Reflective Nursing Practice: Using Tanner’s Reflective Model Of Clinical Judgment

Standard 2 and Standard 4 of the Nursing and Midwifery Board of Australia’s guidelines for effective nursing practices

Question:

Discuss about the Reflection With Tanners Models for Curative and Formative.

The nursing and midwifery board of Australia called NMBA has provided guideline of standard for effective nursing practices. This care ensures that the nurses provide interventions which are preventive, curative, formative, restorative, supporting as well as have different palliative element (Fisher 2017). Out of the different standards, the two which could be used in this assignment are standard 2 and standard  4 which states that Nurses should comprehensively conduct assessment. This assignment will be mainly based on a reflective Framework provided by Tanner which would help in systematic proceedings with the different steps of reflection. This would help me to reflect the experiences in details and thereby derive knowledge from them.

The first step of Tanner’s reflective model of clinical judgment states description of the background of the experience of the nurse. During my internship phase, I experienced an incident where an old patient of an Asian background was admitted and was not a believer of Western mode of treatment. She mainly believed in spiritual healing and considered Ayurveda as the most beneficial treatment. She was suffering from diabetes type 2 and was obese. She was also a patient of Arthritis and had restricted mobility. She had faced racism during her younger years in the nation for which she had become why restrictive and adamant in her approaches towards Australian. She did not want to stay in the hospital but due to the request of her son and daughter in law, she decided to get admitted.

I noticed that she was not cooperating with me as she was not being able to rely on me and on Western education. The racism that she faced in her younger days were restricting her (Birks e al. 2016). She was quite concerned that whether I would be able to follow her cultural traditions. She was not being cooperative and for this reason I was not being able to either start my treatment or diagnose her symptoms closely. She was quite concerned about her autonomy and dignity.

The next stage is called the interpreter stage. From the entire incident, I noticed that the patient might have gone through several unexpected and tragic events with Australians in her yester years. For this, she has suffered both mentally and physically. I also realized that this negative feeling would affect the relationship that needs to be developed between me and the patient for effective treatment. Therefore, it was very important for me to develop a therapeutic relationship with her so that I can gain her trust (Scanlon et al. 2016). Developing trust is very important as this would make the patient feel mentally stable and she would co-ordinate and help me with the interventions. I also noticed that she is quite concerned about her cultural traditions and preferences and therefore she is quite concerned about her treatment methods. Therefore in my treatment methods I have to be very careful so that I do not hurt her emotions about her cultural traditions (Sivaraman and Green 2015).

Effective communication and respect for cultural values and beliefs

At first I tried to cool her down by telling her that the Australian in the early years were insensitive. However with the passing of years the Australians have taken all as their own brothers and sisters. Making her feel comfortable was my primary aim and counseling her about her perceptions about the Australian was extremely necessary to develop trust in me as well as the western Healthcare system.  My procedure of listening her every experience with concern and concentration made her feel respected and important and she gradually started relying on me (Cashin et al. 2015). I was gradually being able to develop a relationship where she was able to confide in me and was following my advices properly. I also educated her about the recent advancements that the Western Healthcare system had made which made her quite amazed. At the same time I also told of the benefits of Ayurveda which made her feel that I also respected her cultural preferences. She was quite happy with the discussion and she became ready to help me and corporate with me in the treatment procedures. To this, all her family members were very happy and they completely were amazed about how I was being able to successfully develop relationship with their mother who was very adamant.

The next stage is called the reflection in action stage.  I started my treatment with the patient first asking for her consent which made her very happy. I first calculated her blood sugar level which was very high at that time. I injected her insulin and provided her with the necessary medication. She was also having wound on her foot due to the effect of diabetes and therefore podologist was called for. I also made her understand about the importance of maintaining the correct diet to properly maintain her weight. I also appointed for a Physiotherapy session with her so that she can be relieved of the pain from her knees as she was also suffering from arthritis (Kyle et al. 2017). It was the patient who told me that my educating her about the entire procedure before applying the interventions made her feel respected and confident that he would get well very soon.

