Reflection in Nursing Essay

This assignment is a reflective draw of events that arose for a nursing student during their first clinical placement in a community hospital. A brief definition of reflection give be given, with emphasis placed on intercourse. This reflection has been chosen to foreground the need for nurses to have remedy communication skills, to provide holistic oversee for those diagnosed with dysphasia or speech loss and the scope of learning opportunities it has provided to improve normal in this area.All names in this text have been changed, to view the confidentiality of the affected role and other health sell professionals (NMC 2002).Reflection, in this instance, is a way of analysing other(prenominal) incidents to promote learning and improve safety, in the delivery of health care in practice. The Gibbs reflective cycle has been chosen as a good example for reflection (see appendix 1).Mr. arriver was admitted to his local community hospital for repose care. He has suffered mult iple, acute strokes in the past, which has left him with severe disabilities. These include paralysis rendering him immobile, aphasia (speech loss) and dysphagia (swallowing difficulties). He relies on carers for all normal activities required for workaday living (Roper et al 1996) and is advised to have a pureed diet and pachydermatous fluids.My mentor asked me to observe her laddering Mr Comer. She had prepared my learning the week previously by providing literature on the subject of feeding elderly patients and password on safe practice for feeding patients with dysphagia.I was alarmed and offhand for the physical sight of this patient, who was coughing noisily and laboriously and a thick, car park stream of mucus was exuding from his mouth.I observed Mr. Comer being federal official and noniced he was coughing more(prenominal) than normal during his meal, but was sure that this was quite normal for him. I was asked to feed him the next day. When I bring out Mr Comers meal he started to cough in the akin manner that I had witnessed before, but this time he evaded all centre contact. I was feeling extremely anxious, but proceeded to load a spoon with his meal. His coughing increased in intensity accompanied by speedy eye blinking, turning his head away from me and throaty groans that I dope only describe as distressed vocal growling.I was panicky at this point and called for assistance, thinking Mr. Comer was having some kind of seizure. I discovered very quickly from a nonher health carer who knew Mr. Comer well, that he was protesting profusely about the pureed dinner I was going to give him which he dislikes immensely. On the previous day, he had received an ordinary meal, mashed to a hushed consistency, which is what his carers provided for him at home.This cause left me feeling very uncomfortcapable and myopic in my role. I tried to understand why he reacted so alarmingly by lay myself in his position. I felt indignation and frustr ation, but more importantly the feeling of helplessness. Not being able to voice my dislike to the meal offered exacerbated the urgency of hunger or thirst.Although this experience was very frightening for me and frustrating for the patient, it has highlighted the need for me to improve my communication skills. NMC (2002) outlines that we mustiness non add extra stress or discomfort to a patient by our actions and we must use our professional skills to identify patients preferences regarding careand the goals of the therapeutic relationship.Severtseen (1990) cited by Duxbury (2000) applies the term therapeutic communication as the dialogue between nurse and patient to pass on goals tailored exclusively to the patients needs. In this case dialogue is used by Mr. Comer in the prepare of body language and noise to distribute his needs because of speech loss.Nelson-Jones (1990) states that facial mouthions are an intrinsic way to express emotions and eye contact is one way to show interest. The avoidance in eye contact displayed by Mr. Comer showed his distinct lack of interest. combining these factors was his facial paralysis, which made it especially difficult for me to ascertain the exact soulality of his feelings.The nurse must be the sender and more importantly the recipient role of clear information. Patients with speech impairment or loss have a more difficult task sending the messages they want and are sometimes unsuccessful in making themselves understood. (Arnold & Boggs 1995).It appeared to me that Mr. Comers cough was not only a physiological disorder caused by his condition, but a way for him to communicate, in this case, his displeasure. Critical analysis of this experience has pointed to the fact that I have inadequacies in 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 proble ms. I had not considered his other needs like his wishes or desires and I had not gathered enough personal information about him beforehand to have a go at it this (Davis & Fallowfield 1991).I had been unsure about what to say or do to assuage Mr. Comers apparent anxieties and had adopted what Watson & Wilkinson (2001) describe as the blockade technique. By continuing my actions to carry on with the meal, I was cutting slight the patients need to communicate a problem. I was influenced in this decision because I felt obliged 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 answer efficiently to reduce his distress and this pressure led me to deal with the smudge inadequately and for that I felt guilty (Nichols 1993).I 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 active 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 best for my patient.Gould (1990) cited by Chauhan & Long (2000) have suggested that many of the non verbal behaviours we use to reassure patients, such as close proximity, prolonged eye contact, clarification, validation, touch, a calm and comfort voice, the effective use of questions, paraphrasing and reflecting thoughts and feelings and summarising are all sub skills with the totality of empathy.thither is an abundance of information about communication, especially for nurses because it is considered by many as the core component to all nursing actions and interventions. Lack of effective communication is a problem that still exists because the learning process that leads to a clever level of ability may take years of experience to resurrect (Watson and Wilkinson 2001).It 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 toleration of ones self, can a person begin to acknowledge another persons uniqueness and build upon this to provide holistic care.