Monday, December 17, 2018

'Reflection in Nursing Essay\r'

'This appointee is a reflective account of events that arose for a nursing student during their first clinical placement in a community hospital. A brief exposition of reflection will be presentn, with emphasis located on communication. This reflection has been chosen to highlight the shoot for nurses to suck therapeutic communication skills, to provide holistic cargon for those diagnosed with dysphasia or speech loss and the setting of learning opportunities it has provided to ameliorate practice in this area.\r\n unaccompanied names in this text have been changed, to detect the confidentiality of the patient and early(a) healthcare professionals (NMC 2002).\r\nReflection, in this instance, is a guidance of analysing past incidents to promote learning and improve risklessty, in the delivery of health care in practice. The Gibbs reflective cycle has been chosen as a framework for reflection (see appendix 1).\r\nMr. reaching was admitted to his topical anaesthetic comm unity hospital for respite care. He has suffered multiple, swell strokes in the past, which has left him with severe disabilities. These include palsy rendering him immobile, aphasia (speech loss) and dysphagia (sw eachowing difficulties). He relies on carers for all natural activities required for daily living (Roper et al 1996) and is certain to have a pureed diet and thickened fluids.\r\nMy learn asked me to observe her alimenting Mr reaching. She had prepared my learning the workweek previously by providing literature on the crush of feeding elderly patients and discussion on safe practice for feeding patients with dysphagia.\r\nI was alarmed and unrehearsed for the physical sight of this patient, who was spit out noisily and laboriously and a thick, green stream of mucus was exuding from his mouth.\r\nI observed Mr. Comer creation fed and spy he was coughing more(prenominal) than normal during his meal, scarcely was in get uped that this was quite normal for him. I was asked to feed him the next day. When I uncovered Mr Comer’s meal he started to cough in the resembling manner that I had witnessed before, nevertheless this time he evaded all meat contact. I was feeling exceedingly anxious, only proceeded to load a spoon with his meal. His coughing increased in intensity accompanied by rapid eye blinking, turning his head out-of-door from me and throaty groans that I can nonetheless differentiate as bothered birdcall growling.\r\nI was frightened at this point and called for assistance, sentiment Mr. Comer was having most kind of seizure. I discovered very chop-chop from a nonher health carer who knew Mr. Comer well, that he was protesting lavishly about the pureed dinner I was going to give him which he dislikes immensely. On the previous day, he had standard an ordinary meal, mashed to a smooth consistency, which is what his carers provided for him at home.\r\nThis hold left me feeling very uncomfortable and misfo rtunate in my role. I tried to understand why he reacted so alarmingly by putting myself in his position. I felt anger and frustration, but more importantly the feeling of helplessness. Not being able to voice my dislike to the meal offered exacerbated the unavoidableness of hunger or thirst.\r\nAlthough this get it on was very stimulate for me and frustrating for the patient, it has highlighted the need for me to improve my communication skills. NMC (2002) outlines that we moldiness not add extra stress or discomfort to a patient by our actions and we moldiness use our professional skills to make patient’s â€Å"preferences regarding care…and the goals of the therapeutic relationshipâ€Å".\r\nSevertseen (1990) cited by Duxbury (2000) applies the termination ‘therapeutic communication’ as the dialogue amid nurse and patient to achieve goals tailored exclusively to the patients needs. In this case dialogue is used by Mr. Comer in the form of body vocabulary and noise to communicate his needs because of speech loss.\r\nNelson-Jones (1990) states that seventh cranial nerve expressions are an intrinsic way to express emotions and eye contact is one way to show interest. The dodging in eye contact displayed by Mr. Comer showed his distinct lack of interest. Compounding these factors was his facial paralysis, which do it especially difficult for me to ascertain the exact genius of his feelings.\r\nThe nurse must be the sender and more importantly the receiver of clear training. Patients with speech balk or loss have a more difficult task sending the messages they want and are sometimes unsuccessful in making themselves understood. (Arnold & group A; Boggs 1995).\r\nIt appeared to me that Mr. Comer’s cough was not only a physiological disorder caused by his condition, but a way for him to communicate, in this case, his displeasure. Critical outline of this experience has pointed to the fact that I have inadequacies i n my skills, to identify covert and overt clues provided by Mr. Comer to his needs. I had focussed too much on the presenting task to feed him, with my mind occupied on his safety due to the nature of his swallowing problems. I had not considered his other needs like his wishes or desires and I had not gathered enough personal breeding about him beforehand to know this (Davis & Fallowfield 1991).\r\nI had been unsure about what to say or do to alleviate Mr. Comer’s apparent anxieties and had choose what Watson & Wilkinson (2001) describe as the blocking technique. By continuing my actions to carry on with the meal, I was carving short the patients need to communicate a problem. I was influenced in this decision because I felt cause to be seen to reduce his anxieties, knowing my actions would be judged by an audience of other care workers and patients on the ward. I did not respond efficiently to reduce his distress and this pressure led me to deal with the situati on inadequately and for that I felt guilty (Nichols 1993).\r\nI should have allowed more time to understand what Mr. Comer was thinking and feeling by putting words to his vocal sounds and actions. I could have shown more empathy in the form of my own body language to promote agile listening (Egan 2002) and not worried about other peoples views on my decisions and beliefs to act in a way I felt comfortable with and thought was outdo for my patient.\r\nGould (1990) cited by Chauhan & Long (2000) have suggested that â€Å" some of the non verbal behaviours we use to reassure patients, such as close proximity, prolonged eye contact, clarification, validation, touch, a placid and soothing voice, the effective use of questions, paraphrasing and reflecting thoughts and feelings and summarising are all sub skills with the totality of empathy”.\r\nThere is an abundance of information about communication, especially for nurses because it is considered by many as the core compon ent to all nursing actions and interventions. deficiency of effective communication is a problem that still exists because the learning process that leads to a skilled level of ability may take years of experience to develop (Watson and Wilkinson 2001).\r\nIt has been quite difficult for me to admit my inadequacies in communication, but Rowe (1999) explains that a person must identify their weaknesses as an initiative for becoming self-aware. Only with bridal of ones self, can a person begin to concede another persons uniqueness and build upon this to provide holistic care.\r\n'

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