childress, 2001). All these transactions were recorded in Miss Xsts care plan file and in com regulariseer. Good record keeping is an integral part of nurse and midwifery practice, and is essential to the provision of safe and effective care. It is not an optional extra to be fitted in if circumstances allow NMC (2009). The con sequences of my actions for the patient and her daughter were that she attended to her daughters urgencys and to her personal hygiene, and made regular fortnightly visits to the clinic. Her mental condition was improved, she was allowed to continue on her moderate medication and she did not have to be readmitted in the hospital. tinctureDuring the handover, I was nervous as I mat up uncomfortable about giving feedback to the whole team. I was worried about making mistakes during my handover that could triad to inappropriate care being given to Miss Xst or could cause her readmission to hospital. As a student nurse I felt I lacked the necessary experience to be passing information to a pigeonholing of qualified staff members. However, I dealt with the situation with outward calm and in a professional manner. I was very pleased that my mentor was available during the handover to offer me support and this increased my corporate trust.EvaluationWhat was good about the experience w as that I was able to carry out the initial assessment and identify what caused Miss Xst failure to comply with the discourse regime. From my assessment I put down the outcome and related what had happened to the MDT with minimal assistance. Accurate documentation of patients care and treatment should communicate to other members of the team in order to provide continuity of care (NMC, 2008). The experience has improved my colloquy skills immensely, I felt supported throughout the handover by my mentor who was constantly involved when I missed out any information. Thomas et al, (1997) explains that supervision is an important development tool for all learners. The team were very supportive throughout the process as they took my information without doubt.What was not good about the experience was the fact that my mentor had not informed me that I was going to handover the information as a result I had not mentally prepared myself for it. I also felt that I needed more time to ob serve other professionals in the team carrying out their handovers before I attempted to carry out mine. During the original MDT meeting, I felt that we did not provide adequate time to freely interact with Miss Xst to identify other psychosocial needs that could impact on her health. However, in any event, she was unable to fully sop up because of her mental state. Turley (2000) suggests that nursing staff should include their interaction with the patient when save assessment details, which can be used to provide evidence for future planning and delivery of care. Dougherty and Lister (2004) have suggested that healthcare professionals should use auditory sniff out as part of assessing patient problems, needs and resources. AnalysisThe literature regarding communication and interpersonal skills is broad and extensive. Upon reading a small amount of the vast literature available, the student was able to analyse the incident, and look at how seriously this situation was handled . I realised communication is the main key in the nursing profession as suggested by Long (1999) who states that interpersonal skills are a form of tool that is necessary for effective communication. I found it difficult to communicate with a patient because I did not understand her condition. It was also difficult for me not to take her behaviour to heart and show emotion at the time, it is clear that this is an area I need to build on for the future. However, Bulman Schutz (2008) argue that this is failure to educate and for us to learn from practice and develop thinking skills. I would agree with them, as I learn best from practical experience, and build on it to improve my skills. With this is mind, I am now going to focus on my weaknesses, in both scheme and practice, and state how, when and why I plan to improve on these.through and through effective communication I was able to convince Miss Xst of the need to take her medication. I was able to pass on the information to the MDT for continuity of care. Roger et al (2003) concluded that communication is an on-going process but can be a difficult process when dealing with mental health problems. During the handover I was pleased that the MDT members were supportive and interested in what I was saying and they asked questions.The patient had no recollection of what she had said to me and since the incident she has made these comments to other staff, which has put me at ease and made me realise that I had done aught wrong. My mentor explained that a patient with Parkinsons can often behave like this as they develop dementia, which Noble (2007) also confirms. Since the incident I have read about Parkinsons and am now aware that the patients expressionless face Netdoctor (2008), also made her comments appear more confusing and aggressive.ConclusionIn conclusion, I have learnt that through effective communication, any problem can be solved regardless of the environment, circumstances or its complexity. There fore, nurses must ensure they are effective communicators. I have identified the weaknesses that should be false to strengths. I am now working on strengthening my assertiveness, confidence and communication skills. Participating in the care of Miss Xst, I have realised that a good background information and feedback about mental health problems before providing care to a clients can assist in accurate diagnosis and progress monitoring. A good relationship surrounded by client and staff nurse is therapeutic and help in expression trust. This can be achieved by a free communication that allows the client to express their feelings and concern without the fear of intimidation. From the experience, I feel the knowledge I have acquired will aid me in future while in practice should such situation arise again.ACTION PLAN FOR MY attainment NEEDSSo that I could identify my strengths and weaknesses in both theory and practice easily, I found that the use of a SWOT analysis provided a good framework to follow. I have then built on this by producing a development plan that focuses on my weaknesses and how, when and why I plan to improve on them. I will now begin to work on these, the main reason being of course, that I am determined to be a competent, professional nurse in the future. I am now more prepared for any future patients with this disease as I have researched it. I will take the time to talk to them, to make sure they are at ease with me, before providing any care. If they appear distressed I would get other member of staff to help me to reassure them.Learning Need plan action to meet this learning needTarget time to meet the learning need.To improve my knowledge about patients illnesses and the risks of relapse associated with not takingMedication.Read books about different illnesses and causes of relapseEnd of third yearTo identify and have good background information and feedback about patients mental health problems before providing care to themTo read my patients notes.On- goingTo ensure a good rapport exist between my patient and I, in order to build up a therapeutic relationship with them and to gain their trust.I will have regular meeting with my clientOn-goingEffective communication with the patients and other members of the multidisciplinary teamA locating time to talk to patients and their relatives take part in the ward round.On-going skills to develop throughout the training.Being prepared talk with senior members of staffOn-goingCONCLUSIONI have clearly demonstrated that by using a reflective model as a guide I have been able to break down, make sense of, and learn from my experience during my placement. At the time of the incident I felt very inadequateIt was also difficult for me not to take her behaviour to heart and show emotion at the time, it is clear that this is an area I need to build on for the future. According to Bulman Schutz (2008), nursing requires effective proviso so that we can care competently, wit h knowledge and professional skills being developed over a professional lifetime. One way this can be achieved is through what Schon (1987) refers to as good rationality, where professionals are problem solvers that select technical means best suited to particular purposes. Problems are solved by applying theory and technique.REFERENCESAdams, L. (2008). Mental Health Nurses can Play a office in Physical Health. Mental Health Today. October 2008 pp27Barker, P. (2004). Assessment in psychiatric and Mental Health treat. Cheltenham, Nelson ThornesBarker, P. Ed (2003). 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