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Driscoll’s Reflective Model

Introduction to Adoption of New Practice Standards in Nursing

Reflective practice is an essential component of effective nursing as it allows the individuals to critically analyse a clinical situation, evaluate the results, and introspect to promote knowledge and improve the outcomes (Smith 2016, p. 552). This paper will apply the Driscoll’s reflective model to analyse a clinical scenario of my PEP placement. The model will be applied through its three core components, that are, “what”, “so what?” and “now what” to discuss the incidence of the clinical situation, evaluation of actions, and reflective introspection for the required improvements respectively (Driscoll et al. 2019, p. 224).

Step I: “What?”

As a student nurse, I was placed in a clinical setting and assist the senior facilitators. I was very nervous as this was my first placement and it was a completely new environment. My facilitator had asked me to record the vitals of the patient who had suffered from an accident injury and was also suffering from mental health problems. It was for the first time I was recording vitals for an individual with Bipolar disorder. I talked to the patient and informed him that I was the care nurse who will be recording the vitals. As I was charting the vitals of the patient, I could not accurately record the blood pressure of the patient as the patient started withdrawing consent from the process and asserted that he did not want to continue with the procedure. I was assisted by the facilitator who communicated with the patient and assured the need for vital assessment. The patient cooperated and we were able to record and chart the vitals of the patient. Before this incident, I had limited experience with managing communications and cooperation with the patient with complex needs and my facilitator assisted me how to assure participation and encourage patients to comply for medical needs through building trust and communication. I noted all the vital observations and documented them in the observation chart. Once the vitals were noted, I was asked to assess the wounds and injuries of the patient and ensure his wellbeing. I sanitized my hands as per the hand hygiene protocol before touching the patient and introduced the procedure to the patient to request cooperation. This time, the patient cooperated and asserted on a particular injury that was causing severe pain. I was a little anxious and nervous throughout the assessment as I did not know what was a suitable way to communicate and ensure compliance and cooperation of the patient. After an assessment of the injuries and wounds, I recorded the observations and presented them to the facilitator. I also sanitized after assessment of the injuries and provided them to the facilitator who pointed out that I had not mentioned the pain score. I collected the pain score of injuries and provided the complete assessment of the facilitator.

Step II: “So What?”

Since this was my first experience in PEP, I was anxious and nervous to be interacting with the patient. Also, the patient possessed complex needs and this was my first experience with an individual with a bipolar disorder. This impacted how I approached the patient as I was extremely cautious and anxious about the procedure. Due to lack of knowledge, I was not able to communicate with the patient freely and thus, was not able to build trust and rapport initially. When the facilitator helped me understand the importance of effective communication in nursing, I was able to communicate with the patient better and assure patient cooperation for further assessments. The Nursing and Midwifery Board of Australia has established an ethical code of conduct that directs the healthcare professionals to ensure enhanced communication with the patients to understand their needs and to provide the highest quality care (Ossenberg et al. 2020, p. 353) Effective communication is also beneficial as it helps in building rapport and ensures person-centred care (Sibiya 2018, p. 1012). While assessing the wounds and recording injury observations I had failed to record the score of the pain of the patient. Assessment of pain is a crucial aspect of primary assessment as it helps in prioritizing the interventions to ensure the comfort of the patient (Huang et al. 2016, p. 2569). Due to my nervousness, I failed to acknowledge the complaint of pain made by the patient and record the pain score index in the initial assessment. However, I later collected the required information and resented them to the facilitator. Therefore, through this experience, I have evaluated that I need to improve my communication skills in nursing as well as improve on the technical aspects that include recording suitable patient information to develop as a competent nurse.

Step III: “Now What?”

As I reflect on my experience, I would describe it to be extremely helpful in providing me with new knowledge and see it as an opportunity to have applied my nursing skills. Through this experience, I was able to learn about the clinical scenarios and their functioning and was also able to understand the importance of nursing duties and responsibilities. The first thing that I have learned through this experience is the prime importance of effective communication in nursing. I have realized that effective communication not only helps in the development of a strong connection with the patient but also helps in understanding their care needs and delivering quality care (Williams et al. 2018, p. 1013). My nervousness and anxiety affected my approach and communication towards the patient that affected the rapport and overall practitioner and patient relationship. To improve my communication skills, I will ensure that I develop on soft skills, enhance my competence, and learn through reading, practice, and taking notes from observation of senior nurses (Witt et al. 2018, p. 18). I will also ensure to encourage patients and promote their participation in care through active listening and understanding their care needs to advance as a competent health care professional (Sibiya 2018, p. 1013). I also acknowledge the need for improvement in my record taking skills as due to my nervousness around the patient, I did not record the pain score. Therefore, I will enhance my skills through reading, participating in clinical placements, and learning from experiences like these. I will make sure to cross-check that I have noted all the required details by noting them in the list and before leaving the patient (Mayo 2017, p. 18). I will also take the assistance of mu seniors and facilitators to guide me for suitable improvements in the course with an accepting and acknowledging attitude (Stewart et al. 2017, p. 585). Through these improvements, I feel, I will be able to enhance my nursing abilities and advance as a good healthcare practitioner.

