The willingness to reflect upon one’s previous experience of practicing their expertise is recognised as reflective practice (Johnston, 2017 p20). In this essay, this practice will be assessed in alignment to the profession of nursing and their engagement with indigenous people. This promotion of this practice will lead to professional growth in the health care petitioners. This essay will be discussed within the framework of Gibbs reflective cycle. This particular tool is used to promote the culture of stimulating the growth of personal and professional aspects of a health care official.
The following essay is the reflection of my personal experiences during the session of my unit. I will reflect on the lessons learnt and their usage at professional workplace and especially with indigenous people with my understanding.
I am currently studying nursing to fulfil my passion of providing care to people in the moments when they need it the most. I will be reflecting upon my understanding of course topics and learning material provided to me during my unit term to analyse my experiences and focus on both the aspects, positive and negative. I will highlight this one incident that happen in the first year of my competent nursing period. An elderly was brought in our ward, as he was ailing from the disease of cancer. He was unable to communicate with us, me and other nurses in my term. He was an old man and his common sense was at a low level, so it was a difficult situation to understand the need of the patient.
The process that was adapted by me and other nurses will be the highlight of this reflective essay. The patient was old and unable to communicate with proper usage of linguistics or one could say verbal communication. Hence, we had to develop some method to communicate with the patient. The significance of coming up with creative nonverbal communication is a positive towards person centred care.
This fact became more evident when the other day, a nurse was speaking to the doctor, and this elderly patient heard words like ‘radiotherapy, which startled him. Then he, started acting uncontrollable because from the fear of the complexity of medical procedures he would have to go through. The patient is a person who is mentally and physically and if the disease is something like cancer, which has the tendency to consume the host. I understood the rationale behind the patient’s behaviour towards something he heard coming out of a discussion in between health care professionals.
I was there when this happened, and I had to jump in to control the patient, as he was moving hastily, hurting himself through the surrounding medical equipment’s and others. I realised that when a person is scared for their life, they tend to act relentlessly at any possible minor mishap they notice, in their perspective. After a while, the patient was calmed and given a sedative so that he could relax for a while, as the situation of his weak condition could not be compromised.
When I saw that reaction of the patient agitating and behaving in an uncontrollable way, I got restless inside my mind too, as I have never come across a situation like this. As I was working there at the post of an intern since 4 months, I was not well assured what to do and what not do. I based my judgements on my moral compass, and I joined the other nurse to calm the parent down. As he was an elderly person, I felt sorrow for the uncomfortable situation he was going through.
The doctor and nurse whose conversation triggered the patient were trying to stop the patient to move his hand fiercely and blatantly as he could hurt himself and others. It was clear that the distressed patient could not be handled with two people, so when I came forward to help, it was accepted and appreciated. Gradually we held the patient down, made him breathe, that slowed his movements. The other nurse filled his saline pouch with medicine that made him sleep in a while.
After the incident was wrapped up, me and my colleagues sat down to discuss about what happened and why did it happen. After some debate and discussions, we reached to a point where everyone agreed that the enabling of therapeutic communication should be practiced (Annoni & Miller, 2016 p87). This communication keeps the patient in the centre of the treatment, as in, their wishes, opinions would be considered in the process of decision-making. Health care professional can provide their efficient service with the application of this communication as it mostly relies on nonverbal communication.
When the event took place, I was unsure what to do, but I did what my integrity guided me to do. I felt good in helping the old main but I felt utter sorrow when I could not do anything earlier to help him or any other patient who might go through these kinds of panic attacks in a nursing environment. When I was trying to calm the patient along with other nurses, I felt that fear in the mind of the patient and I was disheartened as a caregiver.
The other nurses and doctor involved in managing that elderly patient showed mixed kinds of feelings. The doctor was clearly worried, as he got a minor injury on his wrist while handling the patient. The nurse looked irritated and scared with the behaviour of the patient, which in result triggered him more. That is the reason I came forwards, as I noticed the mishap happening. When all of this was finished, and my colleague and me sat down to discuss the reasons of the even happening. The role of inter professional communication was highlighted in the conclusion we all reached at (Foronda, MacWilliams & McArthur, 2016 p 38). This method is applied with the help of self-awareness, emotional intelligence and active listening to what patient is saying or trying to convey.
My feelings about the event was to practice therapeutic communication based on its principles that I was taught in my unit term. I planned to imply it further when I have to engage in communication with patients. This mostly works when one has to manage indigenous patients. For example, if I ever encounter with the patients from Aboriginal and Torres islander people, I would practice therapeutic communication with intra professional skills to provide them with the essence of cultural safety (Bennett-Levy et al., 2017 p19).
The guideline provided for health care professionals while working with indigenous people demands them to build their relationship with them on the grounds of mutual respect (Reccommendation C1) (Ncbi.nlm.nih.gov, 2001). The term ‘respect, is perceived to be valuable emotion and gesture which is widely appreciated and accepted by them. I was made aware of this fact in my course period; hence, I decided to follow that for my future encounters.
The moment that elderly indigenous patient panicked, I had the instinct to my apply my body strength to control him. This made him more restless, which proved my action to be wrong. Therefore, I realised if I had followed the recommendation C2 in the government guideline I would have understood the gap of communication in-between him and me, and according to it (Ncbi.nlm.nih.gov, 2001). For example, if I could use my emotional intelligence to calm the patient through conveying him messages to relax through nonverbal communication.
