This essay will examine a critical incident, which took place during my placement in the mental ward and relate this to the theory in addition to an understanding concerning communication along with interpersonal skills. Jane is a 51 old woman with mental problems. Therefore, in order to exhibit consideration of my perspectives on the skill along with the knowledge of reflection and the matters that surrounds reflective nursing practice, which implies the skills that were and not utilized in the time of the episode (Barker, 2004) Confidentiality would be sustained as needed by the Nursing Midwifery Council Code (NMCC). The importance of the critical analysis, as well as critical incidents, will be briefly explained then followed by the practice of reflection followed by the reflection founded on the selected model. In this essay, I will use Gibb’s model (1988) of the reflection cycle. Gibbs (1998) Reflective Cycle is appropriate for my experience during my placement because it is clear and precise permitting description, analysis, along with the assessment of the experience making me to make logic of experiences, as well as examining my practice (Raynor, Marshall, & Sullivan, 2005). The model will allow me to formulate an action plan towards improving my practice as a nurse in future.
The name of the patient was Jane who was a 51-year old female with mental problems. The results of my acts for the client would be discussed besides the way they can have got better, comprising what I learned from the practice at the time the incident occurred. My emotions regarding the medical knowledge employed to oversee the patient’s care would be recognized and my novel knowledge of the condition in line with the evidence-based practice (EBP) would be taken into consideration (Nursing and Midwifery Council, 2009).
Jane was a 51-year old female suffering from mental challenges, lack of enthusiasm, as well as problems in observing her individual cleanliness, as well as the hygiene of her house. Jane was one of my key adviser’s patient to whom I had been handed over to synchronize along with supervising her care. As a psychological wellbeing nurse, I knew that I owe the patient the duty of care and I was expected to provide an elevated typical of care founded on the present most excellent practice. Jane had been approved Risperidone Consta 36.00 mg fortnightly that is a modest form of treatment to her condition. Though her situation was delicate, it is not severe along with the rationale for this kind of treatment was to assist Jane stabilize her thought that will enable her to support herself in the society (Manderscheid, 2010). Jane did not like visiting the mental hospital where she skipped three successive doctor appointments. Consequently, my mentor made the decision to raise the matter of non-attendance during the handover conference in which the decision was made to see her in the morning, except never met her because she was not there (Scanlon, 2006). A meeting of the multidisciplinary team (MDT) was called that we approved that there was a huge challenge if the subsequent medications was ignored by Jane. The social employee who was present during the meeting agreed that she could organize for a community support employee to assist clean Jane on weekly basis (Nanovic & Kaplan, 2009).
At the subsequent meeting with Jane after agreeing to come to the hospital, she settled for a mutual visit with the Community Psychiatry Nurse and myself to re-evaluate her medical state in addition to possibly reflect on if it was appropriate to refer her case of a counsellor. I was given a chance my mentor to undertake the preliminary assessment that demonstrated that her behaviour was very impulsive and very neglectful (Marrelli, 2004). Jane’s incapacity to take her treatment along with to oversee her individual cleanliness showed that she was not fine. The evaluation instrument that I utilized was the Mental State Examination that assists to establish the degree of understanding her disease, as well as certainly I established that she in a denunciation (Yang et al., 2016). During this time, I emphasized to her the significance of reporting any emerging side effects she might have regarding her treatment to the physician. The consequences of my actions improved her condition and she was never readmitted to the hospital. Jane was able to observe daily cleanliness that included bathing and cleaning her clothes and that of her children. This was a result of frequent attendance and counselling that I offered to Jane (Delaney, 2009).
In the handover meeting, I was anxious as I felt scratchy regarding presenting my response to the entire team. Therefore, I was nervous concerning making errors in my handover, which would result in the improper care given to Jane or would result in readmission to the facility. Being nurse in placement, I felt that I did not have the needed knowledge by presenting client information to a team of competent colleagues. Nonetheless, I handled this condition with external calm, as well as in a proficient way. I was very happy that my adviser was accessible in the time of handover and this improved my confidence (Shattell, Starr & Thomas, 2007).
