Reflection of a Forensic Nursing Placement

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Using no more than 2000 words reflect on your experience of working in this placement area. You should consider what you have learned about the specific practice area, for example whether it is forensic, community nursing speciality, what you have learned about yourself and the complexity of the Learning Disability nurse’s role within it. You are expected to apply a reflective framework of your choice and support your reflection with appropriate references.

This piece of reflection will focus on my experiences whilst on practice placement; I will be using the (Gibbs 1988, cited in Jasper 2003) model of reflection. Gibbs cycle is set out in order of categories made up of different headings (See appendix 1). By using this cycle it allows me to reflect in structured and effective way. The subject of this reflection will cover the development and utilisation of interpersonal skills in order to establish and maintain therapeutic relationships in a forensic setting.

Neal (2003) states a therapeutic relationship can be described as being between nurse and patient and is based on patients’ needs for care assistance and guidance. It is a relationship that is established solely to meet the patient’s needs and is, therefore, therapeutic in nature. Chambers et al (2005) suggest that interpersonal and therapeutic relationships are at the centre of nursing work. The relationship that exists between nurse and patient can often provide the energy and be the catalyst, the motivation and the source of strength to continue with treatment or face difficult and sometimes threatening situations. On placement, I felt the need to develop therapeutic relationships with the patients so that they could feel they could put their trust in me and realise that I was there to listen and talk to them. There is also a need of good interpersonal skills when forming a therapeutic relationship. Cutcliff (2005) states that you can gain comfort from drawing on your interpersonal skills such as having strength and endurance, feeling self-confident and brave, having sufficient competence, feeling independent, being at peace and ease with oneself and also having a sense of being valued and useful.

In my placement, all the patients had been sectioned under the Mental Health Act (2007) albeit for different offences. I had the opportunity to get involved in the admission of one patient, writing his care plans at the beginning of his treatment pathway and planning for his overall care during his time in hospital up to his discharge. When I first started on the unit, I was a little bit concerned when meeting the patients as I was aware of the generalised behaviour which can be exhibited (from a previous placement on a different unit) when faced with someone new on the unit. I knew this was something I needed to overcome and as I started to settle in and understand the routine of the unit, the easier it became. Freshwater et al (2005) suggest that the nurse/patient relationship can be viewed as a major therapeutic tool of effective patient care. According to McHugh-Schuster (2000), communication plays an important role in the therapeutic relationship. Clark & Bridge (1998) indicate that forms of communication such as asking questions, allowing patients to express their feelings, or reassuring patients by means of touch will also result in important patient care, and increase patient satisfaction and well-being. Nichols (cited in McQueen 2000) also suggests that the nurse is the central figure in the patient care and is best placed to provide much of the psychological care which demands good interpersonal skills to form a therapeutic relationship with patients and to communicate more effectively with relatives and other health professionals.

Communication covers a wide range of things including touch and enthusiasm. Touch is important as it showed that I was listening to the patients, it can mean different things and it is a silent language of...
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