Understanding Experiences and Enhancing Learning

Introduction

Reflective writing involves description as well as analysis of own experiences by the individuals which helps them to understand significant aspects, develop clarified thoughts, determine areas that require improvement and lead them to work out strategies for resolving identified problems or weakness. The reflective analysis also helps the instructors develop clearly understand the nature of change they are to approve to improve student learning. Thus, the reflective analysis is developed to help me understand principles of learning, assessment, supervision, teaching, management and leadership experienced by me while working as a trainee nursing associate in the cancer patient ward. In order to frame the reflective analysis, Gibb’s reflective cycle is to be used. The Gibb’s reflective cycle is to be used in writing the reflective analysis because it encourages individuals to think in a systematic manner regarding the experiences they faced during an activity or event (Bishaw and Coyne, 2015). The Gibb’s reflective cycle includes six steps which are description, feelings, evaluation, analysis, conclusion and action plan (Lai, 2019).

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Description

In the ward for cancer patients, I was working as a trainee nursing associate under the supervision of my mentor where I was entrusted to care for an 80-year old male patient with acute leukaemia. The intravenous chemotherapy includes injection of drugs through an intravenous (IV) injection that is directly inserted into a large vein present in the hand, arm or chest region or with the help of a catheter and pump combination (Wang et al. 2018). I was asked by my mentor to prepare the patient to receive injection for chemotherapy that is to be administered intravenously. Moreover, my mentor asked me that the catheter and pump combination is to be used for the patient and mentioned me to attach the catheter on the chest of the patient. I asked my mentor that I wished to be introduced to the patient by him at first but my mentor mentioned me that I need to try on my own as he believes I can make the patient comply with me.

I communicated with the patient in a compassionate and polite way to inform the individual that my mentor is going to execute the therapy and I am going to prepare him to get the therapy as his new carer. Thus, to execute my task I asked the patient to open the shirt but the patient avoided to open it and reported he does not wish to get services from me. The individual even pushed me and asked me to send my mentor who is his key carer to execute the task. Thus, I went on to report the incident to my mentor to ask for her intervention as I was not sure whether or not I would be able to make the patient comply with me. The mentor understood the situation and came along to personally introduce me to the patient.

After the introduction, in the presence of my mentor, I asked the patient to open his shirt so that I can execute my task. However, he was seen to hesitate which made me realise that I am going to fail. In this condition, my mentor came to my help and asked me that she has confidence in me. He mentioned I should use the folding screen so that he could feel private and not exposed to be watched by others while opening his shirt. I executed accordingly and was able to make the patient finally comply with my actions. As I was trying to attach the catheter to his chest, I found the patient is showing increased perspiration and holding my hand to avoid me to execute my task. Thus, to assess his condition I immediately checked the pulse rate and heartbeat which led me to understand the patient is panicked. I asked the patient in a polite and repetitive manner along with showing compassion that while attaching the catheter it is not going to hurt much and he needs to relax. It led the patient to become confident and helped me to progress in executing my task. However, while attaching the catheter I again understood that the patient is panicked as his heartbeat was raised and his eyes were showing frightened expression that was directly looking at his chest. My mentor immediately intervened and mentioned to me that I should ask the patient to look away while attaching the catheter rather than looking towards it. I asked the patient accordingly and was able to properly attach the catheter. Later, my mentor along with the health physician was able to properly execute further steps to provide successful chemotherapy to the patient.

Feelings

During the mentioned activity of preparing the patient for chemotherapy, I feel that I lacked the proper ability to manage the problems on my own that was experienced during the situation. This is evident as I was unable to manage the patient remain calm while attaching the catheter to his chest as well as failed to make him initially convinced and trust me without the help of my mentor that I was trying to deliver him good care. Moreover, the situation made me feel that I lack proper learning regarding the way the privacy of the patient is to be maintained. This is because it was only after the intervention from my mentor that I learned the patient was avoiding complying with me even after knowing and understanding that my intention was to offer him good care as I failed to protect his privacy. However, the situation made me feel that I have the proper ability to assess the emotion and changes in the health of the patient. This is evident as I was able to understand from the patient's expression and physical condition that he may be panicked which led me to check his heart and pulse rate so that effective actions can be taken to ensure him better care.

