Reflecting on Needs in Nursing and Healthcare

Reflecting on Needs in Nursing and Health sustainmentThe aim of this essay is to critically reflect on peerless academic and one practical learning take up. This essay go out reflect in relation with my professional expandment as a health vexation practitioner base on the identified claims. Johns (1995) model of reflection allow be used as an aid to reflect on this assignment. The Nursing and Midwifery Council (NMC) PREP continuing professional study guidelines format impart be implemented during this writing. Confidentiality of the ward and longanimouss tuition pull up stakesing be maintained throughout this essay in line with the United Kingdom, Data Protection Act (1998) and NMC (2008) codes of conduct on confidentiality, therefore the diligent will be referred to as Mark a pseudonyms during description of the scenario.My identified clinical need based on information gathered from the setoff placement of my troika year has meliorate my communication structure dur ing endurings hand everywhere to all members of staff. Improving this need is signifi understructuret to me because, communication during patients handover backside be considered as a paramount aspect of nursing care. Dossey and Keegan (2013) supported this by expressing that effective communication must be enhanced in order for holistic intervention to take effect in nursing fare. I investigateed just about my clinical need for about twenty hours on different databases including government policies prior(prenominal) to writing this essay.On arrival to the ward I was asked by my mentor to hand over Mark a surgical patient to the harbor, health care assistant and an early(a) student nurse. During handover, I wanted to be outstanding and impress the health professionals as well as passing the vital information. However, this left me more than nervous which do me currentised how much I was struggling to articulate my sentence due to deprivation of structure. Odom-Forren (2 007) study analysed handover to be a real time process of passing essential patients information between care allowrs in order to ensure continuity and prophylactic of the patient. The plan of this article was outlined as the importance of using structure for standardizing patients hand over, this make me understand that I kick in not organism commensurate to communicate this during the handover of Mark due to lack of structure. Street et al (2011) research identified how application of structure standardised handover has displayed significant improvement during nurses handover. Structured handover makes the process more concise, objective and relevant (Griffen, 2010). Popovich (2011) research, Novak (2012) and Fenton (2006) study discussed how Implementations of a handover puppet assists in recognising changes in patients status more quickly. Structured handover allows the receiving nurse to ask question related to the patient status and promotes account might between shift s (Laws, 2010) therefore there is correlation in the research regarding structured handover.This motivated me into questioning myself in regards to why I had felt the way I did, and thought perhaps this could be due to insufficient amount of handing over and gathering essential information prior to handover which has not enabled me in developing confidence when handing over. Forren (2007) study sample size only focuses on perianasthesia setting handover which made this study relevant to me as my placement was in the theatre. The study could have been more applicable in future if the sample size was extensive to other clinical area as recommended by Russell and Gregory (2003) that articulated that studies with small samples may help to identify theoretically provocative ideas that merit further research. Lilleyman (2004) described handover as the most perilous procedures in patients care, a communication hotspot it was articulated that errors such as misinformation can jeopardise pat ients safety and get goingflow. I realised how limited my nursing intervention was when it comes to handing over and how I have not being able to adopt a authoritative approach during my communication with the nurses when handing over which can influence the property of care I deliver enchantment in like manner limiting my personal nursing development. This does not comply with the PREP has outlined in the NMC.Manser and Foster (2011) research recognized the significance of effective handover communication as it is critical to patients safety and fibre of care. This has empowered me in recognising that developing my limited structured communication and organising clear thought during handover has numerous amount of effect on patients safety during care. Meeting this essential need withal acquainted me with compliance to government policies such as NHS outcome 2013/14 that sets out the vision of the smock paper which encourages improvement in the care quality provided to pat ient such as reduced delayed care. The Quality and Outcomes Framework (QOF 2013) which is also a reasoned requirement by the care quality commission that focuses on increasing patients standardised safety, experience and outcome.A qualitative research conducted by Benham-Hutchins and Effken (2010) identifies insufficient amount of communication during handover can endanger patients care by causing communication breakdown which can also belong to mistakes such as drug error. This research was conducted in an acute setting, the researchers conducted the research by asking staff to describe the mode used for handing over that one major drawback of this approach is the methodology of the research which appears to be ambiguous. The researchers failed to take into consideration whether the staff nurses will be totally honest in the method used during handover. As I have seen while out in practice that not all nurses follow the tools available for handover, a more set aside method wil l be to observe the nurses during patients handover. An example of communication breakdown can also be identified as report in the Francis inquiry (2009) where patients care was endangered. Understanding of this has enabled me in accepting how I was unk directlyingly limiting my patients care and the partake it has on my ability to perform to my full potential as a final year student nurse which can lead to delay patients care, poor quality, risk and mistakes.In also developing this practical need I will be able to provide an several(prenominal)ised handover based on patients need to