My nursing internship gave me the opportunity to practice my acquired skill set through my unit term at real time workplace. It helped me to grow in my expertise, which is beneficial for me in personal and professional aspects. I realised the significance of inter professional communication to provide person centred care (Santana et al., 2018 p435). It made me aware of the real life situations and its complexity. I now emerge as a confident nurse than I was before the time I started my training. Therefore, I fell more prepared to adapt to any health care organisations working pipeline and the methods of implementing effective nursing skills.
My behaviour noticeably improved, as the reaction or response was mostly positive whenever I engaged with them. This indicated that I am applying the acquired nursing skills that I learnt my term correctly. With the application of holistic approach, I focused to maintain eye contact while speaking to them, show them compassion and document the vital clinical information, which covers the patient’s preferences (Bonczek et al., 2016 p272). The health care staff like me should engage in more time to communicate and interact with the patient to adapt fast to the learning ability that will enable professionals like us to care for the patient efficiently.
The implication of practicing the lessons that I learnt from my course unit in my professional practice area helped me to sharpen my skills and understand the dynamics of the real time workplace as well. The touch points that I covered or I could say that during my experience I identified the problematic area in my skill set. I discovered that effective communication can achieved if I remove my communication barriers (Norouzinia et al., 2016 p65). The most important one is to remove the perceptual barrier followed by the linguistic one, which is more relevant in the case of indigenous people.
If I had chosen not to take any action at that distressed event when the elderly indigenous patient felt panicked and behaved uncontrollably, I would never go into a situation to think about the reasoning of that occurrence. My critical thinking led me to the realisation of adopting new communication method in order to never make my patients feel uncomfortable or the sense of fear and fatality. Therefore, it would have made a great difference in my personal and professional growth if I had chosen to do nothing at that moment of the mentioned event.
If I ever encountered this similar experience, I would instantly reflect back to my previous experiences in the professional department and jog back my memory to revise the skills I learned from my academy during my unit term. I would constantly research and study papers published by scholars to be updated about my skills and make myself adhered to the guidelines complied by the Australian Government. I would indefinitely practice therapeutic communication, which is of two types - verbal and nonverbal. I would put emphasis on nonverbal communication, to overcome the linguistic barrier while treating indigenous people.
In future, my ambition would be to be more proactive in the treatment of my patients and responding towards a panic situation more efficiently. I would also try not to jump into situations without the knowledge of how to handle the situation; I would rather get an expert or a more qualified specialist immediately.
Additionally I would address the needs of the patients first, in my future workplace. I would try to build an inter-professional relationship with the patient to gain their trust in the first place. I could achieve so, with the practice of emotional intelligence and active listening to interpret the meaning conveyed by the patient and its family to me. I would always analyse the approach I would adapt to address a patient and especially if they belong from indigenous background. This is because as a health care professional it is my duty to reduce the gaps of unequal health services provided to the people of my country.
I can never be sure if my colleagues would always be attentive towards the needs of the patients and the same applies to me. Patients come from various backgrounds and understanding what could cause the comfort or discomfort is a complex task, which requires a holistic approach. Therefore, I will always use the proposed framework of Gibbs to reflect upon my actions, in order to bestow myself with constant improvement (Li et al., 2020 p76).
It can be concluded that the application of reflective thinking on the learning period of mine during the course of nursing has led me to measure my powers and flaws extensively. This will now help me in the enhancement of performance exhibited by me at a workplace when I am selected by a health care organisation to provide professional health care services to their patients coming from varied cultural background.
Annoni, M., & Miller, F. G. (2016). Placebo effects and the ethics of therapeutic communication: a pragmatic perspective. Kennedy Institute of Ethics Journal, 26(1), 79-103.
Bennett-Levy, J., Singer, J., DuBois, S., & Hyde, K. (2017). Translating e-mental health into practice: what are the barriers and enablers to e-mental health implementation by Aboriginal and Torres Strait Islander health professionals?. Journal of medical Internet research, 19(1), e1.
Bonczek, M. E., Quinlan-Colwell, A., Tran, S., & Wines, K. (2016). A holistic approach to improve nursing retention during the first year of employment. Nursing administration quarterly, 40(3), 269-275.
Foronda, C., MacWilliams, B., & McArthur, E. (2016). Interprofessional communication in healthcare: An integrative review. Nurse education in practice, 19, 36-40.
Johnston, C. (2017). Reflective practice. Teaching Business & Economics, 21(1), 19-21.
Li, Y., Chen, W., Liu, C., & Deng, M. (2020). Nurses’ Psychological Feelings About the Application of Gibbs Reflective Cycle of Adverse Events. American Journal of Nursing, 9(2), 74-78.
Ncbi.nlm.nih.gov (2001) A Guide for Health Professionals Working with Aboriginal Peoples: Cross Cultural Understanding. Journal SOGC: Journal of the Society of Obstetricians and Gynaecologists of Canada, 1. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3653841/
Norouzinia, R., Aghabarari, M., Shiri, M., Karimi, M., & Samami, E. (2016). Communication barriers perceived by nurses and patients. Global journal of health science, 8(6), 65.
Santana, M. J., Manalili, K., Jolley, R. J., Zelinsky, S., Quan, H., & Lu, M. (2018). How to practice person‐centred care: A conceptual framework. Health Expectations, 21(2), 429-440.
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