After the situation, I feel that my mentor have proper leadership skill in directing her subordinates. This is evident as my mentor showed effective commitment to help me to get introduced to the patients when I asked for her intervention. Moreover, the situation made me feel that my mentor does have proper teaching ability in making their subordinates learn regarding the way problems during activities are to be avoided. This is evident as my mentor taught me regarding the way privacy of the patient and the way they can be avoided from getting panicked while attaching the catheter to their chest during chemotherapy. Thus, after the situation, I feel that I have to improve my learning ability as well as management skill to deliver better care. However, I feel that I do have learning regarding the way to make effective communication with patients so that they do not feel disrespected. This is evident as I always communicating with the mentioned patient in a polite and compassionate manner and he never mentioned that I disrespected him.

Evaluation

The thing that went well during the activity is that I was able to properly assess the emotions and physical health of the patient to understand the steps to be taken to ensure the individual proper care. This is evident as I was able to detect from the expression and later through physical assessment of the patients that he is panicked with the thought of getting the catheter attached to the chest for chemotherapy. As asserted by Pelekasis et al. (2017), patients are to be made calm while offering chemotherapy as stress negatively affects the psychological health of the patient as well as their response towards accepting care. This is because stressed feeling makes patients become unsure of the impact of the care and makes them feel fear of getting hurt. It is seen in case of the mentioned patient as he was avoiding accepting care when he was panicked. As argued by Dawber et al. (2019), inability of the nurses to properly assess health condition of the patients makes them experience hindrance in providing care. This is because the nurses fail to understand the needs of the patients to be fulfilled to make them comply. Thus, the activity informs that being able to properly assessment the health condition of the patients helped me to make him finally comply with me in providing him care.

The other thing which went well as that my mentor being the leader has proper leadership skills as well as teaching ability. This is because she expressed effective knowledge, commitment, confidence and understanding regarding the way to direct and teach me so that the problems experienced in executing my task can be avoided. It evident from the situation when my mentor personally intervened to help me get introduced to the patient, make me aware and learn regarding the way privacy, as well as calm behaviour of the patient, is to be maintained and believed in me that I was able to execute the task while I have lost confidence. As commented by Calzone et al. (2018), effective leaders are to show confidence as well provide support to their subordinates to make them feel inspired to execute tasks. This is seen to be followed by my leader which mentions that effective leadership was present in the situation.

The thing which did not well is that I lacked proper ability to manage the problems on my own that are raised while executing my task. This is evident as I failed to make the patient comply to avail care from me without the intervention from my mentor. Moreover, when my mentor asked me the way to introduce myself to the patient to make him comply with me I was still unable to manage the condition on my own and needed the intervention from my mentor. I lacked effective management skill which is also evident as I was unable to understand regarding the way the patient’s privacy is to be managed and protected to convince him to open his shirt for executing my task of attaching the catheter to his chest. I was also unable to manage the patient to be calm without help so that I can conduct provided responsibility by my mentor. The nurses required to be able to have effective management ability so that proper decision in increased pressure and tough condition can be taken (Dong et al. 2016). However, due to my inability to manage problems experienced I experienced hindrances in accomplishing my task. The NMC informs that nurse requires communicating with the patient in a polite and compassionate manner so that dignity of the patient is upheld (NMC, 2015). Thus, I have followed the code of practice mentioned by the NMC in proper manner even though the patient behaved improperly with me.

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Analysis

The situation being discussed made me analyse that I require improving my management skill as nurse to deliver effective care by resolving problems in complex situations. This is because I often accessed help from my mentor to be able to manage the patient develop compliance with me to avail services without personally trying to identify and resolve the issue. The NMC code informs that a patient's privacy is to be respected in all care aspects (NMC, 2015; Grande et al. 2015). However, in the mentioned activity, it was seen that I was initially unable to ensure the privacy of the patient as I asked him to open his shirt in the room where there was another patient. This indicates that I have failed to ensure proper management of privacy of the patients which is able to make me face negative action and show improper care towards the patient.

The 6 C's of nursing informs that effective commitment and compassion are the keys to deliver quality nursing care to service users (RCN, 2013; Bradshaw, 2016). In the activity, it was seen that even though the patient behaved improperly with me I was always communicating in a compassionate manner. Moreover, though at times I lost my confidence to be able to perform my allocated task yet I never avoided to show commitment and always asked for help from my mentor so that quality care can be assured to the patient. This indicates that though I have failed to ensure providing services as per NMC code to some extent yet I was trying to provide care as per 6 C’s of nursing principle.

