Critical Incident - Preconceived Ideas

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No names are used in this writing to maintain patient confidentiality and conform to the data protection act 1998Critical incidents originated in the United States, Colonel John C Flannagan was a psychologist who worked closely with the Air Force and their procedures for reporting evidence concerning effective or ineffective behaviour within different situations (Ghaye 2006:64-65). Tripp (1993: 24-25) claims that “critical incidents appear to be ‘typical’ rather than critical at first sight, but are rendered critical through analysis”. Critical incidents can be either positive or negative; They “are usually experiences that make you consider the events that have happened to try to give them some sort of meaning” (Hannigan, 2001). Using a critical incident as a way of reflecting helps individuals identify practice that has been helpful or unhelpful in a situation. The value of a critical incident can differ from person to person; it is usually a personal experience with meaning to an individual, however critical incidents can be useful for a range of people for example, students, lecturers, service users and the general public. They give an insight into the feelings of the person writing and are often relatable to others.In appendix 1 I have described my critical incident. Following this I will explain the importance of a critical incident and the effect on practice, in particular how it has influenced my practice as a student nurse. This experience has greatly influenced my training in a number of ways. As a student nurse I believe it is hard to avoid having a preconceived judgement of a patient. After receiving a brief description of the patient’s diagnosis from my mentor, I believed this patient would possibly be frail and sedentary, laid in bed with a poor quality of life. However what I was greeted with was the total opposite. This is affected by the patient’s own judgement of her illness, often receiving a prognosis such as this prompts a dramatic change in the patient’s lifestyle. It can be argued that this is the hardest part in ‘accepting’ a diagnosis is the need to change. ‘In accessing readiness to change, we need to look at the individual’s state’ (Broome 1998:31). If a particular patient is not ready to adapt their lifestyle it can become difficult for them to come to terms with their diagnosis. Patients unable to come to terms with their diagnosis or patients finding their illness difficult after a period of time are likely to suffer from depression or anxiety (Reid, et al 2011). However upon visiting this patient it was clear to me that this patient was able to accept her diagnosis and had readily accepted the challenge to adapt her lifestyle. To me this seemed like a phenomenal act for her to achieve in such a short space of time following the diagnosis. Communication is a key aspect of any type of care, in particular terminal care as the patient in question is likely to feel scared and anxious about their prognosis. There are a number of different reasons for this;“Including diagnosis and treatment of their disease, long-term physiological alterations, fears of relapse and death, dependence on caregivers, survivor guilt and negative effects on families”. (Groenwald et al 1992: 580)Communication should be an equal conversation that allows both the nurse and patient to include what they need to say. For a nurse it is important to listen to a patient as developing a therapeutic relationship will often make the patient feel more open to discussion about their feelings and concerns. The therapeutic relationship facilitates the ability for a patient to achieve their desired state of maximum health (Brooker, and Waugh, 2007:236; Kozier, et al 2012:95-97) Patients should be able to “freely express their beliefs, values and concerns in a non-judgemental and supportive way” (Barker 2010:31). A therapeutic relationship is essential in developing trust between a patient and nurse and is fundamental for care with service...
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