The good thing regarding my experience was the reality that I was in a position to undertake an initial assessment and identified what caused Jane’s failure to adhere to medication regime. From the initial assessment, I documented the outcome along with the relation with what had occurred to the multidisciplinary team with minimum help. Correct compilation of the client’s care along with the medication must converse to other associates of staff of the MDT to offer permanence of care. Thus, the knowledge had enhanced my communication competence and skills considerably; I felt supported all the handover process by my adviser who was consistently engaged when I overlooked any information. I understood that supervision plays a leading role as a development tool for nurses in placement. The MDT was very encouraging all through the course since they took my information with no hesitation (Gamble & Brennan, 2005).
Additionally, what was not excellent concerning my knowledge was the reality that my adviser had not told me earlier that I was going to present my findings to the team; consequently, I was not psychologically equipped for the handover. I too felt that I required additional time to monitor other experts in the MDT undertaking their handovers earlier than I tried to undertake mine. Throughout the primary multidisciplinary team conference, I felt that we did not offer adequate time to generously relate with Jane to recognize other mental requirements, which would affect on her wellbeing (Manderscheid, 2010). Nonetheless, in any occasion, Jane was incapable to totally connect due to her psychological condition. According top Turley (2000), nurses must take in their relations with the client while recording evaluation details that may be utilized to offer proof for prospect planning along with the delivery of healthcare. Thus, health professionals must utilize listening as a component of evaluating the challenges, wants, and the resources of the client (Nursing and Midwifery Council, 2008).
Nurses have the role of safeguarding and promoting the interests of the patients that include ensuring that the nurse’ knowledge along with the competencies commensurate with the role being carried out. Communication plays a primary role in promoting effective practice because it occurs all of the time between individuals in different ways. Clear, effective, and considerate communication is crucial for healthcare experts, who work with, as well as care for some persons. The literature concerning communication along with the interpersonal skills is widespread, as well as vast. I established it hard to converse with the client since I did not comprehend her state. Therefore, it was too hard for me to understand her behaviour to heart beside demonstrate feelings at that period, it is apparent that this is a field that I need to develop for the prospect. Nonetheless, Bulman and Schutz (2008) claim that this is a letdown to inform and for utilization to discover from the nurse profession, as well as build on judgment skills (Bulman & Schutz, 2008). Additionally, I could concur with the authors as I learn best from realistic knowledge, as well as develop it to advance my nursing skills. Thus, with this philosophy, I am currently focusing on my limitations, in both theories in addition to practice, along with affirm how, when besides why I plan to enhance my nursing skills (Oberlander, 2008).
In addition, through effective communication, I was in a position to persuade Jane of the want to resume her medication as scheduled. I was in a position to pass this communication to the multidisciplinary teams for the permanence of care. According to Roger et al (2003), communication is an ongoing development; however, may be a tricky procedure while handling mentally ill patients. In the handover time, I was satisfied to the fact that the multidisciplinary team associates were encouraging, as well as engrossed in what I was uttering and they asked some queries (Roger et al., 2003).
The patient had no recall of what she had said earlier we were communicating and what she had told her friends. This enabled me to recognize the fact that I had made nothing wrong regarding my communication with the patient. My mentor told that this behaviour was attributed to Parkinson disease that made the person to develop dementia as argued by Rask & Brunt (2006). Because of my knowledge based on my research regarding Parkinson and the client’s unresponsive face and her remarks made the client be more violent and worried (Rask & Brunt, 2006). During the communication process, I became aware that developing self-awareness was crucial. The thought of self-awareness is too imperative for developing effectual communication skills. Thus, the nurse should be conscious of the elements of themselves, which may significantly impact the communication process. Reflective practice, as well as the appraisal that is the purpose of the essay, is one means of becoming conscious, with the eventual objective of learning from the expression and enhancing the communication skills (Nursing and Midwifery Council, 2008).
Conclusions
Finally, I have discovered that via efficient communication, any challenge may be resolved despite the setting, situations or its complication. This was evident in the mental case of Jane because I was able to use communication to convince her on the need for regular treatment. Thus, nurses should make sure that they are effective communicators. In addition, nurses should promote listening while communicating so that they better understand the needs of the patient in question. I have recognized the weakness, which must be turned into strengths for effective delivery of care to the patient. I am currently working on improving my boldness, self-confidence along with communication skills. Taking part in the case of Jane gave me the chance to acknowledge that the first-class background of information in addition to feedback regarding mental health challenges prior to the provision of care to patients may help in precise diagnosis along with the progress monitoring. Also, the effective rapport between the patient and nurse is healing along with assist in establishing trust from the patient. This may be attained through a free communication process, which permits the patient to articulate their emotions along with concerns with no panic of threats. From my knowledge, I believe the knowledge that I have received will help me in the prospect whilst in the nursing profession must such incident arise once more. This was a great experience that has improved my nursing practice significantly.