The NMC code informs that nurses are to deliver proper leadership for ensuring that the well-being of the patients remains protected and they experiences improved healthcare system (NMC, 2015). In the activity, it was seen that my mentor was showing effective leadership and teaching skills. This is evident as my mentor assisted me in each aspect of care where I was unable to show proper management of care towards the patient to ensure the individual’s well-being is protected and the person receives effective healthcare services from me at the end. The NMC code also mentions that physical, social as well as psychological needs of the patients are to be properly recognised and responded by the nurses (NMC, 2015). I have been able to follow the code as I was able to show successful assessment of patient’s psychological and physical health while I was trying to place the catheter on his chest and accordingly took proper actions to ensure the health of the patient is effectively managed.

conclusion

The activity regarding placement of catheter for chemotherapy on the patients under the supervision of my mentor while acting as a trainee nursing associate in the cancer ward mentions that I do not have effective learning and management skill regarding the way problem in care are to be resolved. Moreover, in some aspect, I was unable to follow the NMC code while providing care to the patient. However, I was able to effectively assess the health condition of the patient and with the help of my mentor's guidance was able to deliver proper care. In the activity, my mentor showed effective leadership skill by showing commitment towards her responsibility and expressing confidence as well as inspiring me to execute care of the patient in a proper manner. In addition, my mentor was able to properly teach me regarding the way I require to deliver service by overcoming problems.

Action Plan

The evidence from the reflection led me to make the action plan that next time or in future I am going to at first access more effective nursing training to learn regarding the way I can deliver quality services by following NMC code in proper manner. Moreover, I am going to ask to share experiences by my mentor and other senior nurses so that the information can be used by me to teach myself regarding the way I require to resolve problem in care without help. Moreover, I would also access proper teaching through observation regarding the way I can be able to show effective commitment at work and confidence in myself to execute the care services being asked to be offered to patients.

References

Bradshaw, A., 2016. An analysis of E ngland's nursing policy on compassion and the 6 C s: the hidden presence of M. S imone R oach's model of caring. Nursing inquiry, 23(1), pp.78-85.

Bishaw, S. and Coyne, E., 2015. The role of the cancer nurse coordinator: an observational reflective study. Australian Journal of Cancer Nursing, The, 16(2), p.38.

Calzone, K.A., Jenkins, J., Culp, S. and Badzek, L., 2018. Hospital nursing leadership-led interventions increased genomic awareness and educational intent in Magnet settings. Nursing outlook, 66(3), pp.244-253.

Dawber, R., Armour, K., Ferry, P., Mukherjee, B., Carter, C. and Meystre, C., 2019. Comparison of informal caregiver and named nurse assessment of symptoms in elderly patients dying in hospital using the palliative outcome scale. BMJ supportive & palliative care, 9(2), pp.175-182.

Dong, F., Zheng, R., Chen, X., Wang, Y., Zhou, H. and Sun, R., 2016. Caring for dying cancer patients in the Chinese cultural context: A qualitative study from the perspectives of physicians and nurses. European Journal of Oncology Nursing, 21, pp.189-196.

Grande, D., Asch, D.A., Wan, F., Bradbury, A.R., Jagsi, R. and Mitra, N., 2015. Are patients with cancer less willing to share their health information? Privacy, sensitivity, and social purpose. Journal of oncology practice, 11(5), pp.378-383.

Lai, Y.L., 2019. Critical emancipatory reflection on establishing an equal, trusting relationship among surgery participants in clinical practice in China. Frontiers of Nursing, 6(1), pp.47-52.

Pelekasis, P., Matsouka, I. and Koumarianou, A., 2017. Progressive muscle relaxation as a supportive intervention for cancer patients undergoing chemotherapy: A systematic review. Palliative & supportive care, 15(4), pp.465-473.

Wang, H., Zhu, W., Feng, L., Chen, Q., Chao, Y., Dong, Z. and Liu, Z., 2018. Nanoscale covalent organic polymers as a biodegradable nanomedicine for chemotherapy-enhanced photodynamic therapy of cancer. Nano Research, 11(6), pp.3244-3257.

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