Reflective journal is a student’s journal based on the personal experiences. It helps the student to build up skills and self-evaluate the situation and provide suggestions. It empowers the students to segregate information what they know and what they do not know (Silvia, Valerio and Lorenza 2012, pp.102). The journal deals with an incident in which a road accident patient is brought to the hospital. Later on, from the blood sample testing it was found that the patient was having tuberculosis. The main purpose of the journal is to understand the depth of the above-mentioned situation and critical assessment after self-assessing the conditions. To address and analyse the case further Gibb’s reflective model is used which is most used among the health professionals. A discussion on Emotional Intelligence is provided which guides the infection control nurse to tackle the challenges that often plague the nursing field.
The incident occurred on 22nd February 2017, a female patient aged around 47 years was admitted in an emergency ward. The patient had an accident and she was bleeding heavily. Due to excess bleeding the patient was given blood transfusion. While the patient had no identification card with her, a blood group test was done to find the blood group of the patient. I being the infection control nurse did some test with blood samples to investigate whether the patient had any bacterial infection. I was shocked to find the blood samples infected with Mycobacterium Tuberculosis. Later, a chest x-ray of the patient revealed chest infection and it was later established that the patient was later diagnosed with tuberculosis. While, I have seen that nurses and clinical staffs attending the patient were not wearing any surgical mask, medical gloves in the ward.
The case is further discussed according to the procedures mentioned in Gibb’s reflective model. The model is theoretical and is based on the description, analysis and experience of the health professional (Gibbs, 1998).
I was initially shocked to see that the accident patient was bleeding heavily and was having trouble to breath. Blood was all over the patient’s clothes and she was subconscious, I was thinking of the pain the patient was going through. The several clinical staffs, staff nurses that took the patient in a rush to the emergency unit gave a doubt whether the patient even can survive. Later, on I calmed myself and controlled my emotions.
The clinical staff, the staff nurses acted quickly in moving the patient to the emergency unit. Perhaps the clinical staff could have put one cloth on the patient covering the blood stains to reduce the sense of panic among the other hospital staffs and outsiders. I being an infection control nurse look after the prevention of any sort of infection that can spread from the new admitted patients. One bad experience was that in this moment of rush, neither the clinical staffs nor the staff nurses were wearing the surgical masks nor the medical gloves to prevent any spread of probable infection (McHugh 2014, pp.48). I realize that I failed to prioritize the tasks. I should have done management of time according to the needs of the hour. Depending on the urgency, I should have created a separate section or room where the surgical masks, medical gloves are kept in a place systematically. So that during the time of emergency, the staff nurses and the clinical staffs do not forget to use them.
In this incident, I found that my action was not proactive enough. I should have taken the initiative to supervise the staff nurses and the clinical staffs before moving the patient to the emergency unit. I assumed that the staff nurses and the clinical staff were knowledgeable enough to perform their duties effectively. In the future, I will organize some training sessions that will focus on the usage of the surgical mask, medical gloves and try to maintain a hygienic condition which will prevent the spread of any infection. Although I often emphasize on the fact of maintenance of hygiene by the clinical staffs and the staff nurses, I will specially guide them to be careful in dealing with patient who have infectious diseases. For the benefit for all it is better to supervise the clinical staffs and the staff nurses to remove competition and lay emphasis on the mutual cooperation that will increase team work and team playing. This will minimize the mistake committed during the work.
Providing the proper training to the clinical staffs and the staff nurses regarding the maintenance of hygiene, usage of surgical mask and the medical gloves to reduce the incidence of bacterial infections, Spread of infectious diseases and the disease-causing micro-organisms. The Mycobacterium Tuberculosisis a bacterial disease that infects the lungs although it is preventable and curable. Tuberculosis spreads from person to person through air. When the infected person coughs, sneezes, spits then the tuberculosis propels in to the air. Only a few of these needs to be inhaled by another person to get infected (who.int, 2017). Hence, training the clinical staffs and the nurses to wear the surgical mask will prevent them to get infected from the patient and even during assisting the patient the clinical staffs and the staff nurses must wear medical gloves.
The prime motive is to communicate effectively with the staff nurse and the clinical staff, because conflict occurs due to incomplete understanding. Hence, understanding what message the other person wants to convey and then replying back after thorough understanding. It is desirable that a team must work together effectively to achieve a desirable result. Instead to working separately it is a good thing that infection control nurses, staff nurses and the clinical staffs work as a team to reduce the work pressure during the shifts. Mentoring the staff nurse and the clinical staffs will increase the novice nurses and the new clinical staffs to develop knowledge, understanding and confidence (Hnatiuk 2012, pp.43). Mentoring is important and essential to fill the gap between the academic and the practical aspects of nursing. Creating a different department that will deal with all the emergency procedures and the emergency equipment will help the staff nurse and the other clinical staffs to deal with the emergency issues. The emergency department must have the infection control equipment, such as surgical mask, medical gloves and a standard operating procedure to deal with the emergencies.
