In this essay I will be reflecting on an episode of care in which I was involved in during clinical placement. I will be using the Gibbs (1988) reflective cycle, which consists of six stages; 1. Description – What happened?
2. Feelings – What was I thinking and feeling?
3. Evaluation – What was good and bad about the experience? 4. Analysis – What sense was made of the situation?
5. Conclusion – What else could I have done?
6. Action Plan – If the situation arose again, what would I do? Reflection is used to look back at situations and to be able to notice what could be improved or done in a different way for better practice and also for the patients benefit. Atkins and Murphy (1995) states ‘Reflection relates to a complex and deliberate process of thinking about and interpreting experience, either demanding or rewarding, in order to learn from it. Siviter (2004) states that reflecting on situations benefits by gaining confidence, the ability to recognise where improvement is required, learning by own or others mistakes and behaviours, looking at situations from other peoples perspectives and having the ability to improve the future by learning from the past. Reflective practice is widely used by all professionals as and when they face new and different situations and challenges (Jarvis, 1992).
In order to maintain patient confidentiality and to abide by the Nursing and Midwifery Council (NMC) code of professional conduct, I will hereby be calling my patient ‘Jane’ (NMC, 2008).
It was my first ever night shift. I was based on delivery suite. I had worked two previous day shifts so knew the basics of what needs to be done and how events need to be documented. Myself and my mentor were allocated a patient. We went into her room and introduced ourselves to Jane. Jane had no objections to me being present and assisting in her care. Jane was a primigravida, full term, low risk pregnant young lady. She had support from her boyfriend and her best friend. Jane was contracting two – three in ten minutes and was coping well with the pain. Jane was examined by my mentor and appeared to be four centimetres dilated which meant she was in established labour (NICE, 2007). I was given the responsibility of listening into the fetal heart every fifteen minutes, timing and documenting contractions half hourly, monitoring maternal pulse every hour, monitoring fluid input and output and keeping records up to date with all my findings including keeping the partogram up to date as per the NICE guidelines (2007). Later on that evening my mentor was called out of the room and did not return for over an hour. When she finally returned, she checked on the progress of my observations and explained to myself and Jane that there were two other patients that had delivered their babies in the waiting room due to being full on the ward and to top it all up they both had retained placentas and needed to have manual removals in theatre! She reassured me and Jane that what I was doing was correct and for me to push the buzzer if I needed help with anything at any time and left again. About half an hour later Jane started complaining that she was feeling pressure and started to push! I pressed the buzzer and a midwife (not my mentor) entered the room. I explained the situation and also made her aware that Jane was due a vaginal examination to check on dilatation progress as her last one was over four hours ago (NICE, 2007). The midwife carried out the examination and Jane now appeared to be seven centimetres dilated. The midwife explained to Jane that she is not ready to push and asked if she would like to consider any pain relief, Jane agreed to entonox. The midwife advised me to carry on and to press the buzzer again if needed but also advised me that Jane will not be fully dilated for at least another two – three hours and that my mentor would be back by then. Jane managed to nap in between contractions while I kept the...
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