Reflective on practices Essay

This is a considerive examine based on my experiences whilst on my 6 week medical placement on a haematology defend at a local hospital. The aim of this quiz is to discuss the psychological and sociological concussion on the family when a love ace dies, and whence focus on how the take countenanceed the conserve and relatives by and through their outrage. I chose this particular incident as I felt in reality strongly rough the c ar given to this tolerant briefly before her death, and felt the collect to reflect on it further. In order to dish up me with my grammatical construction I cast chosen Gibbs (1988), as the example to help pick out my reflective share ( forecast appendix 1). This model comprises of a process that helps the individual timbre at a event and stand for rough their thoughts and feelings at the m of the incident. contemplative sk grue roughlys help us to conceptualise about what could lease been done, so that if a correspondi ng land site occurs again the experience gained evoke be put ond to deal with the office in a professional air (Palmer et al 1997). To en adequate to(p) me to use this situation for my reflection the patient will be referred to as Ann. This is in order that her existent name is protected and that confident(p)i whollyy retained in situation with the NMC (2002) Code of master copy Conduct. DescriptionAnn was a 58 category old lady married to a precise loving conserve, she had been preliminaryly diagnosed with quaternary myeloma with secondary renal impairment, and had been receiving rungs of chemotherapy. My learn and I were face subsequently Ann on the day interested, her observations were in spite of eruptance the normal limits but she continued to remonstrate of shortness of breath. She became rattling anxious and I could tell by the look in her eyes she was frightened, and asked for me to get individual immediate as she could non come about properly. I c alled my mentor as he was nearby who came over and gave Ann some oxygen. Ann said to the shield I abidet breathe and seemed even more anxious and s anxietyd, she repeat several times that she could non breathe and separately time the go down on replied very sternly and unsympathetically you terminate breathe, you are talking to me. Ann was by instantaneously clutching at my excrete and asking me non to pull out her alone, I reassured her that I would persevere with her as pertinacious as she treasured me to.My mentor then summoned me to attend some other patient nearby, so I explained to Ann and apologised that I had to go and reluctantly did as I was asked by my mentor. On re trolling to Ann she was lay d throw to be tachycardic and having great embarrassingy in breathing. The doctors thenarrived and it was suggested that her husband be called as she was deteriorating. It was at this time I had previous ar ordinatements and so had to forsake the ward for a short time. On my return to the ward a nurse informed me that in that location had been a cardiac arrest on the ward whilst I had been gone, I instinctively knew it was Ann. She had died alone, whist my mentor had been attending some other patient. I was informed that an attempt had been do to resuscitate her, without success, she was then pronounced dead.Anns husband and family were already waiting in the relatives room, and so were informed that she had passed a stylus. It was the families wish to be left alone with Ann, to allow them to avow their farewells, they were reassured by the nurse that someone was available should they command company at this very emotional time. My mentor then spent a short time with the family explaining the procedures and helping them with any information they wanted, including detail on where to go for help and leap out if they needed and where to obtain the death certificate. FeelingsOn reflection of the incident I felt that I did not act in the best interests of Ann, as the NMC (2002) (clause 1) states that I am answerable for my actions and omissions, regardless of advice or directions from another(prenominal) professional. I felt angry that I was do to leave a patient who was obviously very frightened and anxious, when in that respect was no reason for me not to occlusion with her. Scrutton (1995) reinforces this by stating that the support of a pally nurse in stressful situations after part greatly reduce the anxiety and worry of the patient. I agree with this and felt that it was a shame that I was not thither for her and feel she would construct appreciated my company. I understand that nurses are busy and swallow to prioritise their work but at this present time there was no urgent situation that required me to leave her. I felt angry and roiled that when the family came to view her body, the nurse involved actually started to show some concern for Ann when solely a short time former he had no time for her at all. EvaluationIt was a shame that a professional nurse acted in the way that he did, ignoring how anxious and upset she was worthy at not world able to breathe. The nurses compassion and colloquy skillsseemed to be very much lacking, not listening to her concerns and not present any feelingstowards her. Cooley (2000) ack at one timeledges the requirement of all nurses to use basic interpersonal skills, to appear warm and wel attack to patients whilst allocating time and maintenance to communication. Fallowfield and Jenkins (1999) discuss how nurses can worry about not knowing what to say or saying the wrong thing when communicating with dying patients and their relatives, which can create barriers in communication. It was this lack of communication that led to a breakdown in the nurse-patient-relationship, with the patient being fearful of the nurses return to the bedside, and begging me not to leave her alone.Which was in addition in difference of opinion of the NMC Cod e of Professional Conduct (2002) clauses, 1 2 5 and 7. By not listening, reassuring and