In this essay, I am going to describe an episode of care for an individual which I was involved in whilst on placement at a local nursing home. I am going to choose an appropriate model and reflect on this episode and within this reflection examine my own values and beliefs relating to the individual receiving care. I will also explore the values and beliefs that will underpin my future practice as a nurse. Values are ideals, attitudes and beliefs held by individuals or groups to represent what they consider to be important. They are used to guide behaviour as are morals, which provide standards of behaviour where a decision about right and wrong is required (Chitty 2005). It is believed that professional values learned during training, together with individuals altruistic reasons for wanting to work in healthcare will provide a moral framework that lasts throughout their professional life (Tyreman 2011). Most professions have an ethical code, such as The Code set out by the Nursing and Midwifery Council (NMC 2008). These codes give basic guidelines which individuals can apply to different situations when deciding which actions to take and set standards of conduct which nurses need to deliver consistently throughout their career (NMC 2008). There is also Guidance on Professional Conduct (NMC 2011) which is specifically for student nurses and midwives. A code of practice sets out behaviours and actions that are assumed to be correct in a given situation and a good code should reflect what the majority of professional would do in that situation anyway (Tyreman 2011). In 1970 the health care system began looking holistically at the patient and their rights, rather than just treating them medically. This is termed as bioethics, and focuses on situations individually, using ethical principles to determine the best course of action (Chitty 2005). During my nursing home placement, I was able to work with the nurses who came into the home each day to attend to patients. Before entering a resident’s room, the nurse would give me a brief description of what we were going to do. In the case of one resident, who I shall call Mr Smith for the duration of this essay, she described him as being difficult and was not sure if he would even let us into the room to change the dressings on his ulcerated legs. She also warned that he often refused all personal care from the nursing home staff. On entering his room I was quite shocked at the sight of Mr Smith, he had a long beard, long hair and long, dirty fingernails. His room smelt strongly of urine and the bed he was laying in was soaking wet, as was the pyjama shirt he was wearing. Mr Smith did allow us in and the nurse changed the dressings on his legs. His lower legs, ankles and feet were severely ulcerated and Mr Smith was unable to stand so sat on the edge of the bed. Mr Smith complained of being cold and wet and I suggested that whilst he was sitting up I could change his bed for him. He refused to let me do this but did allow me to change his pyjama shirt for a clean one. I tried to persuade him that he would be much more comfortable in a clean dry bed but he was adamant that the bed not be changed. Once the nurse had finished dressing his legs, he got back into the wet bed and we left, informing the nursing home staff of the situation.
Reflective practice is one of the most important ways in which we learn from our experiences, by thinking about them in different way we can gain a greater understanding and identify which actions we can take as a result (Jasper 2003). To assist me with writing my reflection on this episode of care, I looked at a number of reflective models which were recommended to us on our values course. The first one I looked only had three stages and used the questions What, So What and Now What (Rolfe et al 2001), I found this too brief for this essay but I do think it would be useful to reflect on situations which could occur during...
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