Reflective on practices Essay

This is a brooding essay based on my experiences whilst on my six hebdomad medical arrangement on a hematology ward at a local infirmary. The purpose of this essay is to discourse the psychological and sociological impact on the household when a loved one dies. and so concentrate on how the nurse supported the hubby and relations through their loss. I chose this peculiar incident as I felt really strongly about the attention given to this patient shortly before her decease. and felt the demand to reflect on it further. In order to assist me with my contemplation I have chosen Gibbs ( 1988 ) . as the theoretical account to assist steer my brooding procedure ( see appendix 1 ) . This theoretical account comprises of a procedure that helps the single expression at a state of affairs and believe about their ideas and feelings at the clip of the incident. Reflective accomplishments help us to believe about what could hold been done. so that if a similar state of affairs occurs once more the experience gained can be used to cover with the state of affairs in a professional mode ( Palmer et al 1997 ) . To enable me to utilize this state of affairs for my contemplation the patient will be referred to as “Ann” . This is in order that her existent name is protected and that confidentially maintained in line with the NMC ( 2002 ) Code of Professional Conduct. Description

Ann was a 58 twelvemonth old lady married to a really loving hubby. she had been antecedently diagnosed withmultiple myeloma with secondary nephritic damage. and had been having rhythms of chemotherapy. My wise man and I were looking after Ann on the twenty-four hours concerned. her observations were within the normal bounds but she continued to kick of shortness of breath. She became really dying and I could state by the expression in her eyes she was frightened. and asked for me to “get person quick” as she could non take a breath decently. I called my wise man as he was nearby who came over and gave Ann some O. Ann said to the nurse ” I can’t breathe” and seemed even more dying and frightened. she repeated several times that she could non take a breath and each clip the nurse replied really severely and unsympathetically “you can take a breath. you are speaking to me. ” Ann was by now seizing at my manus and inquiring me non to go forth her alone. I reassured her that I would remain with her every bit long as she wanted me to.

My wise man so summoned me to go to another patient nearby. so I explained to Ann and apologised that I had to travel and reluctantly did as I was asked by my wise man. On returning to Ann she was found to be tachycardic and holding great trouble in take a breathing. The physicians so arrived and it was suggested that her hubby be called as she was deteriorating. It was at this clip I had old agreements and so had to go forth the ward for a short clip. On my return to the ward a nurse informed me that there had been a cardiac apprehension on the ward whilst I had been gone. I instinctively knew it was Ann. She had died entirely. whist my wise man had been go toing another patient. I was informed that an effort had been made to revive her. without success. she was so pronounced dead.

Ann’s hubby and household were already waiting in the relatives’ room. and so were informed that she had passed off. It was the households wish to be left entirely with Ann. to let them to state their farewells. they were reassured by the nurse that person was available should they necessitate company at this really emotional clip. My wise man so spent a short clip with the household explicating the processs and assisting them with any information they wanted. including inside informations on where to travel for aid and back up if they needed and where to obtain the decease certification. Feelingss

On contemplation of the incident I felt that I did non move in the best involvements of Ann. as the NMC ( 2002 ) ( clause 1 ) provinces that I am answerable for my actions and skips. regardless of advice or waies from another professional. I felt angry that I was made to go forth a patient who was evidently really scared and dying. when there was no ground for me non to remain with her. Scrutton ( 1995 ) reinforces this by saying that the support of a friendly nurse in nerve-racking state of affairss can greatly cut down the anxiousness and fright of the patient. I agree with this and felt that it was a shame that I was non at that place for her and experience she would hold appreciated my company. I understand that nurses are busy and have to prioritize their work but at this present clip there was no pressing state of affairs that required me to go forth her. I felt angry and annoyed that when the household came to see her organic structure. the nurse involved really started to demo some concern for Ann when merely a short clip earlier he had no clip for her at all. Evaluation

It was a shame that a professional nurse acted in the manner that he did. disregarding how dying and disquieted she was going at non being able to take a breath. The nurses` compassion and communicating skillsseemed to be really much lacking. non listening to her concerns and non demoing any feelings towards her. Cooley ( 2000 ) acknowledges the demand of all nurses to utilize basic interpersonal accomplishments. to look warm and welcoming to patients whilst apportioning clip and attending to communicating. Fallowfield and Jenkins ( 1999 ) discourse how nurses can worry about non cognizing what to state or stating the incorrect thing when pass oning with deceasing patients and their relations. which can make barriers in communicating. It was this deficiency of communicating that led to a dislocation in the nurse-patient-relationship. with the patient being fearful of the nurses return to the bedside. and imploring me non to go forth her alone.

