N8002 Reflective Journal Assessment Answer

Introduction

Reflective practices are an important requirement for personal and professional career development. It helps in getting an idea of what is the scope of practice and how improvement can be done. In nursing, clinical situations and incidents serve best for the reflection on the experience (James et al., 2020). To reflect on a particular clinical situation, various models will be used as Gibb's model of reflection. It is one of the recommended nursing models that is guided by the six stages. The six stages are description, feelings, evaluation, analysis, conclusion and action. The reflective paper will be discussing the clinical learning experience with the application of the Gibbs reflective cycle.

Description

In my nursing placement, I have encountered several clinical incidents that are making me learn about various factors. Three clinical situations that are major contributors to my nursing experience have been reflected. In my initial days, when I was assigned to a patient I provided an incorrect dose. The second incident was in my nursing placement. I encountered the following situation where I had to apply my knowledge to address the requirements of the case. On a busy day in a nursing setting, we are assigned to a patient in the wound care department. I and my fellow nurses were involved in the care of patients for whom we have to perform the dressing. I knew that the patient was sensitive to certain medications but I hadn't informed my fellow nurse (Philip et al., 2019). I got busy with some other task and she applied that medication to the wound and performed the dressing. When we were leaving the ward she informed me about the dressing and used medication (Cole et al., 2019). I was also involved in such an incident when the handover was made to the night shift. Following are three clinical situations that open up the door to learning.

Feelings

I was feeling very terrible and scared as this is my role to inform my fellow nurse about the medication and what prevention needs to be considered. When the nurse informed me, I felt that it was too late to consult anyone about how it can be mended. But as a nurse, it is my responsibility to provide the best care to the patient as benefits and harm depend on the practices given. Firstly, I was nervous about how I will be informing my RN about this. Addressing the educational needs of patients, family and significant others is my role. In the wound care situation and medication error incident, I have to ensure my practices (Chaboyer et al., 2021). As a nurse, I think that three aspects that hold the highest importance are the educational needs of patients, families and significant others, functioning as a nurse in a multidisciplinary healthcare team and ethical dilemmas. In the first two incidents, I have to educate myself and others that manage the error in my practices. If I successfully educate myself and my fellow nurse she will not make such a mistake that makes me nervous. What makes me terrified and fearful is that I come across an ethical dilemma where I have to take steps according to the code of conduct (Karaca & Durna 2019). When I come across such a situation, I become emotionally stressed, which makes me unable to take the decision. 

Evaluation

My evaluation of my practices states that my clinical situation as a novice nurse, in medication error and wound care can be managed. For management, I have to ensure that education for patients and their families is met. In the first case, if the patient is knowing about the dose and medication it will be crucial to give the education that is allowing the patient to check whether the correct medication dosage is provided or not (Kim et al., 2019). I found that in this case meeting the educational needs of the patient is a must that reduces the intensity of error. Second, functioning in a multidisciplinary team would require information and communication skills to be implemented within the team. It will help in the transmission of information that leads to errors being managed. For instance, in wound management, the error occurred due to miscommunication that needed to be resolved to manage the need of the patient (Rossi et al., 2023). Lastly, an ethical dilemma is caused due to which nurses' handover is not done in the right manner. It results in the administration of the wrong medication dosage that leads to harmful side effects for the patient.

Analysis:

According to the analysis, the error can be managed with the appropriate practices that are ensuring the implementation of nursing standards. Firstly, education of the patient and family is the first thing that is allowing the meeting of the need for self-care and providing the standards in hospitalization and outpatient visits. The second is about functioning in a multidisciplinary healthcare team that requires communication and leadership skills to be implemented (Höglander et al., 2023). It will bring a group of healthcare professionals together from different fields to determine the treatment for the patient and design a suitable plan. The positive influence will be seen in terms of collaborative practices that are bringing the nurses together to meet the goals of the patient. Clear communication makes the transfer of information to the nurses and within the patient. It will help the co-nurses to get clear insights about the goals and strategies by which the safe practices are going to meet. Competent leadership skills that are allowing nurses to solve the problem at the self-level and team levels. Lastly, an ethical dilemma is a situation where the nurse decides the competing values in various situations (Haahr et al., 2020). A nurse holds the responsibility to provide ethical and legal practices to the patient that eliminate the chances of consequences. According to my analysis, it is important to take care of the education of the patient and their families. This is the first theme that nurses have to provide to meet the standard. Second is communication by which a multidisciplinary team working can be obtained to work together and meet nursing standards in healthcare settings (Albert et al., 2020). Lastly, working in such a manner that ethical dilemmas can be overcome makes compliance with the standards of nursing practices.