all member of staffs rather than a broad overview of patients. NMC code of conduct (2008) expects nurses to treat patient as an individual and respect their dignity. Pertinent information will also be assimilated in order to provide continuity of care to my patient as ac friendshipd in Manias and Street, (2010) research. Development of this need will enable to me to provide adequate handover which sho ws my competency while also enabling me to be accountable for my actions in order to make informed decisions and provide seamless care as obligatory by the NMC code of conduct (2008). My communication skill during handover will also be improved as it shows my professional development which is a requirement for PREP. This is also authorised by the Joint Commission (2012) that emphasises that well organised communication is extremely aboriginal to patients safety as communication can be considered as one of the leading issues contributing to patients harm. Therefore they recommended in the national patient safety goals that effectiveness of communication should be improved among care givers. Organising my thoughts before handover will support me to work in accordance to the embracement of the 6Cs set of care, compassion, competence, communication, courage and commitment of the nursing practice.Reflecting on areas that I went wrong and the positive feedback received from my mentor ha s equipped me in feeling more confident while also promoting self-regulation of clinical reasoning and questioning prior to, after handover and also during any form of nursing intervention. Scott and Ely (2007) emphasised that, positive performance should also be considered in reflection. In eagerness to improve this need I started incorporating evidence based into my practice during handover through reading, making notes of the structure used by notice my mentor when she handed over. Situation, background, assessment, recommendation known as the (SBAR) was one of the tool I observed my mentor and other nurses using in practice. The application of this tool aided my handover process as the questions within the tool allowed me to focus on vital information and be concise. Using this tool also enabled me in disbursal less time on handover as the information needed for communication during handover was gathered before handover. This action facilitated clarity, effective and assertive ness in my communication which made the lying-in of handing over a lot more easily.Another tool that I used as a structure in providing effective handover is the circumscribed early warning scores (MEWS) pathway. This pathway allowed me to identifying when a patient starts to deteriorate. in order for a patients deterioration to be passed on during handover as it was recommended on the chart that a patient with a MEWS score of four or more can be transferred within department as long this is communicated with the receiving department. The Mews chart enabled me to stand as an advocate in ensuring the patients care handed over to the other staff will not be compromised as I was able to document the exact figure of observation on the chart for monitoring while also maintaining patients continuity of care and safety. NMC code of conduct (2008) expressed, nurses to act as an advocate for those in their care, helping them to access relevant health and social care, information and suppor t. Currie (2002) CUBAN was used to enhanced patients care during handover by adopting Confidentiality during handover, uninterrupted communication, brief and concise information, accurate and relevant need, and Name nurse would be me and my mentor as we were looking after the patientBased on the knowledge I have gained through research and in- shrewdness reading of this need, I now have more detailed understanding of the effect the gap in my knowledge had on how I was limiting my patients care as I was missing pieces of important information. Now I can confidently apply the handover tools to practice which shows evidence based. This has changed my practice to improve the care I give on daily basis as indorsed by PREP.My identified academic need is critical view. The learning activity of this need took place over the first semester of my final year. The learning activity took me a week to gather all my feedbacks together from my entire previously submitted essay. After reading throu gh my feedbacks in depth I realised how all my tutors have stated I need to apply critical thought to my essays. Research on this academic need took me xv hours of gathering literatures to enhance my knowledge of this need in order to be able to critically analyse the need in accordance to my development.I have decided to elaborate on my academic need of critical opinion because Girot (2000) identified that in order for nurses to be safe, compassionate, competent and skilled practitioners must develop an aptitude of critical thinking. This made me realised how crucial it is for me to develop critical thinking as a nurse as it will assist me in identifying and challenging assumptions in practice and when writing my essays. McGloin (2007) research made me understand how I have not being reading widely to empower my ability of being able to think critically through development of arguments which has influenced my written work and care given to patient therefore limiting my personal development (PREP). Greetham (2008) also discussed how most student underused critical thinking whereas it is the most pertinent skill needed to improve academic writing.In meeting my academic need I am expecting to get better understanding of my work prior to writing my essay. Cotrell (2008) suggested that having a clear thought through reading widely about that specific area before writing the essay enables student to gain adequate result. This shows that low marks in my essays are intrusioned by my lack of reading and lack of appropriate supply before writing my essays. The ability of not being able to source evidence based practice will also have an effect on my nursing care. Critical thinking will allow me as a student to prioritise my work elongate when writing essays and while also out in practice (Hutchfield and Standing, 2012). Prioritising work load also provides space to be able to review and edit work on different occasions (Davis et al, 2011). Having a critical think ing skill will influence my patient care as I would be able to apply the skill of reasoning and questioning into complex situation encountered in practice. The Department of health (2010) also