reflective on methods essay
This is a reflective dissertation based on my own experiences whilst on my 6 week medical placement on a haematology ward at a nearby hospital. The aim of this article is to talk about the emotional and sociological impact on the family every time a loved one passes away, and then focus on how the registered nurse supported your spouse and relatives through their particular loss. I selected this particular incident as I sensed very strongly about the care directed at this affected person shortly before her fatality, and sensed the need to think about it even more.
In order to assist with my own reflection I use chosen Gibbs (1988), while the version to help information my reflecting process (see appendix 1). This model comprises of a process in order to the individual take a look at a situation and think about all their thoughts and feelings during the time of the incident. Reflective expertise help all of us to think about might have been done, so that if a similar circumstance occurs again the experience attained can be used to manage the situation designed to promote your event (Palmer ou al 1997).
To allow me to use this situation intended for my expression the patient will probably be referred to as “Ann. This is to ensure that her real name is definitely protected and that confidentially taken care of in line with the NMC (2002) Code of Professional Conduct. Description
Ann was a fifty eight year old girl married into a very supportive husband, the lady had been recently diagnosed withmultiple myeloma with secondary renal impairment, together been getting cycles of chemotherapy. My personal mentor and I were maintaining Ann when needed concerned, her observations were within the typical limits but she continued to complain of shortness of breath. Your woman became extremely anxious and I could tell by the try looking in her eye she was frightened, and asked for me to “get someone quick as the lady could not inhale and exhale properly. I actually called my personal mentor as he was nearby who came up over and provided Ann some oxygen. Ann said to the nurse I cannot breathe and seemed more anxious and scared, the girl repeated many times that she could not inhale and each time the doctor replied very sternly and unsympathetically “you can breathe in, you happen to be talking to me. Ann was chances are clutching at my hand and asking myself not to leave her alone, We reassured her that I would stick to her given that she desired me to.
My instructor then summoned me to go to another individual nearby, thus i explained to Ann and apologised that I needed to go and reluctantly performed as I was asked by my coach. On getting back to Ann she was identified to be tachycardic and having great difficulty in breathing. The doctors thenarrived and it was recommended that her husband always be called since she was deteriorating. It had been at this time I had previous agreements and so had to leave the ward for any short time. In the return to the ward a nurse informed me that generally there had been a cardiac arrest for the ward even though I had been absent, I intuitively knew it was Ann. The girl had passed away alone, whist my instructor had been participating another sufferer. I was knowledgeable that an make an effort had been made to resuscitate her, without success, the girl was then simply pronounced dead.
Ann’s spouse and relatives were previously waiting in the relatives’ place, and so had been informed that she experienced passed away. It absolutely was the households wish to be still left alone with Ann, to allow them to say their particular farewells, these were reassured by the nurse that someone was available whenever they need organization at this incredibly emotional period. My advisor then spent a short time together with the family describing the types of procedures and supporting them with details they desired, including details on where to go to get help and support in the event that they needed and where you should obtain the fatality certificate. Emotions
On reflection of the occurrence I believed that I did not act inside the best interests of Ann, because the NMC (2002) (clause 1) claims that I was answerable for my activities and absences, regardless of suggestions or directions from an additional professional. We felt upset that I was made to keep a patient who was obviously incredibly frightened and anxious, the moment there was simply no reason for myself not to keep with her. Scrutton (1995) reephasizes this by simply stating that the support of a friendly registered nurse in stress filled situations can greatly reduce the anxiety and fear of the sufferer. I agree with this and felt that it was a disgrace that I had not been there on her and experience she would have got appreciated my own company. I am aware that healthcare professionals are occupied and have to prioritise all their work although at this present time there was no crisis that needed me to leave her. I felt angry and frustrated that when the family found view her body, the nurse engaged actually did start to show a few concern intended for Ann when ever only a short time earlier he had no time on her behalf at all. Evaluation
It was a shame that a professional registered nurse acted in the manner that this individual did, neglecting how anxious and upset she was becoming at not being able to breathe. The nurses` consideration and connection skillsseemed to get very much missing, not playing her concerns and not showing any feelingstowards her. Cooley (2000) acknowledges the requirement of most nurses to work with basic interpersonal skills, appearing warm and welcoming to patients although allocating some attention to interaction. Fallowfield and Jenkins (1999) discuss how nurses may worry about being unsure of what to claim or stating the wrong issue when conntacting dying individuals and their relatives, which can produce barriers in communication. It had been this lack of communication that led to a breakdown in the nurse-patient-relationship, with the affected person being anxious of the rns return to the bedside, and begging myself not to ditch her alone.