Conclusion on Adoption of New Practice Standards in Nursing

This paper provides a reflective analysis of a PEP placement where I had to record vitals and to the primary injury assessment of a patient of a bipolar disorder who had suffered from injuries after an accident. This reflective paper applies Driscoll’s reflective model and provides an analysis of the clinical experience in terms of event, actions, and learnings. Further, a brief action plan to develop my communication skills and record-keeping skills for patients has also been included in this paper.

References for Adoption of New Practice Standards in Nursing

Driscoll, J., Stacey, G., Harrison-Dening, K., Boyd, C. and Shaw, T. 2019. ‘Enhancing the quality of clinical supervision in nursing practice.’ Nursing Standard, vol. 34, no.5, pp. 224 <https://pdfs.semanticscholar.org/6e37/13961e3f95377d2e4beec9a0b16db1b9afa2.pdf >

Huang, T., Xiao, P., Zhang, W., Chen, X., Xiaoxia, L.I., Cheng, S. and Luo, J. 2016. ‘Applying specialist nursing assessment indicator system to improve nurse′ s assessment ability in orthopedic department’. Chinese Journal of Practical Nursing, vol. 32, no.33, pp.2565-2569. <http://wprim.whocc.org.cn/admin/article/articleDetail?WPRIMID=508989&articleId=508989>

Mayo, P. 2017. ‘Undertaking an accurate and comprehensive assessment of the acutely ill adult’. Nursing Standard, vol.32, no.8, pp.16-20 <http://search.ebscohost.com/login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=00296570&AN=125833482&h=xk2qlRP91vnNL1q6adsyQ%2BOOhYbxkbmEw8dR5uv9qYW%2B6pD35zk4%2BP%2FP60INXZE5SLPr%2BX9Df7%2BhyCHF8JexRQ%3D%3D&crl=c>

Ossenberg, C., Mitchell, M. and Henderson, A. 2020. ‘Adoption of new practice standards in nursing: revalidation of a tool to measure performance using the Australian registered nurse standards for practice’. Collegian, vol. 27, no.4, pp.352-360. <https://www.sciencedirect.com/science/article/pii/S1322769619303841>

Sibiya, M.N., 2018. ‘Effective communication in nursing’. Nursing, vol. 19, no.7, pp.1012 <https://books.google.com/books?hl=en&lr=&id=Ib-QDwAAQBAJ&oi=fnd&pg=PA19&dq=communication+in+nursing&ots=7ftEKWt4oE&sig=h_208Ae1xpXh9sU4diW0hJOdKFM >

Smith, K. 2016. ‘Reflection and person-centredness in practice development’. International Practice Development Journal, vol. 6, np. 1, pp. 552. <http://www.academia.edu/download/50189861/IPDJ_0601_12.pdf>

Stewart, K., Doody, O., Bailey, M. and Moran, S. 2017. ‘Improving the quality of nursing documentation in a palliative care setting: a quality improvement initiative’. International Journal of Palliative Nursing, vol.23, no.12, pp.577-585. <https://www.magonlinelibrary.com/doi/abs/10.12968/ijpn.2017.23.12.577>

Williams, K.N., Perkhounkova, Y., Jao, Y.L., Bossen, A., Hein, M., Chung, S., Starykowicz, A. and Turk, M. 2018. ‘Person-centered communication for nursing home residents with dementia: four communication analysis methods’. Western Journal of Nursing Research, vol. 40, no.7, pp.1012-1031. <https://journals.sagepub.com/doi/abs/10.1177/0193945917697226> 

Witt, M.A., McGaughan, K. and Smaldone, A. 2018. ‘Standardized patient simulation experiences improves mental health assessment and communication’. Clinical Simulation in Nursing, vol.23, pp.16-20. <https://www.sciencedirect.com/science/article/pii/S1876139917303730>

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