encourages critical thinking as it is a lark that is needed to be an advanced professional practice which is also required.Whiffin and Hasselder (2013) Research paper discussed how critical thinking is one of the characteristics that should be possessed by registered practitioners who owes the trading of providing critical solutions to problems that are complex. Gopee (2002) discussed that health care practitioners and student nurses applies critical thinking skill in their day to day practice whether they undertake the degree take or diploma programme but finds it difficult to transfer it into writing. Chan (2013) discussed how all nursing students can be considered as critical thinkers due to relating theory of what is learnt in class into practice. Hicks (2001) suggested that critical th inking can be substantial through experience that involves undertaken complexity activity. Lauder and James (2001) study analysed that there are no significant differences for graduate and non-graduate student when it comes to critical thinking which nicely correlate with Gopee (2002). Understanding of this and having read through different research on what critical thinking is has enabled me to understand what the term critical thinking is. This made me recognise this is a skill I have been applying into my practice unknowingly which I have developed through series of placement but I have not being able to apply it thorough into my academic essay. For example in practice I was told by my mentor that we needed to trial without catheter (TWOC) a patient, this made me question why we were taken this action earlier than usual, whether it was documented by the Doctors, if the patient has been informed and what the after plans were. Reflecting back made me understand this action can be considered as being critical to maintain efficient care. However Girot (2000) research causes lack of consensus by articulating that graduate nursing students possessed greater care planning and decision making skills than non-graduate nursing students. Development of my need connect more with Gopee(2002), Lauder and James (2001) because not all nurses seen in practice undertook the degree program but they are still able to apply critical thinking into the daily nursing activities.Critical thinking will enable me to have the characteristics of a critical thinker while making me accountable for my actions and provide quality nursing care as recommended by Scheffer and Rubenfield (2000) that analysed critical thinkers in nursing exhibit habits of confidence, contextual perspective, flexibility, inquisitiveness, open mindedness and reflection. In realising this it made me understand development of this need has huge impact on my nursing profession as it essential for me to examine ever y underlying assumption. Critical thinking will result in me providing higher quality of care as I will be able to meet the need and concerns of my patient which is required by the care quality commission. In meeting this need I will be able to consider alternatives, preferences and question any uncertainty. Booth (2008) discussed practitioners must sought after the vanquish available tool to reach the best available decision when providing nursing intervention. In order to impact my patient with positive experience, maintain safety and deliver positive outcome I will need to apply my critical thinking skill by assessing the best practice for my patient through autonomously holistic care. Profetto-McGrath (2005) and Scheffer and Rubenfield (2000) discussed how critical thinking improves patients outcome through evidence based practice. Gadamer (2000) research discussed how critical thinking enable nurses to develop as an expert through knowledge and proficiency stage as this allows the nurse to move from being task orientated towards patient specific care and need. This academic need has been limiting my development because awareness of this has made me gathered how much I could have been task orientated in my essays and nursing intervention in order to get the task done rather than reading and seeking for ways to provide an expertise care and work. Chan (2013) study made me realise reading widely is encouraged as it assist student to develop more sophisticated form of reasoning which make complex problems a lot more easier to deal with.This need has a huge impact on my nursing development because appliance of critical thinking enables me to provide quality essay through informed research and also provide safe evidence based care through clinical judgement by finding and applying guidelines in practice (Young, 2004). Critical thinking will enhance my professional development by enabling me to seek out the truth by actively exploring a problem or situation. It will also facilitate me to provide adequate patient centred nursing assessment and intervention while also acting as an advocate for my patient. Development of critical thinking reflects my competency as this is one of the expectations of the NMC code of conduct (2008) and National Institute of health and care excellence (2010) laid emphasised are laid on the importance of critical thinking in nursing practice to perform higher care (Chang et al 2011). Development of this truth seeking need can also leave an impression on my colleagues to strive for the best practice available hence influencing the work environment positively which has a great impact on patients experience as covered in Chan (2013).Applying critical thinking into my essays has enabled me to be more analytical when using research as evidence to back up points in my writing. Critical thinking has assisted me in planning efficiently before conducting my academic work for example I had to utilise this skill when it cam e to selecting the best literature to critique and analyse my work prior to writing. Price and Harrington (2010) discussed one of the components of successful academic writing is thorough preparation and through planning. As critical thinking is an on-going skill I will continue applying it to my learning and practice by reading more. Critical thinking can be considered as a key ingredient to lifelong learning that characterizes personal growth and development through experience and practice (Banning, 2006).In completion development of these needs has influenced my knowledge and ability of being able to provide evidence based practice into my patients care. It has also impacted my academic work by enabling me to question the validity of research before applying it to my essay.