Reflection of Incident in Community Healthcare †MyAssignmenthelp

Question: Discuss about the Reflection of Incident in Community Healthcare. Answer: Introduction: Everyday the healthcare sector is changing and vastly evolving. Along with this evolution, the healthcare professionals working in this sector have to be evolved and competent. To increase the competency level in healthcare professional, reflective practices are frequently used as per the literature to directly understand the base of the problem (Chan 2013). The aim of reflective practice is to prepare the students studying to be healthcare professionals to learn acting and thinking professionally. According to the famous educator John Dewey, reflection is actually our learning by doing something (Price 2013). We can directly relate Deweys definition of reflection to our own understanding of critical thinking. We can interpret reflection as a process through which we witness somebodys experience and have a precise view on it. The most important aspect of reflective practice is that, it problematizes many situations regarding professional practice, with the purpose of making the situa tions as the potential learning situation. With reflective practice, the aspiring healthcare professionals learn and develops competency to face such problems later within their practice (Chung 2014). The purpose of the report is to discuss and demonstrate the importance of reflection in clinical settings. The report is based on an important and significant event from my own recollection of memory of the mental health community clinic I am working on as an enrolled nurse in New South Wales, Australia. The incident I am reflecting on can be used as a learning experience as it will show the significance of using therapeutic communication skills. Having a good communication skill is important for any nurse, especially for those working in a mental health sector (Palmer 2012). It helps the nurse to keep up with the professional code of ethics, which directs the nurses to maintain proper nurse-patient relationship. Description of the event: As it is the duty of a nurse to respect the confidentiality and protect the privacy of the patients and coworkers, I will not disclose the name of the patient and the colleague who are the central point of this incident. Therefore, I will address my patient as Jessica and address the male nurse as John. This incident happened six months earlier, when I started working as an EN (Enrolled Nurse) in a community care clinic. A patient named Jessica, a 51-year-old schizophrenic who also suffers from partial deafness and is aggressive came to the community center with her daughter to receive her weekly session with the doctor. The patient was visibly agitated and shouting when I saw her enter the community care. Her daughter does not live with her as her college is far from home. The patients condition with schizophrenia was worsening and with the consultation of her psychiatrist, her daughter has appointed two nurses to help her, as the patient needs special care sometimes during the night. When I went to the room, she started getting irritated and aggressive. She was shouting that she wants answer for the misbehave she went through last night. I was very surprised and told her that I would do everything on my capability to help her. After half an hour, she calmed down a little and expla ined the incident to me. She said, last night she approached the nurses to help her fight the demons she saw in her room. A male nurse named John shouted at her harshly and told her to return to her room. When she was returning to her room, she heard that John is mimicking her voice and telling the other nurse that Jessica is problematic. After knowing the incident, I gave her the allotted medication. Throughout the whole time she spent with me, she kept asking me to help her with the situation. I promised her that I would do my best to help her with that. After doing my duty with her, I went to the Nurse-in-charge and told her about the incident. I also asked the Nurse-in-charge that whether I should report the incident to the logbook or not. After having a discussion with her, we both decided to log this incident together and she told me that she would personally discuss it to the doctor, the accused nurse and the administration. That day, she informed me that, after reporting the incident to the administration, the management have show-caused the accused nurse and that can terminate the nurse. I went to the patient to inform her about the result of her plight. She looked happy and relieved. Thoughts and question: When Jessica informed me about the whole incident, I felt that, the whole situation she faced is horrific. She is a patient receiving care in the community care facility I work with and she deserved to be treated with respect. I was feeling very disappointed and angry because of the fact that some of the nurses have forgotten the basic ethics of this holistic profession. However, I reconsidered the truthfulness of the incident because I have personally known that accused nurse for a month and he seemed like a sweet person to me. I also considered the fact that the patient is partially deaf, because of that John might have spoke in a high voice to make his voice audible to her. I also considered the fact that the patient is suffering from schizophrenia and she might making this incident up in her head. I thought that if I report the incident and if the accused nurse is innocent, it might make a glitch in his career. However, I also thought that, it was very insensitive of the nurse as he dismissed the concern of the patient and did not assign anybody to come with her and help her sleep. He and the other nurse did not even try to know the reason why the patient was upset. I considered the worst possible outcome of the incident if the patient is telling the truth. I considered the fact that if the accusation is true, many of the patients with whom John would encounter with