Transition Into Nursing Studies

Description of clinical practice exercises using Gibbs’ six model cycle

Discuss about the Transition into Nursing Studies.

Today, the nursing industry is advancing due to the use of sophisticated health equipment in delivering quality healthcare. The mechanism calls for nursing professionals to continuously work and adapt to the dynamic health sector by updating their knowledge and skills so as to handle patients and healthcare issues. Firstly, clinical reflective practice exercises is, therefore, an integral part of today’s health sector rendering nurses competent in delivering quality health care and serves as a measure of how qualified professionals are to address health challenges.   Secondly, clinical reflective practice exercise allows one to learn from personal experiences and develop competence in identification and learning needs; where reflection calls for an integrated approach that entails the understanding of a patient’s belief, values, and attitudes and relates to the code of ethics. Lastly, a curricular that involves critical reflective practice advocates for the understanding of new and current health system as a medium through which health professionals  engage in self-monitoring programs. As such, arguments in this paper seek to illustrate the need for a curricular that integrates clinical reflective practice in nursing hospitals in Australia. Notably, the first section will descriptively discuss the clinical practice exercises using Gibbs’ reflective cycle while the second section will assess the health and nursing care on a case study as shown below.

Description of clinical practice exercises using Gibbs’ six model cycle

The term reflective practice dates way back in the year 1983 where Boyd and Fales, 1983, were of the opinion that reflective practice involves internalizing and relating an experience to the outside world views. Additionally, several models and theories are conforming to the norm of reflective practice. For instance, Gibbs’ Model of Reflection and Johns’ Model of Reflection offer guidance for health practitioners to critically evaluate their experiences in a clinical setting and draw conclusions regarding the experiences. Likewise, “the pyramid of evidence-quantitative studies” sets a platform for the discussion of Evidence-Based Practices which can substitute clinical reflective practices. Research has it that in the former nurses applied the best-selected practices to manage patients and offer quality health care.

Currently, I am a second-year student at Federation University Australia pursuing Bachelors of Nursing Program. In my first year of study, I had the opportunity to conduct a fieldwork research where the method of data collection entailed personal interview with a mentally chronic patient.  The incident occurred around Sydney where I was to interview my participant for the first time. After introducing ourselves the personal assistant to the patient and the patient allowed me to ask questions. However, when I was due to start asking questions, I got tongue tied and started fumbling. I was unable to utter any word, and my hands were shaking. Seeing the incident, the assistant to the patient stood up and off they took. I was left hanging with no one to speak to and offer help.

I felt bad and cried because it portrayed a bad image to the participants; it was as if I did not want to interact much and get in contact. The embarrassment made me think of quit nursing and resort to my passion for art and design. After a day I felt that the participant wasn’t patient enough to understand my situation and she judged me basing on my inability to express myself.  After reflecting on the case, I decide to call back to the Dean School of Nursing to explain the scenario, and it also came to my understanding that being nervous is a common thing during interviews.

Physical and mental health assessment components

After internalizing the experience, I came to understand that people respond differently to non-verbal cues. In my position, I portrayed a bad image of undermining the participant, and the assistant saw it wise to avoid ridicule. After speaking to my classmates I was relieved after realizing that it is a common thing to be nervous when in contact with new groups and patients. Moreover, as part of my evaluation, I spoke to a friend who was a third-year student and the response given encouraging when she talked about her first interview being with an infected patient. She was not only able to speak to her but also interact to the level of eating from the same plate.

The situation looked ugly because of my actions and both the assistants’. I feel that it could have been good had I spoke and stood up to him, then allowing him to take off without even saying a word and unhappy immediately. By contrast, I chose to talk to the Dean School of Nursing and never made a follow up on meeting with my participant again. However, preventing the assistant from taking off with the patient could have done his instincts right. After meeting with the Dean and the member with the assistant he argued out that it could have been better if I had said something to avoid making the patient feel out of place.

In future am planning on building healthy relationships with classmates, senior students, and teachers. Currently, I am working with a team of four students on conducting an interview with different patients faced with various health conditions. Additionally, we are in talks with our teachers to have a curricular on how carry out fieldworks in various social set ups so as to enable us to understand how to associate with different people based on ethnic background, race, language, and gender roles. I have planned a presentation on effective communication to deliver to the first year students and teach them on ways to overcome nervousness; I plan to do this with other students and the help of our teachers. Regarding training, I am partly working with the Clinics and Services under the Primary Care Clinic which is open to the public so as to gain confidence when addressing the public.

Kevin is a 28-year-old Community worker, who was rushed into the emergency department by the brother after being found at work trying to commit murder. I observed Kevin’s assessment alongside other health professionals and his response was proof that he was mentally disturbed; Kevin said that he could not understand why at times the patient felt the negative energy took control of him and that his conscious was not aware of what he was doing. In the clinic emergency section, Kevin was assessed and advised. I observed Kevin’s hygiene was deteriorated despite being a community worker. The brother helped him in answering the questions, and it was evident that Kevin had not shown up for work for a week.

Background information

The section outlines the medical and nursing history of Kevin and his family. Also, the article will discuss the social history of the disease and analyze the physical examination results.

Kevin has a chronically mental disorder. The event that led to his appearance in the clinic emergency department is because he had stopped using his medication for two weeks. Recent studies have it that creating a good relationship with a chronically mental patient will foster the uptake of medicines. The chronic mental disorder is characterized by the following traits namely hallucinations and delusions. Hallucination is the deficiency in sensory reception affecting reality. The condition makes Kevin perceive fantasy as reality, and to some extent, he sees things people cannot visualize. Delusion is false beliefs that cause imbalance in thinking and sees Kevin make irrational decisions when challenged.