To enable me to recognize my key strengths along with the faults in both the practice and theory effortlessly I ensured that I capitalized on weaknesses and explore opportunities. Therefore, I will at the present start to work on this, the primary rationale is that I am strong-minded to be a knowledgeable, proficient nurse in the prospect. I am currently more equipped for any prospect cleanliness with this illness as I have studied. I would spend some time to converse with clients to ensure that they are free with me while communicating, prior to offering any form of care. Finally, if the patients seem troubled, it would get a different staff to assist me to restore the confidence of the clients (Farley-Toombs, 2011).
References
Barker, P. 2004. Assessment in Psychiatric and Mental Health Nursing. Cheltenham, Nelson Thornes.
Bulman, C. & Schutz, S. 2008. ‘An Introduction to Reflection’. In: Bulman, C. Schutz, S. (ed.) Reflective Practice in Nursing, 4th edition. Oxford, Blackwell Publishing Ltd, pp 6 – 8.
Delaney, K.R. 2009. ‘Looking 10 years back and 5 years ahead: Framing the Clinical Nurse Specialist debate for our students’, Arch Psychiat Nurs. 23(2):454-456.
Farley-Toombs, C. 2011. ‘Shaping the future of PMH-APRN practice through engagement’, J Am Psychiat Nurs Ass. 17(1):250-252.
Gamble, C & Brennan, G. 2005. Working with serious mental illness: a manual for clinical practice. Oxford: Bailliere Tindall.
Manderscheid, R.W. 2010. Evolution and integration of primary care services with specialty services in mental health services: A public health perspective. 3rd Ed. B Levin, K Hennessy, J Petrila, eds. New York: Oxford University. 389-400.
Marrelli, T. M. 2004. The Nurse Manager’s Survival Guide: Practical Answer to Everyday Problems. United States of America: Elsevier.
Nanovic, L, & Kaplan, B. 2009. ‘Reliability of Medicare claim forms for outcome studies in kidney transplant recipients: Epidemiology in clinical outcome trials’, Clin J Am Soc Nephro. 4(1):1156-1158.
Nursing and Midwifery Council. 2008. The Code Standards of conduct, Performance and Ethics for Nurses and Midwives. London: Nursing and Midwifery Council.
Nursing and Midwifery Council. 2009. Record keeping: Guidance for nurses and midwives. London: Nursing and Midwifery Council.
Oberlander, J. 2008. ‘The partisan divide- The McCain and Obama plans for US health care reform’, New Engl J Med. 359(21):781-784.
Rask, M. & Brunt, D. 2006. ‘Verbal and social interactions in Swedish forensic psychiatric nursing care as perceived by the patient and nurses’, International Journal of Mental Health Nursing. 15(2):100-110.
Raynor, M. D., Marshall, J. E., & Sullivan, A. 2005. Decision making in midwifery practice. Edinburgh: Elsevier Churchill Livingstone.
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Scanlon, A. 2006. ‘Psychiatric nurses perceptions of the constituents of the therapeutic relationship: a grounded theory study’, Journal of Psychiatric and Mental Health Nursing.13 (1):319-329.
Shattell. M., Starr, S.S. & Thomas, S.P. 2007. ‘Take my hand, help me out’: Mental health service recipients’ experience of the therapeutic relationship’, International Journal of Mental Health Nursing. 16 (2):274-284.
Turley, J.P. 2000. ‘Toward and integrated view of health informatics’, Information Technology in Nursing, 12 (13): 31-49.
Yang, L., Yan, J., Jin, X., Jin, Y., Yu, W., Xu, S., & Wu, H. 2016. ‘Screening for Dementia in Older Adults: Comparison of Mini-Mental State Examination, Mini-Cog, Clock Drawing Test and AD8’, PLoS ONE, 11(12), 1–9.
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