Reflective essay examples nursing

Reflective Nursing Essay

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Case Study One
In this case study I will use Gibbs (1988) model of reflection to write a personal account of an abdominal examination carried out in general practice under the supervision of my mentor, utilising the skills taught during the module thus far.

What happened
During morning routine sick parade I was presented with a 21 year old male soldier experiencing severe acute, non specific, abdominal pain. Under the supervision of the medical officer (MO) I proceeded to carry out a full assessment and abdominal examination, using Byrne and Long’s (1976) model to structure the consultation. I requested the patients’ consent before conducting the examination, as is essential before commencement of any medical procedure, be it a physical examination or a critical surgical procedure (Seidal et al, 2006).

The patient was quite agitated on arrival and appeared to be in a great deal of pain, and so before continuing with the physical examination I reassured him and made him comfortable in the treatment room. On examination his abdomen was soft, palpable with no tenderness, on auscultation bowel sounds where normal, vital signs normal, with cramping centralised pain.

Feelings
I was feeling confident in my ability to deal with the patient and perform the examination effectively as I had practiced this several times previously using the university resources and mock OSCE with my facilitator. As I am often solely responsible for the care and management of patients during out of hours (OOH) I felt comfortable assessing and triaging the patient. However, under normal circumstances I would assess the patient and refer them to the MO if I was concerned about their condition, in order for a decision to be made. I was also being closely monitored throughout which did increase the pressure to deliver the correct diagnosis and make appropriate decisions. However, by utilising the consultation model I feel I managed to keep a focused approach and ensure the correct questions where asked.

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Evaluation
I feel I gained a good history from the patient by using the SOLER principles (Egan, 1990) taught in the history taking presentation. Thus allowing me to form a differential diagnosis and rule out certain causes, such as; constipation, and indigestion. Subsequently, the physical examination enabled me to confirm a diagnosis of acute abdomen. As the patient was not experiencing any worrying (red flag) symptoms associated with abdominal emergencies, such as; appendicitis or pancreatitis. However, I did forget certain aspects of the physical examination and had to be prompted by the MO. Although with more practice such incidence would be reduced.

Analysis
I was happy that I managed to rule out any distinct causes of the abdominal pain by performing the examination to collect data, analyse it, and use the results to make an appropriate decision (Schon, 1984). However, had I performed the examination without assistance I may not have gained all the information required to confirm diagnosis, as I did forget some aspects.

Conclusion
The MO seemed happy with my diagnosis and care plan, though he did highlight the importance of practicing the physical examination skills in order to become a more competent practitioner. Overall I feel gaining knowledge and skills in translating a patients’ history and physical examination results, has enabled me to become more confident in making a diagnosis and has improved my decision making skills.

Action Plan
In order to become a more capable and effective practitioner I must continue to perform physical examinations under the guidance of a more senior practitioner, and utilise their expertise during the decision making process.

Additionally, I will continue to develop my consultation and history taking skills by using Byrne and Long’s (1976) consultation model to assist my practice and aid future development.

References
BYRNE, P, S., LONG, B, E, L. (1976) Doctors talking to patients. London: HMSO EGAN, G. (1998) The Skilled Helper: A problem-management approach to helping. 6th edn. Pacific Grove, London: Brooks/Cole. GIBBS, G. (1988) Learning by doing: a guide to teaching and learning methods. Oxford: further education unit, oxford polytechnic SEIDAL, H, M., BALL, J, W., DAINS, J, E., BENEDICT, G, W. (2006) Mosby’s Guide to Physical Examination. 6th edn. Philadelphia: Elsevier. SCHON, D. (1984) The Reflective Practitioner: how professionals think in action. New York: Basic Books.

A reflective essay based on an episode of patient care.