comforting the patient, all of this added tautological stressors to Ann who was already anxious and extremely scared. I feel that I should have play offed other than in this situation and been more confident and assertive and stand up to my mentor and say that I would stay with Ann, as she wanted me to. I could not see any penny-pinching points at inaugural in the situation itself, however on reflection of the situation I think it made me take a profound look inside myself and think of how I would have handled the situation if I were the rung nurse, again I keep coming up with the same thoughts of how serious good communication, compassion and basic nursing skills are, being there to reassure a patient when they are scared or anxious, also being there to hold their hand and tender some support.Which in turn made me more aware of my own communication skills and how effective they are an d if there is any room for utility, due to this reflection process and looking within myself I have seen a vast improvement in my nursing skills and patient observations and the care I deliver. From my point of view it has been a good exercise in display me how not to treat patients. Analysis making known the relatives of the death of their loved one is possibly one of the most distressing and gruelling acts performed by health professions, and must(prenominal) be handled with genuinely caring and sensitive panache (Reed 2002). The news of Anns death came as a great traumatize to her husband and relatives, even though they knew she was terminally ill they were not mentally prepared for her death, and so were in a state of shock and disbelief when initially informed of her death. Scrutton (1995) discusses how the death of a partneris the most difficult injusticees to come to terms with and the nurse has an important role in reenforcement relatives through this very emotional time. Kbler-Ross (1981) suggests that the presence of the nurse who was looking after the patient helps the family feel more at ease, even when the news is told by a member of medical stave.According to Worden (1991) individuals react to release in a physique of different ways, it is common for relatives to be angry, in disbelief or frustrated and nurses need to be aware of the differences responses to handout and offer appropriate support to the individual. Parkes (1988) theory of loss explains the challenges involved in situations of loss, which according to Worden (1991) can affect individuals in an emotional, physical, behavioural or psychological way. Parkes (1988) suggests a process of realisation, defence mechanism and avoidance followed by feelings of anxiety, restlessness and fear. Nurses must be fully aware of the range of emotions and the psychological affect the loss of a loved one can have on the family. The relatives wanted to spend some time alone with Ann to say their goodbyes, so the nurse ensured they were given privacy to modify them to do this.Preparing the body for the relatives to see before the last offices is very important (Wright 1991). black lovage et al (1994) have highlighted the importance of this and have stated that the last sight of their loved one will remain in their memory of the relatives for a very long time, so it is the nurses responsibility to ensure that the appearing of the body does not disturb them. The death of Ann has also had a great sociological impact on the family, they have suffered multiple losses this being the initial loss of the person themselves, and a loss of roles and relationships the loss of the whole family unit, and finally the loss of hopes and dreams her husband and family had for their future together (Heming & Colmer 2003). It is the nurses role to support the family through these first arranges of loss, to listen to them showing genuine care and compassion for the badgering and upset they are feeling. decisivenessI felt that the approach I took was not correct, after all the patients needs were predominant and although I am a student, I should have acted in the patients best interests. overall I have found it very rewarding reflecting on this incident, I have been able to identify my weaknesses that can now be turned into strengths. I now feel that I am a stronger person growing in cartel and now will ensure I confront my fears of acting against someone in the defence of a patient. Action pictureUsing Gibbss reflective cycle has helped me make more sense of the situation and launch things into perspective, recognising how I can put this learning experience to positive use in my future practice as a Nursing professional. If this situation were to hook again I know I would now have the courage to interrogative mood the nurses attitude at an earlier stage pointing out that bad practice by anyone is not acceptable. I have made arrangements to discus this incid ent, and others I am concerned with to the ward manager, as it my first consideration to protect the interests and safety of patients, in line with the NMC (2002) Code of Professional Conduct, (clause 8). This reflection has highlighted the need to increase my knowledge and understanding of the process of loss and grief, I will address these issues by visiting the bereavement ships officer for the trust, listening and learning from the qualified staff and by reading relevant literature. ConclusionIn conclusion it can be seen that the nurse has a very important role in supporting the patients relatives through their loss, emotionally, psychologically and a caring perspective. It can be seen from this reflection that effective communication and listening skills are the key to effective care to enable nurses to support families through their loss. Parkes (1988) model of loss has been useful in understanding the psychological impact of the loss of a family member, helping nurses to su pport those experiencing loss, although each person will react otherwise it gives nurses a framework enabling them to be more prepared.