in future, may have to go through the same situation and the ultimate outcome of the incident might not be good. I was very disheartened by the possibility of the fact that the nurse mimicked her voice and called her a nuisance. Considering all the aspect I could have thought for, I decided to tell the Nurse-in-charge about the incident. The nurse-in-charge was supportive of the patient and I was happy to see that. The Nurse-in-charge communicated with me and discussed the whole incident vastly. As a newly appointed enrolled nurse, I was deeply touched by her gesture as gave equally importance to my remark about the incident and helped me to report the incident. She also told me that she would personally look into the incident. When I returned to the patient with the news about the accused nurse, who has been show caused because of that incident, the patient seemed happy. I was also happy about the fact that I could help the patient through such a situation and indirectly help the other patients as well in the process. I was feeling very relieved because of the fact that I could help her in this tough situation. I think this incident would also be a learning experience for the other nurse who was on the duty with John that day and she would think twice before behaving and communicating with the other patients such a way. Deconstruction: When Jessica confronted me aggressively, it was not a nice experience as she has a history of being aggressive and as I am new in the system, calming her down was hard for me. However, I remembered the holistic approach of nursing I learnt during my studies and was able to calm her down. When I confronted the patient, I talked to her calmly as I professionally realized how important it is to talk to the patient properly and as a nurse in a mental health clinic, I have to be keeping my patience to handle such patients. Nevertheless, I know that nursing is a tough job and being a mental health nurse is tougher. The patients, the mental health nurses handle, are very tough to be managed, so it is easy for any nurse to behave harshly with any of these patients (Bateman, and Fonagy 2012). This incident has been a learning experience for me as I learnt it is important to talk to all the patients very nicely as it might help them to calm down and may be their whole behavior would change tow ards the nurse. I think as a nurse my first priority would be, to behave nicely with everyone, the patients and the coworkers. When the patient started to describe the whole incident, which happened with her to me, I was left aback. I strongly feel that this kind of incident should not happen anywhere. The way the accused nurse reacted with the patient Jessica, left a bad effect on her mind. I feel the worst part about the incident was the other nurse has not confronted John about the situation and told him that his approach is wrong (Hansson et al. 2013). They did not show any support to the patient during that incident at night. The behavior of the accused nurse towards her was bad and he should not have told that she creates problem. I feel along with the accused nurse, the other nurse is also responsible for this situation as she enjoyed the mimicry. According to Stockwell, dealing with the difficult patient can be unsatisfactory for everyone as the inadequacies in nursing practice could worsen the situation (Boyd et al. 2014). When I decided to report the incident to the Nurse-in-charge, I was in a dilemma over the fact that the career of the nurse would be in danger if I report the incident. I thought about the fact that the patient is schizophrenic, so she could imagine the incident. The patient is also partially deaf, so the accused nurse might have talked loudly to make his own voice audible to the patient. However, I think I did the right thing by reporting this incident to the Nurse-in-charge. If I think of this incident as a student, I feel, this incident can be interpreted as the learning experience for any nursing students. As a nurse, I remembered every line of the work ethics I have to go through and I intent to remember it until the last day of my work. It was painful to see that my senior colleagues has forgotten about it and behaved badly with the patient. Reconstruction: From the incident, I can interpret that the nurses did not properly interacted with the patient, Jessica as when she approached the nurses there; they dismissed her and then mocked her. I can understand that the whole experience might be traumatic for her as a patient. I can understand the fact that the nurses might be busy and had a little time to listen to her problem, but it was unprofessional of them to dismiss her. The other nurse should have interacted with her to make her feel comfortable and understood. I was sad that I was not present at the situation during that shift. I think if I were present at this situation, I would have interacted with her in that condition to make her feel heard and needed. I was sad that she returned to her room while feeling belittled and upset. The NMBA standard for practice for enrolled nurses clearly states that the nurses have to form therapeutic relationship with the patients and have to ensure the dignity of the patient (Nursingmidwiferyboard.gov.au 2017). I remember every part of it and I would have maintain it if I was present in that situation. The accused nurse is a registered nurse, and he breached the NMBA standard for the registered nurses. The standard 6 clearly states that all the registered nurses have to provide quality and ethical care to the patient (Nursingmidwiferyboard.gov.au 2017). The accused nurse and the other ward nurses were not maintaining their ethics. The standard 2 section of the NMBA standard clearly states that the nurses have to communicate effectively with the patient and have to maintain the dignity of the patient (Nursingmidwiferyboard.gov.au 2017). In this context, the nursing team did not show any compassion to the patient. I personally feel that I have the