The next stage is called the Reflection or action stage. With the help of standard 2, I was effectively able to handle the patient. It says engagement in therapeutic and professional relationships by the nurse. It states that there is an urgency to communicate effectively and be respectful of the dignity of a person as well as her culture, values and beliefs. While handling the patient I followed this criterion which helped me to communicate with her easily and thereby be respectful to her dignity and culture. This made her comfortable with me and she was able to open her up in front of me with all the experiences of a life. This Standard also states the importance of recognition of patients as the experts in their experience of their life. Therefore while communication I gave her enough scope so that she can open up the experiences of her life and thereby I can develop an understanding of the different hardship she had gone through her life. Tthis helped me in developing my treatment approach. This standard also stated providing support to the patient and directing them to resources so that they can optimize health related decisions (“Standard of practice, Nursing and midwifery board of Australia”, 2017). Here I educated her about the importance of proper diet and how proper diet can help for maintain her blood sugar level as well as her pain in the arthritis.

The importance of holistic assessment

The next standard that was followed by me was standard 4 called comprehensively conducting assessment. It states the importance of conducting assessments with a Holistic as well as culturally appropriate (“Standard of practice, Nursing and midwifery board of Australia”, 2017). Therefore I mainly focused on making the patient comfortable mentally as well as physically so that the treatment I provide give the best outcome. Forcing a patient with interventions which are without his or her wish does not yield successful result. Therefore I followed culturally appropriate as well as holistic treatment methods which kept her internally peaceful and  happy. Moreover, it also stated the importance of the use of assessment techniques to collect relevant and accurate information to inform practice. Besides the various important diagnostics that have been performed to measure her blood sugar level, I also took verbal consent from both the family members as well as the patient in documented form about the different assessments which were conducted. Moreover I also engaged in to effective communication with the patient to gain relevant data about her health and also followed medical history which was provided to us by her family members. It also states the importance of working in partnership with different experts to determine the factors that affect the health of the patient. Therefore I also took suggestions of doctors, podologist and Physiotherapist so that the care which is provided to her becomes comprehensive in nature.

Therefore in my future practices also I will strictly follow each and every standards of the code in order to ensure the safest care to patients.

References:

Birks, M., Davis, J., Smithson, J. and Cant, R., 2016. Registered nurse scope of practice in Australia: an integrative review of the literature. Contemporary nurse, 52(5), pp.522-543.

Cashin, A., Buckley, T., Donoghue, J., Heartfield, M., Bryce, J., Cox, D., Waters, D., Gosby, H., Kelly, J. and Dunn, S.V., 2015. Development of the nurse practitioner standards for practice Australia. Policy, Politics, & Nursing Practice, 16(1-2), pp.27-37.

Fisher, M., 2017. Professional standards for nursing practice: How do they shape contemporary rehabilitation nursing practice?. Journal of the Australasian Rehabilitation Nurses Association, 20(1), p.4.

Kyle, R.G., Medford, W., Blundell, J., Webster, E., Munoz, S.A. and Macaden, L., 2017. Learning and unlearning dignity in care: Experiential and experimental educational approaches. Nurse Education in Practice, 25, pp.50-56.

Scanlon, A., Cashin, A., Bryce, J., Kelly, J.G. and Buckely, T., 2016. The complexities of defining nurse practitioner scope of practice in the Australian context. Collegian, 23(1), pp.129-142.

Sivaraman, G. and Green, N., 2015. Continuing professional development: Can-and should-what you do on social media cost you your career?. Queensland Nurse, The, 34(4), p.32.

Standard of practice, Nursing and midwifery board of Australia. (2017). Retrieved 19 October 2017, from https://file:///C:/Users/user00/Downloads/1798150_1830561517_Nursing-and-Midwifery-Board—.PDF