Through, the usage of Gibbs reflective cycle several point can be identified which otherwise will be hard to recognize. The initial feelings of the nurse and can be interpreted which reflects her emotions. Secondly, the nurse herself evaluates and analyzes her actions along with the actions of other staffs, like what went wrong in such actions. Thirdly, the nurse suggests an action plan through which wrong action can be corrected and several other solutions of the different problems experienced by her and the other staffs. Thus, Gibbs reflective cycle is apt for the situation discussed above and helps in writing reflective analysis of events in an effective way.
The major issues include the staff nurses and the clinical staffs that did not wore the surgical masks, medical gloves when moving the patient to the emergency unit. The conflict between the clinical staffs, staff nurse and the infection control nurse. The lack of communication between the clinical staffs and the infection control nurses. According to me, the minor issues can be the work pressure or the emergency when an emergency case arrives. At this very moment of emergency often staffs in a hurry forget to follow the standard operating procedure.
A nurse’s life has all the different types of experiences whether it is the show of love from the patient or the doctor behaving rudely for an unnecessary reason. All these feelings come to a nurse in a single day or in a single shift. These experiences can be positive and negative and it impacts the life of a nurse. Positive experiences definitely are morale booster while the negative experiences teach to manage and overcome challenging issues in the long run (Nursing.osu.edu, 2017). The various feeling can be described as follows:
Anxiety- Anxiety is one the commonest feeling of a nurse, this happens due to ill treatment by the patient, by our superior doctors, conflict with the co-workers and even from the work pressure. While these are the reasons for anxiety among the us, this very reason can help us to overcome anxiety. Another important thing to note, that if this reasons for anxiety become chronic then it will hamper the working efficiency of the concerned nurse, which may further lead to medication and counselling (Ratanasiripong, Ratanasiripong and Kathalae 2012, pp.55).
Compassion- Compassion is the emotion that moves us when we see the suffering of a patient. We honestly feel the eagerness to help the patient when he/she is going through this hard phase. We too feel let down by our helplessness when we see that the patient is going to a stage from where he or she can never return. I think one of the best way through which we can contribute our bit is by trying to connect with the patient, by sharing a joke with them, making them laugh. These actions will act as an antidote when for us to recover from the daily up and downs that we experience from the shifts (Bramley and Matiti 2014, pp.2796).
Frustration- It is one of the major problems experienced by us. We often get frustrated by the behaviour of a sick patient, doctors and co-workers. This is a daily experience that we had to bear in a regular basis. Hence, we must put an effort to get out the situations that often lead to frustration (Görgens?Ekermans and Brand 2012, pp.2277).
Joy- This is another hard to see emotion because these moments do not come very often. The moment becomes joyful when we make a patient feel comfortable, when we catch a problem faced by the patient. Ignoring the moments of joy is easy but if we learn to grow with it, it will help us in the long run (Nam and Kwon 2013, pp.334).
Like the infection control Nurses, the Clinical staffs also face certain hardships and challenges from the doctors which are as follows:
Work pressure- Due to the unavoidable rush in a hospital, the clinical staffs face a lot of work overload. The clinical staffs experience more responsibilities which is above their comfort level. Due to this the clinical staffs are bound to make mistakes which often lead to disastrous results. The vulnerability of the patients often increases to a greater extent due to the work pressure. (Morse et al. 2012, pp.345).
Poor salary- It is one of the major conflicting issues among the clinical staffs. Often the clinical staff have to work and be under paid, which renders the staff insensitive towards the work. Poor salary even reduces the effective performance of the clinical staffs (Ahmed, Tolera and Angamo 2013, pp.2351).
Mentoring- Often in several organizations it is prominently found that the clinical staffs are complaining about the lack of mentoring opportunities. Mentoring the clinical staffs often lead to boost their morale and increases their effective performance. Although in certain organizations there is ample scope of mentoring but still they are not employed effectively (Roe and Whyte-Marshall 2012, pp.179).
Insufficient training- It is said that proper training often helps the staffs to handle challenging situations which are otherwise not possible for the untrained staffs. Hence, providing the in-house training is the common training programs that are effective to train the clinical staffs (Shearer et al. 2012, pp.15).
Know the patients- It is often seen that nurses deal with the patients most of the time. While, often it is seen that during performing certain tests and administering anaesthesia, the clinical staffs often make some mistake which leads to problems of the patients. The doctors even don’t communicate the necessary information to the clinical staff. Hence, the staffs often stay in the dark (Saunders et al. 2012, pp.210).
Infection control nurse and the clinical staff often come into conflict due to miscommunication. Clinical staffs often neglect the direction of the infection control nurses regarding the usage of medical gloves, wearing of the surgical mask and maintaining of the hand hygiene compliance.
