Reflection in Nursing

Topics: Health care, Patient, Communication Pages: 5 (1478 words) Published: June 26, 2013
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1st year reflection using Gibbs reflective cycle
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1st year reflection using Gibbs reflective cycle
« Thread started on: Nov 16th, 2007, 1:39pm »

-------------------------------------------------------------------------------- This assignment is a reflective account of events that arose for a nursing student during their first clinical placement in a community hospital. A brief definition of reflection will be given, with emphasis placed on communication. This reflection has been chosen to highlight the need for nurses to have therapeutic communication skills, to provide holistic care for those diagnosed with dysphasia or speech loss and the scope of learning opportunities it has provided to improve practice in this area.

All names in this text have been changed, to respect the confidentiality of the patient and other healthcare professionals (NMC 2002).

Reflection, in this instance, is a way of analysing past incidents to promote learning and improve safety, in the delivery of health care in practice. The Gibbs reflective cycle has been chosen as a framework for reflection (see appendix 1).

Mr. Comer was admitted to his local community hospital for respite care. He has suffered multiple, acute strokes in the past, which has left him with severe disabilities. These include paralysis rendering him immobile, aphasia (speech loss) and dysphagia (swallowing difficulties). He relies on carers for all normal activities required for daily living (Roper et al 1996) and is advised to have a pureed diet and thickened fluids.

My mentor asked me to observe her feeding Mr Comer. She had prepared my learning the week previously by providing literature on the subject of feeding elderly patients and discussion on safe practice for feeding patients with dysphagia.

I was alarmed and unprepared for the physical sight of this patient, who was coughing noisily and laboriously and a thick, green stream of mucus was exuding from his mouth.

I observed Mr. Comer being fed and noticed he was coughing more than normal during his meal, but was informed that this was quite normal for him. I was asked to feed him the next day. When I uncovered Mr Comer’s meal he started to cough in the same manner that I had witnessed before, but this time he evaded all eye contact. I was feeling extremely anxious, but proceeded to load a spoon with his meal. His coughing increased in intensity accompanied by rapid eye blinking, turning his head away from me and throaty groans that I can only describe as distressed vocal growling.

I was terrified at this point and called for assistance, thinking Mr. Comer was having some kind of seizure. I discovered very quickly from another health carer who knew Mr. Comer well, that he was protesting profusely about the pureed dinner I was going to give him which he dislikes immensely. On the previous day, he had received an ordinary meal, mashed to a smooth consistency, which is what his carers provided for him at home.

This experience left me feeling very uncomfortable and inadequate in my role. I tried to understand why he reacted so alarmingly by putting myself in his position. I felt anger and frustration, but more importantly the feeling of helplessness. Not being able to voice my dislike to the meal offered exacerbated the urgency of hunger or thirst.

Although this experience was very frightening for me and frustrating for the patient, it has highlighted the need for me to improve my communication skills. NMC...
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