Family and social history

Kevin’s father was diagnosed with the chronic mental disorder at the age of thirty-six years old and moved to a rehabilitation center for mentally disturbed.

Kevin was defensive during assessment and did not want any medical officer to get near him. His brother helped him in answering the questions during the assessment. Kevin’s hygiene deteriorated evident by unkempt hair, dirty teeth, and clothes.  The brother reported that Kevin had not been having enough sleep and was not eating. I noted that during the assessment Kevin avoided direct eye contact with the chief doctor. Another key thing to remember is that Kevin’s brother was not willing to stay with Kevin when he was off medication.

Nursing diagnoses, nursing interventions, and patient outcomes are important nursing issues that determine the formulation of a nursing care plan in any health institution; be it a mental health facility or a general hospital. Nursing diagnoses is a clinical record of a family or an individual depending on the health experiences. A nursing diagnosis is based on assessment data, and it should present a solution to the health condition at the time of evaluation. Nursing interventions are system that gives an in-depth analysis of how nurses perform duties in a health institution so as to treat and manage health disorders; for instance, mental health nurses will use a guideline provided by the health provider to treat and administer medication. Last but not least, patient outcome is the first-hand information offered by patients to health professionals and help in improvising and implementing treatment.

Firstly, Kevin was put on antipsychotic medication of 20mg one time daily in the first week and scheduled to double at the start of the second week. The administering of the medication by the doctors followed the report by the World Health Organization on care planning on chronically mental disorder; where organization officials suggested that use of antipsychotic to treat chronic mental illness is of significant to stabilizing the patient.

Secondly, Kevin was taken to psychotherapy alongside his brother where the doctor talked about his conditions and related mental health issues. During the session, Kevin’s brother was made aware of the feelings and behavioral acts of Kevin and factors that agitate his actions. Besides, he was taught on ways to cope with the stress. At the end of the discussion, Kevin agreed to have long-term consultation psychotherapy with the doctor to improve his emotional and behavior.

Family and social history

Thirdly, Kevin was moved to a psychiatric care inpatient unit to be monitored for the next twenty-four hours. The move was aimed at improving Kevin’s mental health as well as his hygiene. In the psychiatric unit, Kevin was put on antidepressants and mood-stabilizing medications. The antidepressants are used to treat anxiety and depressions. The drugs improve a patient’s lack of energy and relax the mind. On the other hand, mood-stabilizing drugs are used alongside antidepressants to treat depression and to some extent treat bipolar mania conditions of patients.

During the twenty-four hours monitoring in the psychiatric care unit Kevin showed improved signs and promised never to threaten to commit murder.  Community group therapy was administered during the period. After the twenty-four hours, Kevin was discharged back to his family where his medication is overseen by the home based health care practitioner. Kevin also attends sessions twice a week for people with the chronic mental disorder.

Recently the Australian College of Mental Health Nurses in partnership with the World Health Organization launched an online CPD with the aim of improving the knowledge and skills of nurses to curb mental health conditions related t chronic diseases (Badland et al. 2014). Subsequently, the ACMHN is creating awareness on the increased case of the chronic disease in the state by training nurses on how to identify, intervene, treat and manage mental illness in a population with the chronic disorder. Notably, it is important for mental health nurses as well as all medical practitioners to have the knowledge and skill on how to treat and manage chronic illness owing to the fact most health professionals are at the grassroots of health care provision in Australia. The ACMHN has paid attention to details on the idea of psychotherapy and having hospital psychiatric units’ to monitor patients (Badland et al. 2014).

The ACMHN has an eLearning program which lasts for up to 20 minutes and focuses on chronic illness such as cancer, diabetes, cardiovascular disease and mental health. The modules are aimed at shifting the level of awareness of patients on the chronic disorder to ensure sustainability of the project, enable relatives to cope with the stress of living with chronic mental disorder patients, and support families and patients while building healthy working relationships.

Conclusion

To sum up, I believe that I can do a lot to better service delivery in the nursing sector. Firstly, I ought to have spoken to the assistant before meeting them with the patient as it could have orientated me for the day (Holloway and Galvin, 2016). Secondly, the fieldwork made me appreciate the importance of team work during a study; it breeds creativity and makes it easy to handle any work due to the diverse nature of the team. Thirdly, I feel that it could have been better to contact the Dean before starting the fieldwork so as to familiarize with the scope of study; it could offer a solution for curbing the nervousness, and the interview could have been successful. Lastly, it could have been a good choice if I had read much on the mentally chronic disease before taking to the field.

To that end, it is evident that Evidence-Based Practices offer medical officers a chance to apply clinical reflective practices in their work.  The first interview was hectic due to my naivety and lack of exposure.  However, after internalizing and reflecting on actions, I was able to hold a presentation before the first year students and use my experience to create awareness on how effective to conduct an interview. Clinical reflective practices also serve an important role in giving nurses identity to their personal experiences and make the best out of it. Most importantly, the treatment and management of chronic mental disorder entail integration of both social and cultural factors where the community decision is placed at the center of the directorate process. What is more, is that the ministry of health in Australia and stakeholder in the nursing industry need to implement the clinical reflective practice exercise in the curricula starting from senior schools.  It is, therefore, possible to treat and manage chronic illness provided the relationship between the patient, the nurse, and the family is well maintained.

References

Badland, H., Whitzman, C., Lowe, M., Davern, M., Aye, L., Butterworth, I., … & Giles-Corti, B. (2014). Urban liveability: emerging lessons from Australia for exploring the potential for indicators to measure the social determinants of health. Social science & medicine, 111, 64-73.

Holloway, I., & Galvin, K. (2016). Qualitative research in nursing and healthcare