Critical Incident

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The reason for this essay is to reflect on a critical incident that took place during my three week placement as a student nurse at Foster ward in Ankaful Psychiatric Hospital. The incident chosen is on language barrier in communication. This incident has made an impact on me due to the fact that effective communication is key to patient health outcomes and language has influence on effective communication. . There are various reflective models written by various theorists and they include:

Atkins and Murphy (1993)
Stephen (1993)
Johns (1988)
Gibbs (1988)
For this critical incident the model I have chosen to use is Gibbs (1988) reflective model as a guide because it is more understandable and will reflects more clearly on this critical incident. It is widely known that experience alone is not adequate enough to guarantee that any learning takes place. So it is important that integration of past experience with new experience occurs. This is done through the process of reflection. (Kilty 1983, Kolb 1984). The Gibbs reflective model will help me improve on my reflective skills to identify or create further strengths as a student nurse or in my own further studies. For the sake of confidentiality, pseudonyms shall be used. The patient shall be called MB. The critical incident technique was developed during World War II by john Flanagan then head of aviation psychology programme. The technique has been further developed since the 1950’s. It has become widely used as an action oriented assessment method today; it is recognized as an effective exploratory and investigative tool (Raphata h, Marc S, 2006). According to Sera (2010) critical incident at the individual level can be events or circumstances that made one stop and think, perhaps revisit one’s assumptions or impacted one’s personal and professional learning. At the collective level, it can be a systematic problem from organizational adaptive or an issue arising from differences among stake holders. In short an incident can be defined as critical. When the action(s) taken contributed to an effective or an ineffective outcome (Oliver Serra, 2010). To be self aware is to be conscious of one’s character, including beliefs, values, qualities, strengths and limitation. It is about knowing oneself (Burnard, 1992). Through reflection you develop skills in being able to watch yourself in action, during the course of your work, noticing the nature of interactions and their outcomes. Reflection is an important human activity in which people recaptures their experience, one may also reflect on practice while one is on the midst of it. This process involves both reflections in action, and reflection in practice (john freshwater, 1998). Schon states that reflection in action consists of on the spot surfacing. Criticizing and testing of initiative understanding of experienced phenomenon (Schon, 1983).P241. Reflective learning involves assessment and reassessment of assumption and critical reflection occurs whenever underlying premises are being questioned (Williams, 2001).P.29. Gibbs reflective model (1988) would be illustrated under the following six headings 1. Description – what happened?

2. Feelings - what were you feeling?
3. Evaluation- what was good or bad about the experience? 4. Analysis- what sense can be made of the situation?
5. Conclusion- what else could you have done?
6. Action plan- if the situation arises again what would you do.

The first part of Gibbs (1988) model of reflective practice requires the nurse to describe the events that occurred. This incident happened at foster ward in Ankaful psychiatric hospital. The client, who is an Ivorian, was admitted to the ward on the 8th of February 2011, with the diagnosis of schizophrenia. He was having cellulites on the right foot. He does not understand any Ghanaian language he only speaks French fluently and understands a few words in English. In...
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