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Reflection is a way to look back on what a person came across on a certain event (Bulman and Schutz, 2008). The target of this reflective essay is for me to mull over on what I have learned from my direct experiences on placement. I opt to utilise on this reflective essay, “A Model of Structured Reflection”, by Driscoll (2007). This Model has three questions, namely: ‘what’, ‘so what’ and ‘now what’. These questions must be answered by me relative to the experiences I acquired from my placement. Hence, I chose to take advantage on Driscoll’s model as it is very handy to apply even with or without a paper and pen. All I need to bring to mind is the aforementioned three questions. I will discuss what I think it matters most to me during my two weeks practice placement and give analysis whether I gained knowledge and understanding based from the learning plan I prepared prior to my placement; thereby continually apply it in every situation I may undergo (Howatson-Jones, 2010).
I spent my whole duration of the introductory period of duty experience in the ward. On my first day, the Ward Manager introduced me to her team. She told me that my mentor was not around on that day. Thus, she handed me over to the nurse in-charge. As I arrived on an early shift, I duly observed the handover of patients from the night shift staff to the day shift staff. Handover is a daily reporting of patients’ status to the incoming shift for the provision of continuity of care (Wywialowski, 2003). As a neophyte, I was a bit muddled up on how the night nurse was endorsing the patient; however, I was attentive on what she was doing so I could learn from such activity. There are acronyms on the handover that they used that I could not understand, as a consequence, I made a point that I must familiarise and memorise the medical terms. Even though I am supernumerary I strongly desire to a part and parcel of the team whilst learning (Jelphs and Dickinson, 2008). After the handover, the nurse instructed me to be with the Health Care Assistant (HCA) for the time being so that I can be acquainted with patients and adapt with the daily routine. Indeed, favoured that the HCA was willing to help me. She taught me the safer way on handling patients whilst maintaining their dignity and respect (Tschudin, 2003). She demonstrated proper use the Blood Glucose monitor and how to document it on patient’s chart (The Global Diabetes Community, 2013). In addition, she told me that if the patient is not on closed observation, normally they take the vital signs every four hourly. The days have gone by so quick; I was productive on my day to day experience as a student nurse. I never wasted my time just standing there without accomplishing anything at the end of my shift. Motivated with my passion of extending care to patients, I find joy and fulfilment in rendering services for them, such as assisting them to the toilet and giving a hand to those who are unable to look after themselves. I became certain on writing down the nursing care plan of a patient (Lloyd, 2010), observed the Nasogastric tube (NGT) (Macmillan Cancer Support, 2013) and Electrocardiogram (ECG) procedures done by the staff nurse and HCA respectively (British Heart Foundation, 2013). I volunteered myself as well to get the take away medication of the patient from the Pharmacy. Furthermore, I have learned how to fill up the Nursing Assessment forms for a newly admitted patient. I accomplished the said forms by means of communicating with the patient and family. I have mentioned the word communicating as there was a non-spoken English patient admitted because of lower back pain. In complying with the Nursing and Midwifery Council (NMC) Code of Professional Conduct (2010) about confidentiality, I will be using a pseudonym for her. I was aware that English is not her first language; hence, Mrs. C cannot speak and comprehend well. When I went to her bedside to take her vital signs, I have seen the grimace caused by pain on her lower back. I asked if she was in pain at that moment, she suddenly nodded her head whilst touching her lower back (White, 2005). I reported to the nurse right away that Mrs. C was in pain, and based on her Drug Chart she was due for another dose of pain killer. I had administrated the said medication under the supervision of the nurse (NMC, 2010). On the next day, I informed Mrs. C through the use of verbal and non-verbal gestures that she will undergo Colonoscopy to check what’s causing her pain (Sully and Dallas, 2010). We waited for her nephew before accompanying them in the Gastroenterology Department as she needs somebody else to translate the procedure to be done. Since it was my first time to watch a patient undergoing such procedure, I grabbed the opportunity to request from the Specialist Nurse if I can be allowed inside to observe the procedure which she willingly approved. I was grateful that her nephew told me that his aunt wanted me to accompany her in the Colonoscopy room despite without asking permission (NMC, 2010). During the procedure, I sat next to Mrs. C whilst holding her hand as she was feeling uneasy with the endoscope inserted into her anus. The Specialist Nurse has given me few insights relative to what she was trying to look inside the colon of Mrs. C. I was privileged for having an exquisite time of basic understanding about Colonoscopy (BUPA, 2011). After the procedure, Mrs. C has given me a hug and was very thankful. I smiled and responded that it was my pleasure to assist her. Afterwards, we went back to the ward, and before I left Mrs. C on her bed with the assurance that she was comfortable and safe, her nephew expressed his appreciation for looking after his aunt whilst he was not around. Moreover, Mrs. C told him about me being there rubbing her lower back when she was in agony. I felt flattered on how they recognised my presence in assisting and comforting her.
On the above scenario, I suppose I have achieved one of my learning needs, that is, the effective communication between patient and me as a student nurse. Despite the inability of Mrs. C to express herself verbally, I was so sensitive observing her gestures and actions, thus, I can extend the appropriate care and assistance she needed. By intently looking at her countenance, I can interpret what she was trying to convey to me; henceforth, I was able to address her needs. I have realised that verbal and non-verbal communications in nursing are very vital in rendering quality care. As a student nurse, I should not let language be a hindrance in giving the nursing intervention for the patient’s quick recovery (Andrews and Boyle, 2008). Care of people is the priority of all nurses; this is one of the four principles of NMC Code (2010). The provision of care for the patient should be done in a holistic approach which includes their daily living activities (Newton, 1991). A simple act of care means a lot to the patient and therefore, this must be instilled in the heart of every nurse (Department of Health, 2010). As for me I will surely put into practice what I have learned from this placement.
Another learning need that I partially accomplished was being able to observe how to perform the Colonoscopy procedure. To supplement what I have observed, I did some informative readings.
In summary, I was able to see the nurses’ duties and responsibilities. Such as, how they manage to give the best nursing interventions in a busy ward, how they collaborate to other health professionals for updating the patients’ care plan and how they attend to patients with care and compassion. I am fully aware that most patients usually depend on nurses as they are the ones who provide direct care for them (Altman, 2010). I do believe that nursing is a never ending process of learning; hence, nurses are oblige to update their trainings and continue to learn more by reading evidence-based practice resources for self-enrichment (Sackett et al., 1996). As a student, I have to be dedicated, motivated and inspired to achieve my ambitions in life; continually accepting any challenge for my personal development (Maslow, 1954). For the meantime, I will set my goals on what I want to learn; recognising any learning outcome on my learning plan as this will draw me closer to my aspiration, to be a Qualified Nurse (Peate, 2006). My two weeks practice experience was superlative. The Faculty of Nursing in the hospital provided teaching sessions that will develop us to become competent in our chosen field (McNiff, 1993). All the staff in the ward where I worked with were supportive and compassionate. I am looking forward for my next placement, for me to implement what I have learned from my previous one, and be able to identify new learning opportunities.
In conclusion, practice placement is an opportunity of experience, an opportunity of new learning and an opportunity of development.
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