Conclusion:

In conclusion, I found that I have to be a little bit alert and work with consciousness. It helps me to focus and eliminate such situations that I encountered recently. I have to ensure that my patient is well versed in what kind of practices, and medication is provided to them. It helps them to be active while treatment is provided to them. In addition, it will make the patient get involved in the self-care practices that are much needed for the self-care practices. I have to assure that I am communicating with my other team members so that they will be aware of the practices. It makes them aware of the conditions of the patient and can make the right decision for the patient. To meet the standard of nurses, I have to bring the leadership skills in my practices that make me able to deal with such situations as wrong dressing and taking the wrong medication. Lastly, I have to reflect on a timely basis. That is my practice according to the ethics and legal aspects. It will be helping me to adhere to the standard of nurses in healthcare practices. Last, it allows me to meet the basic minimal necessity of a nurse.

Action plan:

With the above incidents, I found three scopes of improvement that are eliminating the medication error, wound care and handing over to other nurses. My action plan will involve the following components that help me to improve my practices:

Involvement of patients, families and carers in the delivery of care and designing of the treatment plan. It will be increasing the chances of recovery in the healthcare settings that are making the quality of care to be provided. In addition, it promotes self-care among patients by creating an awareness of the side effects of drugs and so on.

Working in a multidisciplinary team: I found that when I and my co-nurse were placed in the wound care department; an error occurred. The reason for the error is that I did not inform the nurse about what is happening with the patient and what the patient. It becomes the point of error that makes the nurse apply the wrong medication. In any case, if I communicated with a fellow nurse it would be easy to provide the practices and overcome such mistakes. So, I found that communication needed to improve on my end.

Gaining knowledge about ethical concepts helps me to overcome ethical dilemmas. It can be done by applying the nursing standards in practice. The positive influence will be seen in terms of working with the ethical and legal aspects of the nursing practice. Altogether, the areas of improvement will make the nursing practice to get elevated.

References

Albert, J. S., Younas, A., & Sana, S. (2020). Nursing students' ethical dilemmas regarding patient care: An integrative review. Nurse education today , 88 , 104389. https://doi.org/10.1016/j.nedt.2020.104389

Chaboyer, W., Harbeck, E., Lee, B. O., & Grealish, L. (2021). Missed nursing care: An overview of reviews. The Kaohsiung Journal of medical sciences , 37 (2), 82-91.https://doi.org/10.1002/kjm2.12308

Cole, E., Wu, M., Cheng-Boivin, O., Sarah, L., & Sylvain, B. (2019). Interprofessional communication in the operating room: a narrative review to advance research and practice. Canadian Journal of Anesthesia , 66 (10), 1251-1260. https://doi.org/ 10.1007/s12630-019-01413-9

Haahr, A., Norlyk, A., Martinsen, B., & Dreyer, P. (2020). Nurse's experiences of ethical dilemmas: A review. Nursing ethics , 27 (1), 258-272.https://doi.org/10.1177/0969733019832941

Höglander, J., Holmström, I. K., Lövenmark, A., Van Dulmen, S., Eide, H., & Sundler, A. J. (2023). Registered nurse–patient communication research: An integrative review for future directions in nursing research. Journal of Advanced Nursing , 79 (2), 539-562. https://doi.org/10.1111/jan.15548

James, S., McInnes, S., Halcomb, E., & Desborough, J. (2020). Lifestyle risk factor communication by nurses in general practice: Understanding the interactional elements. Journal of Advanced Nursing , 76 (1), 234-242.https://doi.org/10.1111/jan.14221

Karaca, A., & Durna, Z. (2019). Patient satisfaction with the quality of nursing care. Nursing Open , 6 (2), 535-545.https://doi.org/10.1002/nop2.237

Kim, Y. M., Yoon, Y. S., Hong, H. C., & Min, A. (2019). Effects of a patient safety course using a flipped classroom approach among undergraduate nursing students: A quasi-experimental study. Nurse Education Today , 79 , 180-187. https://doi.org/10.1016/j.nedt.2019.05.033

Philip, S., Woodward‐Kron, R., & Manias, E. (2019). Overseas qualified nurses’ communication with other nurses and health professionals: An observational study. Journal of Clinical Nursing , 28 (19-20), 3505-3521. https://doi.org/10.1111/jocn.14942

Rossi, L., Butler, S., Coakley, A., & Flanagan, J. (2023). Nursing knowledge captured in electronic health records. International Journal of Nursing Knowledge , 34 (1), 72-84. https://doi.org/10.1111/2047-3095.12365

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