Reflective Practice

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Reflective practice in nursing is considered an important aspect to nursing. Durgahee ( 1997) defines reflective practice as a process of learning and teaching professional maturity through the critical analysis of experience, whilst John ( 2009) up to date explanation of reflection is learning through our everyday experience towards realising one vision of desirable practice as a lived reality.

Portfolio entry one
Practice placement reflection

Whilst there are many notion for reflection the main goal is for health professionals to learn, grow and develop through practice. There are a number of models of reflection to help engage in the process of reflection. In this entry I would be using the Driscoll framework of reflection (1984) to reflect on an experience I had on placement.

The patient that I am basing my reflective experience is a woman in her 40s who is suffering from personality disorder. The Diagnostic and statistical manual of mental disorders (DSM-IV ) 1994 defines a personality disorder as an enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible. People with personality disorders usually make it difficult to form friends and may feel alienated and alone (Gormon 2007).

What

Upon entering the patients house she maintained eye contact, her speech was coherent she maintained rapport although tearful at times. There was no evidence of threatening behaviour towards the team

On the 14/1/10 I attended the patient home address with the doctor and a community practice nurse (CPN), the patient was distressed as she was upset with the number of people who was entering her house and the fact that we turned up late. Upon entering the CPN spoke to the patient about her low mood .She complained about the team not informing her that a doctor and student nurse would be attending the visit. As she said she could have made her home more presentable .Ignoring what the patient said the CPN asked the patient about her medication and what she does in her spare time. The patient wanted to talk to the CPN a bit more about her mood and the medication that she was taking however within 10mins of sitting down with the patient the CPN decided that we should go even though the patient wanted to talk more. I felt that we should have listened more to what the patient has to say and I felt that the visit was rushed because it was around lunch time , however I did not say anything to the CPN I attended the visit with. I waited until I got to the office until I mentioned anything to the CPN. Back at the office the CPN and I were informed that the patient had called to complain about us arriving late and leaving very quickly. When we were informed that the patient called the doctor and CPN that I attended the patient with just brushed it of. I probed the team about this patient and I was told by another team member that that her home is always untidy and that she constantly calls the office just to talk to somebody. I was also told by the rest of the team in handover that this patient is very dependent on the team and anytime they try to refer her to the community mental health team she would drink alcohol to stop being discharged.

So What
At the time that this experience occurred I felt helpless as I was inexperienced and did not know the patient as long as the other CPNs and support workers. I felt that the staffs were unprofessional by not making the patients needs their first concern. I felt frustrated and upset but did not show this to the team. I began to feel sorry for the patient not realising I was becoming emotionally involved. I was angry that we did not spend more time listening to the client needs as our aim is to help people recover from a mental illness, live a daily life by supporting them before they are referred to the community mental health team (CMHT).

The feelings of anger, frustration and sympathy...
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