Reflection Assignment 3
Following Johns Model of Structured Reflection
For this reflective piece I am going to write about a situation I encountered whilst on my community placement with the district nurse. To write the essay I will be following "Johns model of structured reflection" as a basis to structure my reflection around.
Johns Model of Structured Reflection (Johns 1998)
1.Write a description of the experience. Ask yourself:
*'What are the significant issues I need to pay attention to?'
Whilst on my community placement for one of my initial spokes, I arranged to spend the morning with the district nurse on her rounds, to gain an insight into her role within the community and find out first hand exactly what her job entails.
I met up with Claire (changed name) early on Thursday morning where she discussed with me what the plan for the day was and showed me the notes of the people we were going to visit, to get some idea of what kind of things I would be seeing. I didn't have time to read the notes properly in the car before we arrived at the first appointment at 8.15am he was an elderly gentleman who had been discharged from hospital after major eye surgery and was having to have drops applied 4 times a day.
On entering the house I was taken aback by the initial smell of damp and I noted some damp patches and mould on the carpet in the corners. When we entered the living room Tom was slouched over in his couch. The room and kitchen where both quite dirty and unkempt. When Claire introduced me and asked if it was ok for me to be there it became apparent that Tom was very drunk, agitated and not happy with the situation. Firstly Claire did an initial assessment of how he was coping with the posture holding, which he had to hold for eight hours a day. I later learned that this was because he'd had a bubble of gel injected into his eye after the surgery, to hold the retina in place, for it to heal correctly. This it seemed was giving him severe back pain and he was getting quite annoyed. Whilst Claire was preparing the drops she asked me if I would like to administer them as I had mentioned earlier that my first placement was on an eye ward. I declined her offer saying that I would feel better if she did it and I watched this time.
2.Explore the experience using the reflective cues:
*Aesthetic: Ask yourself:
a)-'What was I trying to achieve?'
b)-'Why did I respond as I did?'
c)-'What were the consequences of that for:
a) We were trying to achieve the correct sterile application of eye drops for Tom, to assess his condition and situation, all in a correct professional manner with as little discomfort and agitation as possible.
b) I think there where several factors that made me respond as I did. For a start this was my first home visit, which made me very apprehensive about what to expect. Also the fact that it was someone's home made me feel quite uncomfortable, as there were no reassurances that you have in a ward situation. I did not know Claire that well as we had only met about an hour earlier so did not feel confident enough in her company to apply the drops, also she was aproned and gloved up and I was not. As Tom was quite obviously drunk and a little uncoordinated I found it hard to disguise my surprise and felt I would not have the concentration while applying the drops. I was also surprised at the dishevelled and dirty state of his place and was worried about keeping sterile.
c) * For Tom there was no direct consequence from my reaction as he received his drops as normal from Claire, if anything me being there cheered him up slightly as I was a different face to talk and moan to.
* For Claire at first I thought that her opinion of my ability would drop, as she seemed to think that us 'up and coming "M.A.D." students' should know everything. I also felt as though I was getting in her way as she was rushing around...
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