That was also in contravention in the NMC Code of Specialist Conduct (2002) clauses, one particular ” a couple of ” five and 7. By certainly not listening, comforting and soothing the patient, all of this added extra stressors to Ann who was already stressed and extremely scared. I feel that I will have reacted differently in this situation and been certain and assertive and stand up to my mentor and admit I would keep with Ann, while she desired me to. I could certainly not see worth it points at first in the situation on its own, however in reflection from the situation I do think it made me take a very good look inside myself and think of can certainly make money would have taken care of the situation basically were the staff nurse, once again I keep coming up with the same thoughts of how important good communication, compassion and basic nursing abilities are, becoming there to reassure someone when they are afraid or stressed, also being there to hold their side and offer some support.
Which in turn made me even more aware of my own communication abilities and how effective they are and if there is any room to get improvement, because of this reflection process and looking within just myself I possess seen a huge improvement during my nursing abilities and individual observations as well as the care I deliver. From my point of view it has been a fantastic exercise in showing me personally how not to treat patients. Analysis
Telling the family of the death of their beloved is perhaps one of the distressing and difficult acts performed by well being professions, and must be taken care of with honestly caring and sensitive way (Reed 2002). The news of Ann’s death came as a great shock to her spouse and family, even though they knew she was terminally ill these people were not psychologically prepared for her death, and thus were within a state of shock and disbelief the moment initially knowledgeable of her death. Scrutton (1995) covers how the death of a partneris the most tough losses to come to terms with and the health professional has an natural part in promoting relatives through this very emotional time. Kübler-Ross (1981) suggests that the presence of the nurse who was maintaining the patient assists the family members feel more at ease, even when the news is informed by a part of medical staff.
According to Worden (1991) individuals respond to loss in several different ways, it is common for relatives to be irritated, in disbelief or disappointed and rns need to be mindful of the differences replies to loss and offer appropriate support to the individual. Parkes (1988) theory of reduction explains the challenges involved with situations of loss, which in turn according to Worden (1991) can affect persons in an mental, physical, behavioural or mental way. Parkes (1988) suggests a process of realisation, refusal and elimination followed by thoughts of anxiety, trouble sleeping and dread. Nurses has to be fully mindful of the range of emotions and the psychological affect the loss of someone you care about can have on the relatives. The family members wanted to spend time alone with Ann to say their goodbyes, so the registered nurse ensured these people were given personal privacy to enable them to do this.
Preparing the entire body for the relatives to view before the previous offices is important (Wright 1991). Alexander ou al (1994) have pointed out the importance on this and have mentioned that the last sight of their loved one will stay in their storage of the relatives for a very long time, so it is the nurses responsibility to ensure that the appearance of the body does not disturb these people. The loss of life of Ann has also a new great sociological impact on the family, they have suffered multiple losses: this kind of being the first loss of anyone themselves, and a loss in roles and relationships the losing of the whole family unit, and finally losing hopes and dreams her husband and family experienced for their future together (Heming & Colmer 2003). Is it doesn’t nurses’ function to support the family through these 1st stages of loss, to become them demonstrating genuine proper care and consideration for the anguish and upset they can be feeling. Summary
I experienced that the approach I required was not appropriate, after all the patients demands were very important and even though I am a student, I will have served in the patients’ best interests. General I have found this very rewarding reflecting within this incident, I have already been able to discover my disadvantages that can certainly be turned into strengths. I now feel that I am a stronger person developing inconfidence and after this will ensure I actually confront my own fears of behaving against somebody in the defence of a affected person. Action Plan
Using Gibbs’s refractive cycle offers helped me make more sense of the condition and put points into point of view, recognising how i could put this kind of learning experience to positive use in my personal future practice as a Nursing jobs professional. In the event that this situation were to arise again I know I might now have the courage to question the nurses attitude at an previously stage showing that that ‘bad practice’ by anyone is certainly not acceptable. I’ve made agreements to roundel this incident, and others I am interested in to the ward manager, as it my 1st consideration to protect the pursuits and safety of individuals, in line with the NMC (2002) Code of Professional Conduct, (clause 8). This expression has pointed out the need to maximize my expertise and comprehension of the process of reduction and tremendous grief, I will addresses these issues by going to the bereavement officer intended for the trust, listening and learning from the qualified staff and by reading relevant books. Conclusion
In summary it can be noticed that the registered nurse has a very important role in supporting the patients relatives through their loss, emotionally, psychologically and a nurturing perspective. It could be seen out of this reflection that effective conversation and hearing skills will be the key to powerful care to enable nurses to aid families through their damage. Parkes (1988) model of reduction has been within understanding the emotional impact with the loss of a relative, helping nurses to support these experiencing damage, although every person will react differently it offers nurses a framework allowing them to be prepared.
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