Which was besides in dispute of the NMC Code of Professional Conduct ( 2002 ) clauses. 1 – 2 – 5 and 7. By non listening. reassuring and soothing the patient. all of this added excess stressors to Ann who was already dying and highly frightened. I feel that I should hold reacted otherwise in this state of affairs and been more confident and self-asserting and stand up to my wise man and say that I would remain with Ann. as she wanted me to. I could non see any good points at first in the state of affairs itself. nevertheless on contemplation of the state of affairs I think it made me take a good expression inside myself and believe of how I would hold handled the state of affairs if I were the staff nurse. once more I keep coming up with the same ideas of how of import good communicating. compassion and basic nursing accomplishments are. being at that place to reassure a patient when they are scared or dying. besides being at that place to keep their manus and offer some support.

Which in bend made me more cognizant of my ain communicating accomplishments and how effectual they are and if there is any room for betterment. due to this contemplation procedure and looking within myself I have seen a huge betterment in my nursing accomplishments and patient observations and the attention I deliver. From my point of position it has been a good exercising in demoing me how non to handle patients. Analysis

Informing the relations of the decease of their loved one is possibly one of the most distressful and hard Acts of the Apostless performed by wellness professions. and must be handled with truly caring and sensitive mode ( Reed 2002 ) . The intelligence of Ann’s decease came as a great daze to her hubby and relations. even though they knew she was terminally sick they were non mentally prepared for her decease. and so were in a province of daze and incredulity when ab initio informed of her decease. Scrutton ( 1995 ) discusses how the decease of a spouse is the most hard losingss to come to footings with and the nurse has an of import function in back uping relations through this really emotional clip. Kubler-Ross ( 1981 ) suggests that the presence of the nurse who was looking after the patient helps the household experience more at easiness. even when the intelligence is told by a member of medical staff.

Harmonizing to Worden ( 1991 ) persons react to loss in a assortment of different ways. it is common for relations to be angry. in incredulity or frustrated and nurses need to be cognizant of the differences responses to loss and offer appropriate support to the person. Parkes ( 1988 ) theory of loss explains the challenges involved in state of affairss of loss. which harmonizing to Worden ( 1991 ) can impact persons in an emotional. physical. behavioral or psychological manner. Parkes ( 1988 ) suggests a procedure of realization. denial and turning away followed by feelings of anxiousness. restlessness and fright. Nurses must be to the full cognizant of the scope of emotions and the psychological affect the loss of a loved one can hold on the household. The relations wanted to pass some clip entirely with Ann to state their adieus. so the nurse ensured they were given privateness to enable them to make this.

Fixing the organic structure for the relations to see before the last offices is really of import ( Wright 1991 ) . Alexander et Al ( 1994 ) have highlighted the importance of this and have stated that the last sight of their loved one will stay in their memory of the relations for a really long clip. so it is the nurses duty to guarantee that the visual aspect of the organic structure does non upset them. The decease of Ann has besides had a great sociological impact on the household. they have suffered multiple losingss: this being the initial loss of the individual themselves. and a loss of functions and relationships the loss of the whole household unit. and eventually the loss of hopes and dreams her hubby and household had for their hereafter together ( Heming & A ; Colmer 2003 ) . It is the nurses’ function to back up the household through these first phases of loss. to listen to them demoing echt attention and compassion for the anguish and disquieted they are experiencing. Decision

I felt that the attack I took was non right. after all the patients demands were paramount and although I am a pupil. I should hold acted in the patients’ best involvements. Overall I have found it really honoring reflecting on this incident. I have been able to place my failings that can now be turned into strengths. I now feel that I am a stronger individual turning in assurance and now will guarantee I confront my frights of moving against person in the defense mechanism of a patient. Action Plan

Using Gibbs’s brooding rhythm has helped me do more sense of the state of affairs and set things into position. recognizing how I can set this acquisition experience to positive usage in my hereafter pattern as a Nursing professional. If this state of affairs were to originate once more I know I would now hold the bravery to oppugn the nurses attitude at an earlier phase indicating out that ‘bad practice’ by anyone is non acceptable. I have made agreements to discus this incident. and others I am concerned with to the ward director. as it my first consideration to protect the involvements and safety of patients. in line with the NMC ( 2002 ) Code of Professional Conduct. ( clause 8 ) . This contemplation has highlighted the demand to increase my cognition and apprehension of the procedure of loss and heartache. I will turn to these issues by sing the bereavement officer for the trust. hearing and acquisition from the qualified staff and by reading relevant literature. Decision

In decision it can be seen that the nurse has a really of import function in back uping the patients relatives through their loss. emotionally. psychologically and a lovingness position. It can be seen from this contemplation that effectual communicating and hearing accomplishments are the key to effectual attention to enable nurses to back up households through their loss. Parkes ( 1988 ) theoretical account of loss has been utile in understanding the psychological impact of the loss of a household member. assisting nurses to back up those experiencing loss. although each individual will respond otherwise it gives nurses a model enabling them to be more prepared.


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