compassion and communication skills management to handle the patient during such a condition. As I confronted the patient at her worst, and I was able to calm her down, I can now say that I have the ability to handle such situation in any condition. Ramsdale and Dale (2013) explains that if there is any patient who thinks that the nurse is not paying attention to him or her is tends to lose faith to the service the nurse provides (Ramsdale, and Dale 2013). As the nurses did not paid attention to her and mocker her, the patient became very offensive towards my care and when I entered the room of the patient in the morning, she stood up defensively and started shouting. As she used the defensive posture to make me know that, she does not believe in my care (Jin-Kyoung and Suk-Won 2015). This incident has made me understand the disability of the ward nurses to make the patient as their first priority. As I calmed her down and talked with her, she became easy. I acknowledged her situation and made her feel special by listening to her. I tried to manage the situation by showing sympathy and being genuine. I believe that all the nursing staff in this facility should work on their communication skills for providing the patients with competent care (Townsend 2014). I think the communications skills should be developed for the fact that only a few of the healthcare professionals cannot maintain the quality of nursing of the complete healthcare facility. Evaluation: When I was talking with the nurse- in-charge about the patient, I came to know that the patient is receiving her treatment and counseling sessions here for only a few weeks and the nurses were assigned to continue their service at her home during the same time. I could understand that the patients problem from inside. She was alone, far away from her primary caregiver, her daughter. Moreover, she is still not comfortable with the nurses as well. The main reason of her being unheard by the other staff nurses is only the communication gap (Kourkouta, and Papathanasiou 2014) (Neese 2015). With this scenario, I came to understand about the importance of communication in nursing practice. I also understood the huge effect communication could imply to the capability of practice of a nurse as the patient rejected my presence at first she saw me. I also saw that the patient calmed down promptly when she saw that I am communicating properly with her. We, as nurses have to understand that the time, commitment of a patient is valuable, and we cannot waste it. As the NMBA standard tells us, every patient is different and has different beliefs and we need to understand it and respect it (Hemsley, Balandin and Worrall 2012). Although, in this case, the patient is schizophrenic, but the nurses should understand the fact that she is alone from home and family. Due to her schizophrenia, she is imagining demons in her room. It was among the duty of the nurses to go with her and comfort her. By communicating with her, they could have understood her problem (Bach and Grant 2015). Interacting with someone may be hard for some people but as a nurse, we have to understand the fact that, proper communication is the only way to improve our skills (Riley 2015). After the interaction with her, I have realized that Jessica has been being neglected by the nurses. According to Leadbetter and Patterson, the nurses can manage someones aggressiveness by showing empathy to the patients (Kirsebo m, Wadensten, and Hedstrm 2013). John, the accused nurse and the other nurse who were at her service did not show any respect and empathy to the patient. From this incident, I think the all the nurses in my facility should learn about the ethics related to nursing and should learn the importance of communication. They should not forget that, it is the nurses who works as a channel between the doctors, the patient and the family of the patients. Therefore, it is important that the nurses should learn how to communicate properly (Corrigan, Druss, and Perlick 2014). From this reflection, one can understand that, breaking down a communication is too easy to happen (Happell, and Gaskin 2013). As a nurse, we need to interact with people like the patients, the other nurses and the family of the patient (McCabe, and Timmins 2013). From this incident, we can learn about the effectiveness of communication. After facing Jessica, I have gained confidence about my ability to handle such a patient. When I went to the nurse-in-charge, I was pleased with her attitude as she took an immediate action for this incident. I was glad that there are a few nurses, who are still holding the holistic flag of this profession according to ethics. This type of from two registered nurses is not expected, but this incident can be a learning experience for the student nurses. Conclusion: According to Taylor, when an event is detailed, analyzed, reconstructed, deconstructed and then evaluated, all the unpicked small action is considered (Shinnick, and Woo 2013). It deliberately increases someones ability of thinking critically, which ensures safe practice for the healthcare professionals (Kong et al. 2014). The main aim of the case study was to know the importance of showing proper communication to the patient with the broader purpose of knowing the proper way of thinking critically and acting professionally (Walfish et al. 2012). I would never forget the learning I have acquired from this case study and would carry forward the learning through my nursing career. From now on, I would be more aware of the communication process when I am interacting with others and I would like to incorporate my learning to the other team members for better healthcare outcome of this facility. As the mental patients suffer a lot because of their problem, Jessica has been through hell as the incident was mentally traumatic for her. The community care facility nurses present in that interaction should have thought about that. 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