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  • Subject Name : Nursing

Practice Standard : Applying Knowledge to Practice

Professional practise is important for every profession but when it comes to nursing they expected to be extra careful concerning the working practise. The nurses continuously improve their skills and professional practise to improve patient experiences and health status. The nurses utilized the professional practise model that utilized the framework to improve safety and patient-centric care. The professional practices that improve the working practice of the nurses include leadership, partnership, interdisciplinary relationship, shared vision and clinical practise (Slatyer et al., 2015). The area where the nurses lack while following the professional practice is the gap between the theory and clinical practise. Numerous concepts and theories are included in the nursing curriculum but they lack information concerning how to apply this theoretical knowledge in clinical practice. There is a need to improve the integration of the clinical practise with theory to improve the professional practice of the nurses (Safazadeh et al., 2018).

Reflective learning is considered to be an important aspect to improve the professional practice of nurses in health care. Reflective learning helps the individual to evaluate their past clinical practise so that issue identification can be done to improve future practice. Different stages of reflection can be used to understand the incident by evaluating every aspect. Nurses can utilize reflective learning to improve their professional practise that is necessary for better patient experiences. The incident that can be used for the reflection can be good or bad but the main aim of the exercises to learn from the past to improve future practise (Koshy et al., 2017). Evidence-based practise is also important to improve the professional practise in nursing as it helps to understand the latest practice skills and techniques that are required to improve the professional practice. The nurses are expected to utilize the best external evidence that is necessary to update the working practises. It helps to integrate individual knowledge with relevant evidence to improve clinical practice. The nurse should include evidence-based practice in clinical practice to update and improve professional practice. Evidence-based practise not only unitized to identify the past practice but it also helps to update the old practice to update them as per new health care services (Reid et al., 2017).

As a nurse, I will try to improve my professional practice skills by utilizing different methods that are necessary to identify the gap in the skills. During my clinical practice, I have realized that when it comes to working in a team I lack collaboration and integration are necessary to work within a team. I should improve my professional practice skills by addressing this gap to improve my performance in the team when it comes to patient care. The main aim to improve professional practice is to increase the understanding of reading the different skills and qualifications that are necessary to be a nurse. I will try to improve my clinical practise skills that will improve my understanding of the scope of practice as a nurse.

Standard 3 The Mental Health Nurse develops a therapeutic relationship that is respectful of the individual’s choices, experiences and circumstances. This involves building on strengths, holding hope and enhancing resilience to promote recovery.

During my clinical placement when I was taking vital of the patient I observed that my colleague was performing the Generalized Anxiety Disorder- 7 (GAD-7) assessment but she was facing issue while communicating with the patient. She was trying to explain to the patient that this assessment is necessary to evaluate the health status of the patient. The article presented by Toney-Butler & Unison-Pace (2019) discussed the importance of the patient assessment before starting the treatment as it helps to identify the root cause of the issue. The patient was reluctant toward the assessment as he was not finding this assessment to be useful for the treatment process. Then, I immediately attended the patient by the consent of my colleagues and utilized my therapeutic communication skills to explain the importance of the assessment. Being a nurse it is my responsibility to explain the importance of the assessment to the patient so that he can understand and cooperate in the process (Christalle et al., 2019). Then, I explained the importance of therapeutic communication skills to my colleague and help her to with understanding the different aspect of the therapeutic communication skills.

 I was very happy how my therapeutic communication skills were utilized at the right time to improve patient health status. I have been improving my skills by using evidence practise because as a nurse it is my responsibility to fulfil the need of the patient. I was amazed at how easily I explained the importance of therapeutic communication and professional relationship with the patient. I was also feeling sad that due to the incompatibility of the nurse patient was facing issue to understand the need of the hour. Therapeutic communication is considered to be a skill of the nurse as it helps to improve two-way communication. The verbal and nonverbal communication methods are utilized appropriately to improve the level of communication and understanding with the two parties. The changing health care sector that focuses on the holistic and patient-centric approach demands better therapeutic communication skills to express their perspective with other individuals (Abdolrahim et al., 2017).