WritePass — Essay Writing — Dissertation Topics [TOC]

Introduction

This is a reflective essay based on an episode of care that I was directly involved in managing during a community placement. This episode of care will be analysed using up to date references, health care policies and relevant models. Issues and theories relating to leadership qualities and management styles will also be explored, taking into consideration any legal, ethical and political factors that may have impacted on patient care. Care delivery, delegation and prioritisation will be examined along with team working, risk assessment and patient safety. I will also take into consideration my role as a supervised student nurse and analyse the roles and responsibilities of those supervising me and what influence this has on my practice. These issues will be debated and questioned within the framework of leadership and management theory

In order that I could use this situation for my reflection the patient will be referred to as “Mrs A”. In this assignment confidentiality will be maintained by the use of pseudonyms, this is to maintain privacy and confidentiality in line with the NMC Code of Professional Conduct (NMC, 2008), “as a registered nurse, midwife or health visitor, you must protect confidential information”, and to “Treat information about patients and clients as confidential and use it only for the purpose for which it was given.”

Starting an extended practice placement as a third year nursing student enables the student to develop their knowledge and skills in management and leadership ready for their role as a qualified adult nurse. During my extended practice placement there were many opportunities to develop these skills and manage my own caseload of patients and arrange many complex aspects of their care.

During this placement an 88 year old patient, to be known as Mrs A, was due to be discharged from a rehab centre following recurrent falls, issues with safety at home, and self neglect, the referral had been made by a concerned General Practitioner. Mrs A had spent the last 6 weeks receiving holistic multidisciplinary care, including; intensive physiotherapy, occupational therapy and nursing care. Mrs A had made much improvement and was able to safely administer her own medication.

One of the Physiotherapists called Ken, had commented during handover, that Mrs A had seemed confused during their session together, and asked if the nurses would go in and review her. Upon visiting Mrs A it was clearly evident that she was not herself, and seemed confused. Following discussion with my mentor I felt that Mrs A was not safe to administer her own medication. I recommended to the patient to let the rehabilitation staff administer her medication. Mrs A consented to this, thus reducing a great risk of Mrs A causing her-self harm. I delegated to the support workers to obtain a urine sample which was tested and confirmed that Mrs A had a urinary tract infection, antibiotics were prescribed by her GP. The team leader at the rehabilitation centre was informed of Mrs A’s infection and plan to handover the administration of her medication to them, she was happy with this decision and pleased that I had informed her.

This episode of care was managed effectively as the underlying cause of the patients confusion was discovered and treated, a risk assessment was completed and a referral was promptly made to medicine management and a dossett box was supplied to Mrs A, to help her manage her own medications safely. All members of the multi-disciplinary team were fully committed to the team approach to care delivery and this facilitated efficient and organised care delivery. The care delivered was patient-centred and teamwork was integral to providing this care.

First will be a discussion on the importance of self awareness and how this awareness enabled a more assertive and confidant approach to be made to managing patient care.

Self awareness must be considered as the foundation for management and is a vital skill and quality needed in leadership. If you wish to provide care that is of a high standard and improve your own performance as a skilled health care professional you need to manage the cognitive, affective and behavioural self in order to engage effectively in therapeutic relationships. Self awareness is the process of understanding one’s own beliefs, thoughts, motivations, biases and limitations and recognising how they affect the care and services provided (Whetten and Cameron, 2010).

Without being self aware, recognising personal and cultural beliefs, and understanding interpersonal strengths and limitations, it is impossible to establish and maintain good relationship with co-workers and patients. Maslow’s Hierarchy of Needs Theory (1954) depicts self-actualisation at the highest level of the hierarchy of needs. This relates to the need to maximise potential and achieve a sense of personal fulfilment, competence, and accomplishment (Maslow, 1954). It is important as a student nurse to be completely aware of strengths and weaknesses, and to be conscious of any limitations, self-awareness helps to exploit strengths and cope with weaknesses (Walshe and Smith, 2006).