According to Goleman (1998a, pp.94), the idea of emotional intelligence is deeply related with the field of nursing. The ability to perform a proper care of the patients leads to develop a nurse’s career successfully. More than the nursing skills, it is the self-awareness skills that play a major role in a nursing career. It is mandatory that the nurse must gather skill to not only to communicate with the clinical staffs but must have the capability to connect with the patients.
The five major components of emotional intelligence at work are as follows:
The incident taught me several important lessons. I came with a solution that will be helpful to handle emergency situations. An emergency section or room can be set up containing all the necessary equipment necessary for handling the patients that either have infectious diseases or not, just to make sure that germs are not spread due to neglect and haste. At the time of emergency often the clinical staffs forget to follow the standard operating procedures, emergency drills can be conducted to make the clinical staffs habituated to the several emergency situations.
Therefore, from the above disclosure, I can conclude that it is necessary to follow precautionary measure when dealing with any patient. It is a must for the clinical staffs and the staff nurse to assist and handle hygienically to prevent any sort of spread of infection. I feel that the job of Infection control nurse is a challenging job because there are several instances of conflict, that can arise between the infection control nurse and the staff nurse, clinical staff. Hence, it is necessary to communicate information to the clinical staffs and the staff nurses effectively to reduce issues that may arise during the shifts. The role of clinical staffs also plays a major role because task big or small are performed by them. Hence, a proper training, good salary, proper mentoring and comfortable work pressure ensures that the clinical staffs perform their best.Lastly, the emotional intelligence provides an important teaching account for the nurses. Emotional intelligence helps and guides the nurses to overcome all the problems experienced by them. Emotional intelligence gives an insight of increasing the self- awareness, ways to self-regulate nurse feelings, providing motivation, teaching to be more be empathic towards the patients, and honing the necessary social skills.
References
Ahmed, S.M., Tolera, M. and Angamo, M.T., 2013. Assessment of job satisfaction among pharmacy professionals in south-west Ethiopia. International Journal of Pharmaceutical Sciences and Research, 4(6), p.2351.
Bramley, L. and Matiti, M., 2014. How does it really feel to be in my shoes? Patients’ experiences of compassion within nursing care and their perceptions of developing compassionate nurses. Journal of clinical nursing, 23(19-20), pp.2790-2799.
Gibbs, G., 1988. Learning by Doing: A Guide to Teaching and Learning Methods. Oxford: Oxford Further Education.
Goleman, D 1998b, Working with emotional intelligence, New York, Bantam press.
Görgens?Ekermans, G. and Brand, T., 2012. Emotional intelligence as a moderator in the stress–burnout relationship: a questionnaire study on nurses. Journal of clinical nursing, 21(15?16), pp.2275-2285.
McHugh, S.M., Corrigan, M.A., Hill, A.D.K. and Humphreys, H., 2014. Surgical attire, practices and their perception in the prevention of surgical site infection. The Surgeon, 12(1), pp.47-52.
Morse, G., Salyers, M.P., Rollins, A.L., Monroe-DeVita, M. and Pfahler, C., 2012. Burnout in mental health services: A review of the problem and its remediation. Administration and Policy in Mental Health and Mental Health Services Research, 39(5), pp.341-352.
Nam, M.H. and Kwon, Y.C., 2013. Factors influencing happiness index of hospital nurses. Journal of Korean Academy of Nursing Administration, 19(3), pp.329-339.
Nursing.osu.edu (2017). Home | College of Nursing. [online] Nursing.osu.edu. Available at: https://nursing.osu.edu/ [Accessed 26 Oct. 2017].
Ratanasiripong, P., Ratanasiripong, N. and Kathalae, D., 2012. Biofeedback intervention for stress and anxiety among nursing students: a randomized controlled trial. ISRN nursing, 2012.
Roe, E.A. and Whyte-Marshall, M., 2012. Mentoring for evidence-based practice: A collaborative approach. Journal for Nurses in Professional Development, 28(4), pp.177-181.
Saunders, K.E., Hawton, K., Fortune, S. and Farrell, S., 2012. Attitudes and knowledge of clinical staff regarding people who self-harm: a systematic review. Journal of affective disorders, 139(3), pp.205-216
Shearer, B., Marshall, S., Buist, M.D., Finnigan, M., Kitto, S., Hore, T., Sturgess, T., Wilson, S. and Ramsay, W., 2012. What stops hospital clinical staff from following protocols? An analysis of the incidence and factors behind the failure of bedside clinical staff to activate the rapid response system in a multi-campus Australian metropolitan healthcare service. BMJ Qual Saf, pp.bmjqs-2011.
Silvia, B., Valerio, D. and Lorenza, G., 2012. The reflective journal: A tool for enhancing experience-based learning in nursing students in clinical practice. Journal of Nursing Education and Practice, 3(3), p.102.
UnitHnatiuk, C.N., 2012. Mentoring nurses toward success. Minority Nurse, 5, pp.42-45.
who.int (2017). What is TB? How is it treated?. [online] World Health Organization. Available at: https://www.who.int/features/qa/08/en/ [Accessed 9 Nov. 2017].
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