Professional relationship with the patient helps to easily express the issue that can be associated with the deteriorated health status of the patient. The professional relationship with the client helps the nurse to provide the patient-centric care that is necessary to reduce the patient recovery time. It improves the climate of interaction that is necessary for the accurate conversations of the patient with the nurse concerning the health-related issue (Kornhaber et al., 2016). As a nurse, it is our responsibility to connect with the patient by utilizing our therapeutic communication skills that help in developing a professional relationship to improve the care process. Nurses play a central role when it comes to patient care and how actions directly impact their health. After this incident, I realized that I will improve my communication skills to improve the professional relationship and I will help my colleagues to update their skills. 

Standard 6 The Mental Health Nurse actively pursues opportunities to reduce stigma and promotes social inclusion and community participation for all people with mental health issues.

Being a nurse you have to deal with the patient of different medical issue and you have to follow your professional working practice to improve the health status. In my reflection, I will discuss my previous clinical experience working with a patient belonging to the indigenous community. I was instructed to attend a patient in the emergency department and she was facing breathing and anxiety issue. When I went to attend her, she was having major shortness of breath and that was increasing her complication. Then I evaluated the different risk factor for the patient followed by administration of the oxygen therapy to reduce her discomfort. I discussed the scenario with the mentor to understand that I have done right or wrong concerning the situation. My mentor explained that as a nurse we have to work as per the scope of the practice to provide safe care to the patient. He explained to me that I have done the appropriate action to assist the patient in need.

As per Lawati et al. (2018), patient safety is the priority of the health care professionals and they are expected to identify the different risk that can be reduced by the intervention. Patient in the emergency department needs urgent attention with critical thinking ability to evaluate the condition and work according to the condition. The oxygen therapies help the patient to reduce the breathing discomfort that is the need of the hour because she is major discomfort and anxiety. I was glad that due to my professional working practice and duty of care I was able to improve the comfort of the patient. Nurses are expected to provide safe and appropriate care to the patient having the mental issue so that the recovery can speed up. I was pleased with how my mentor helped me out to understand the importance of safe and appropriate care in health care. Being associated with the patient having mental issue nurses are expected to provide safe care to improve the mental wellbeing of the patient.

Patient safety is one of the major concerns for the mental health patient and nurses are expected to follow the duty of care. The patient suffering from the mental issue face multiple difficulties and thus they nurses should utilize the risk assessment tool to understand the issue. In the care, process nurse is expected to provide equal attention to the physical and mental health of the patient to improve the recovery time (D’Lima et al., 2016). Nurses are expected to include patient safety, quality assurance of the care and quality improvement as per the client health status. The safety indicates that protecting the patient from any harm that can be due to medical error, the issue with the handover, lack of teamwork and less education (Slemon et al., 2017). As a nurse, I will try to improve the duty of care as per the scope of practice so that safety and appropriate care can be balanced when it comes to patient health status.

Standard 2: The Mental Health Nurse establishes collaborative partnerships that facilitate and support people with mental health issues to participate in all aspects of their care.

The incident is regarding one of my patients, he was a diabetic and facing depression due to loneliness so he was admitted to the hospital. I was working with an interdisciplinary team that is involved in the care and I was not able to correlate with them during the treatment that is directly affecting the patient health. According to Rosen et al. (2018) in the health care sector collaborating and integration within the team is important to improve the quality of care. Teamwork helps the individual to improve the care and learn a new technique from the expert that is useful in future practice. Teamwork is necessary to solve the different issue that patient face and it helps to develop a different framework that is necessary to address the issue concerning with the patient (Rosen et al., 2018). I tried my communication skills to collaborate with the team so that I can assist them during patient care. However, after working with them I realised that I lack teamwork skills that are necessary to improve the teamwork while dealing with the patient. 

I was sad due to my lack of skills and incompatibility patient was facing an issue concerning the health status. This incident has made me realize that there is a gap between the teamwork skills that are required during the care process and the skills I have. I was also frustrated at how can I lack as a nurse because my action will directly impact the patient and their fast recovery is our main aim. After this incident, I discussed this scenario with my senior because I was not able to fulfil the professional standard. My senior explained to me that sometimes you lack some skills but it is important to identify them and work upon them to improve the professional skills. 

