Critical Reflection on One Nurse-Family Interaction

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Introduction
This paper describes a significant learning family interaction that occurred when I was working in a community placement as a student nurse. I would be reflecting on that family interaction and use the “One Question Question” approach and analyse how this would contribute to your learning needs and nursing practice. Critical or significant interactions can be defined as situations that make an impression or have a special meaning to an individual. The analysis of such incidents, a useful reflective technique helps us to identify professional capabilities, increase knowledge of self and improve patient care outcomes (Lian, 2001) and lead to practice that is better informed than before the reflection (Usher et al, 2001). Critical reflection on one nurse-family interaction and the impact I was in my community placement where I got an opportunity to interact with an adolescent who was Insulin Dependent Type 2 diabetes and his family. The community nurse visited for the monitoring of the BGL tests and insulin administration as he had fluctuating BGLs and he had a history of not complying with the insulin. He was admitted to hospital numerous times with episodes of hypoglycaemias and hyperglycaemias. The family were very concerned about him and were worried about his erratic lifestyle. I must say the interactions I had with this family had some impact on me and I realised my shortcomings and learning needs. I used John’s model of reflection to access, make sense of, and learn through this type of experience. My reflection involved what was I trying to achieve, why I did act as I did, what were the consequences of my actions - for the patient and family, for myself, & for people I work with. It also involved about how I felt about this experience when it was happening, how the patient felt about it, and how I know how the patient felt about it. (Johns’, 2004) This model was a guide for analysis of my critical incident family interaction or indeed general reflection on my experience and was useful for more complex decision making. Johns’ suggests that- The need for learners to be supported through their learning experience/guided reflection and that students should maintain and reflective diary. Sharing reflections on learning experiences allows for greater understanding of those experiences can be achieved than by reflection as a lone exercise. (Johns’, 2004)

Identification of three key challenges of the family interaction From the interactions with the adolescent and the family, I learnt some of the things that I hadn’t come across and needed to improve on. Some of these shortcomings were due to lack of knowledge and experience, and some were due to my emotions from the overwhelming situation. The challenges that I faced during the interaction with this family and the teenager were: * Challenge in educating the parents and adolescent about effective diabetes management due to knowledge gap. * Challenge in maintaining a therapeutic relationship with the teenager patient due to lack of exposure and their age * Unable to control my grief and acting professional thinking about the overwhelming situation of the parents. One Question Question (OQQ)

The “One Question Question” (OQQ) approach was first introduced by Dr. Lorraine M. Wright (Wright, 1989) as a tool to explore family member’s most important health care needs. The OQQ I would be asking to this family is: “What are you doing as a family including the son to control the diabetes effectively and how is the son going about it?" By asking this question I am trying to gain an insight of the parents’ awareness of their roles and responsibilities in diabetes management of their child. The answer to the OQQ will also reveal what measure they have been using to manage their son’s diabetes, and how the son is doing with his self-management of diabetes. The answer would also give some light into the compliance of the son with the diabetic management plan....
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