Critical Reflective Journal Summary

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INTRODUCTION In the era of evidence based practice and knowledge-driven healthcare, nurses are constantly challenged to discover new and better ways of delivering care. Thus, journaling and reflective practice becomes an important tool in Nursing Practice. Reflective writing through keeping a journal allows nurses to become more sensitive observers and encourages enquiry which focuses on the roles as well as direction of nursing (Holly, 1987). Through this professional journal writing, I discovered the value of the reflective process. This process has changed my feelings, belief and assumption in enhancing holistic care to my patients, peers and even for my family. Atkins (1995, pp.32) supports this by saying that “reflective writing is the process of internally examining and exploring an issue of concern triggered by an experience which created and clarifies, meaning in forms of self”. I used four methods of seeing to demonstrate my level of understanding namely, literal, lateral, critical and speculative. By critically analyzing the nursing articles, I have developed a greater understanding about nursing, especially about my own practice within the nursing discipline. Reflecting on the practice based description in the professional journal which I maintained over my career, I have discovered a number of emergent themes relevant to ways of knowing and the empirical, interpretive and critical paradigms. In order to comprehensively explain and analyze my ideas, I have used headings entitled Describing, Informing, Challenging and Reconstructing. DESCRIBING I have used the tenants of Benner (1984, 2000, and 2001) to form the eclectic conceptual framework. Specifically, Benner’s work on Novice to Expert (1984) provides me useful descriptions to describe my four practice descriptions. It explained well the events, interaction, thinking, concern and feelings which I have been experience in my practice descriptions. The following practice description is extracted from my professional journal which serves as a sensible point to the many issues discussed in these articles. PRACTICE DESCRIPTION 1 Mr. Alan was a Chronic Myeloid Leukemia patient at relapsed stage. He was our regular client who always came for blood transfusion under the care of Doctor Y. Nurse M received this case. Mr Alan’s platelet count was only 600U/L. Therefore, Doctor Y requested me to insert IV (Intravenous) line for him since nurse M was a novice. I went to see Mr. Alan who knew me very well due to his frequent hospital visits. Previous experience in setting IV lines had made him confident of my work. I had successfully inserted the IV line and started infusion Normal Saline while waiting for the blood product. Upon receiving the blood product, Nurse M called me to check it. Mr. Alan was to be transfused with 4 units of platelet concentrate and 2 units of Fresh Frozen Plasma. While checking, we noticed that 2 units of platelet concentrate had expired one day prior to Mr. Alan’s admission. I immediately informed the Lab Technologist on duty about this. He told me that Mr. Alan was supposed to be admitted on the previous day for transfusion but he refused to do so. Private hospitals like ours depend on the General Hospital to obtain blood product for all in patients. The General Hospital could only supply us with two units platelet concentrate on the previous day and with an additional two units on the following days. Next, I discussed this problem with doctor Y. I strongly insisted that the act of transfusing expired platelet to patients is against medical laws. Since the cells in the platelet die after the expiry date, this does not benefit the patient and may cause other complications. Doctor Y firmly and furiously told me to proceed with the blood transfusion without any guilty conscience. Since the doctor, ordered to give. We have no choice rather than to start

Yogeswary Arumugam

the blood transfusion. I feel sorry...
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