When organising and planning patient care it is vital to have effective management and leadership skills, this is part of every nurse’s role, and involves planning, delivering and evaluating patient care. These management responsibilities are part of every nurse’s role (Sullivan and Garland, 2010) and to exhibit these professional behaviours demonstrates their value to the organisation (Huber, 1996). To understand nursing management it is crucial to understand what nursing management is and the theory behind it.

Managers are defined as “a member of a specific professional group who manages resources and activities and usually has clearly defined subordinates” (Gopee & Galloway, 2009). Another definition of management is a process by which organisational goals are met through the application of skills and the use of resources (Huber, 1996).

Borkowski (2010) argues that Douglas McGregor made a significant impact on organisational behaviour and was an American social psychologist that proposed the ‘X-Y’ theory of management and motivation. McGregor (1966) describes the ‘X-Y’ concept as the theory that underpins the practices and attitudes of managers with regard to their employees. Huber (2006) states that theory ‘X’ managers assume that employees are lazy, that they dislike responsibility, would rather be directed, oppose change and desire safety. Theory ‘X’ implies that employees are rational and easily motivated (either by money or threat of punishment); therefore managers need to impose structure and control and be active managers (Huber, 2000).

Huber (2000) asserts that the opposing theory, (‘Y’) assumes that people are not lazy and unreliable by nature rather that they are self-directed and creative if well motivated in order to release their true potential. Businenessballs. com (2002) asserts that most managers are inclined towards the ‘X’ theory and usually obtain poor results whereas managers who implement the ‘Y’ theory produce better performance and results thus allowing people to grow and develop (Businessballs. com, 2002).

References

Borkowski, N. (2009) Organizational behaviour, theory, and design in health care , USA: Jones & Bartlett Publishers

Cameron, K. and Whetten, D. (2010) Developing Management Skills, USA: Prentice Hall

Gopee, N. and Galloway, J. (2009) Leadership in Management in Heathcare, London: Sage Publishers

Huber, D. (2006) Leadership and Nursing care Management. 3 rd Edn. USA: W. B Saunders Company

Maslow, A. (1954) Motivation and Personality, New York: Harper & Row

McGregor, D. (1966). The human side of enterprise. Leadership and motivation. Cambridge:

MA: The MIT Press.

Sullivan, E. And Garland, G. (2010) Practical Leadership and Management in Nursing, Essex: Pearson Education Limited

Walshe, K. And Smith, J. (2006) Healthcare Management, New York: Open University Press

10+ Reflective Essay Examples & Samples – PDF

Sometimes, the things that make us grow personally cannot be found in books nor are they taught in schools. What makes us strong, makes us better people, are the experiences that we encounter in life. Whether they are made up of happy thoughts or bad and horrible incidents, still they teach us valuable teaching in life. You may also see analytical essay examples & samples.

They say that being wise is better that being knowledgeable. Wisdom is acquired through reflection of one’s experience as well as of the environment. The more we reflect the more we become aware of ourselves. We become mindful of our existence as well as the meaning of life and all the things that surround us. Here we present different formats of essays likeВ essays in doc.

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What Is a Reflective Essay?

A reflective essay is a written piece of literature that focuses on presenting and narrating a person’s experience and how it becomes an instrument towards a change of perception in life.

It is a way for a writer to share an important event in his/her life and how it affected him/her so that others may learn something from it. Reflective writingВ root on life changing events. The writer shares a specific experience, provides a narration of the incident including the material elements. It offers a realization so that others who may have had the same experience can draw out a shared mutual lesson from it.

How to Write a Reflective Essay

To write a reflective short essay, you need to have the right disposition as well as the momentum. Remember that you are not just writing to say something but to share an important lesson in life.

1. Think of an important event. WhatВ you will be writing on your reflective essay is something that is rooted from your own personal experience or encounter of something. Think deep and concentrate. You may also see personal essay examples & samples.

2. Introduce your topic. In your introduction, write the concrete event or experience that you want to share. Pattern it in a story form.

3. Develop your point. Write the main content of your essay with at least three to five paragraphs supporting your main topic.