This assignment will discuss proficiency from within the pre-registration clinical profile. The proficiency to be discussed shall be clause 4.1 'Personal and Professional Development'. The rationale as to why this proficiency was chosen was to reflect on a challenging situation in regards a client with personality disorder, which the author experienced during a clinical placement. The client who shall be referred to as 'Trevor,' as to protect his identity in regulation to the Nursing and Midwifery Councils (NMC) 2004 Code of Professional Conduct regarding confidentiality (clause 3.2, pp 5). To help facilitate this assignment, a reflective model (Gibbs model 1988) will be incorporated to discuss how the author has achieved the necessary level of competence during nurse training.
The rationale to why this proficiency was chosen was mainly due to reflective practice being one of the pinnacle aspects to nursing, and especially so when faced with challenging situations. By reflection the student nurse can learn from past experiences by looking intensely at what the actual situation involved and to remember how emotions, thoughts and feelings played a part in the outcome. By evaluating and analysing on these points the nurse can develop an action plan to support future clinical practice. From reflecting on clinical aspects a student nurse can make the transition to professional nurse.
Gibbs (1988) model of reflection incorporates the following: description, feelings, evaluation, analysis, conclusion and an action plan.
The model will be applied to the essay to facilitate critical thoughts, relating theory to practice where the model allows. Also appropriate legislations will be included to support the assignment. A conclusion to the essay will then be given which will discuss how reflection skills contribute to acknowledging competence and provide evidence to personal and professional development.
The primary part of Gibbs (1988) reflective cycles suggests a description of events. Whilst on placement on a busy, elderly medical ward Trevor a gentleman aged 60 years with a past medical history of personality disorders was admitted onto the ward.
A personality disorder is defined by Woods (2005) as;
"A group of disorders characterized by pathological trends in personality structure. It may show itself by lack of good judgment or poor relationships with others, accompanied by little anxiety and no personal sense of distress."
The first process in nursing was to admit Trevor onto the ward, and then assess the situation and implement care plans to assist in caring for him. His mental capacity, his level of communication and understanding, was severely limited, so my main source from which I could gain relevant information about Trevor, was by reading through his notes, mainly his 'Easy care' information ( a continuous care plan documentation which holds information e.g. next of kin, medical conditions, medications etc, Leeds Teaching hospital 2007).
I made the relevant care plans using information presented on the easy care documentation and went into the ward he was occupying to take his vital observations. After I had introduced myself to Trevor, I approached him in a non-threatening manner and explained my intentions, he started prodding me hard in the chest, shouting incoherent words, his tone was aggressive and I felt threatened. Although I understood he may have felt disorientated and confused, I did feel frightened and completely out of my depth.
I spoke to Trevor using a soft unthreatening voice as to gain his confidence in me; however this was to no avail as he continued to be aggressive. I felt a complete failure and momentarily questioned my choice of career. I tried to place myself in his situation, looking at how I would feel. I looked at reasons other than his health problem which would make him lash out, I guessed it might have been he felt...