Collective Intelligence is one of the important aspects of health care and as a nurse, it is important to work with the team to improve the quality of care. The communication skills are also important when it comes to teamwork it helps to put forward their perspectives that are necessary for patient welfare. There are different method for integration that includes coordination, cooperation, shared decision making and partnership (Morley & Cashell, 2017). Collaboration and integration with the patients are also important to improve the standard of the care process. The patient participation in the care process helps to frame the different intervention as per client preferences that are important for better health results. The nurse should collaborate with the patient using their therapeutic communication skills that are necessary to develop the rapport with the patient (Menear et al., 2019). This incident has helped me to realize that I need to improve my collaborating and integration skills that are important to work with the team. I will utilize the evidence to understand the different techniques that can help to improve the teamwork.

References for Professional Standard in Nursing

Abdolrahimi, M., Ghiyasvandian, S., Zakerimoghadam, M., & Ebadi, A. (2017). Therapeutic communication in nursing students: A Walker & Avant concept analysis. Electronic Physician, 9(8), 4968–4977. http://dx.doi.org/10.19082/4968

Christalle, E., Zill, J. M., Frerichs, W., Härter, M., Nestoriuc, Y., Dirmaier, J., & Scholl, I. (2019). Assessment of patient information needs: A systematic review of measures. PLOS ONE, 14(1), 1-15. http://dx.doi.org/10.1371/journal.pone.0209165 

D’Lima, D., Archer, S., & Thibaut, B.I. (2016). A systematic review of patient safety in mental health: A protocol based on the inpatient setting. Systematic Reviews, 5(203), 1-11. http://dx.doi.org/10.1186/s13643-016-0365-7

Kornhaber, R., Walsh, K., Duff, J., & Walker, K. (2016). Enhancing adult therapeutic interpersonal relationships in the acute health care setting: An integrative review. Journal of Multidisciplinary Healthcare, 9, 537–546. http://dx.doi.org/10.2147/JMDH.S116957

Koshy, K., Limb, C., Gundogan, B., Whitehurst, K., & Jafree, D. J. (2017). Reflective practice in health care and how to reflect effectively. International Journal of Surgery. Oncology, 2(6), 1-3. https://doi.org/10.1097/IJ9.0000000000000020

Lawati, M., Dennis, S., Short, S. D., & Abdulhadi, N. N. (2018). Patient safety and safety culture in primary health care: A systematic review. BMC Family Practice, 19(104), 1-12.  http://dx.doi.org/ 10.1186/s12875-018-0793-7

Menear, M., Dugas, M., Careau, E., Chouinard, M.-C., Dogba, M. J., Gagnon, M.-P., & Légaré, F. (2019). Strategies for engaging patients and families in collaborative care programs for depression and anxiety disorders: A systematic review. Journal of Affective Disorders, 2019, 1-12. http://dx.doi.org/10.1016/j.jad.2019.11.008

Morley, L., & Cashell, A. (2017). Collaboration in health care. Journal of Medical Imaging and Radiation Sciences, 48(2), 207–216. DOI: 10.1016/j.jmir.2017.02.071.

Reid, J., Briggs, J., Carlisle, S., Scott, D., & Lewis, C. (2017). Enhancing utility and understanding of evidence based practice through undergraduate nurse education. BMC Nursing, 16(58), 1-8. https://doi.org/10.1186/s12912-017-0251-1

Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. The American Psychologist, 73(4), 433–450. https://doi.org/10.1037/amp0000298

Safazadeh, S., Irajpour, A., Alimohammadi, N., & Haghani, F. (2018). Exploring the reasons for theory-practice gap in emergency nursing education: A qualitative research. Journal of Education and Health Promotion7, 132. https://doi.org/10.4103/jehp.jehp_25_18

Slatyer, S., Coventry, L. L., Twigg, D., & Davis, S. (2015). Professional practice models for nursing: A review of the literature and synthesis of key components. Journal of Nursing Management, 24(2), 139–150. https://doi.org /10.1111/jonm.12309

Slemon, A., Jenkins, E., & Bungay, V. (2017). Safety in psychiatric inpatient care: The impact of risk management culture on mental health nursing practice. Nursing Inquiry, 24(4), 1-10. http://dx.doi.org/10.1111/nin.12199

Toney-Butler, T. J., & Unison-Pace, W. J. (2019). Nursing admission assessment and examination. Treasure Island, United Kingdom: StatPearls Publishing.

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