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The professional values I wish to reflect upon and improve are the qualities of risk assessment and communication skills. To elaborate on my reflection, I will be using the Driscoll Model of reflection cycle. Reflection is one of the most crucial parts of being a nurse, as it is reflective writing that helps them analyse and understand their ways so that they can work on improving their interaction skills with both patients and colleagues (Mirmoghtadaie et al 2019).
I was working at the Concord hospital where I had been placed on one of my clinical placements. I had been given the responsibility to care for and 89-year-old female patient who had been admitted in the hospital for R shoulder Pain. The patient also had a history of Osteoporosis. As per my duties, each day I allocated to one registered nurse. One day, the patient requested to go to the toilet, prior to the transfer the RN and I checked her status and her physiotherapy plan. She was on 2x 4ww transfer. Both the RN and I assisted her to the toilet seat using the 4-wheeler walker. After this, the patient requested us to leave so that she could have some privacy. We stood outside the bathroom waiting. After a few minutes we heard a scream. The RN and I immediately opened the bath room to find the patient grasping the railing by the toilet seat with fear written all over her place. Th Rn went and helped her up and asked her why she had tried to get up. The patient answered that her physiotherapist had suggested her to do some mild sitting and standing exercises, at an extremely slow pace to help with her mobility. For a second, I had been extremely scared to hear her scream. I immediately gained composure and helped the RN to take her to her bed.
I have realized that despite our constant training and lessons on being calm under situations, it’s a human reaction to panic for a second in a moment of crisis. As soon as I got calm after that one second of fear, I immediately took the patient and asked her of she was okay. Her little face was extremely perplexed, made my heart go out to her. I gently patted her shoulder and assured her that she was fine. I understand why the patient felt the need to do it, and I am extremely glad that I was present at that moment to help her out. Yet a part of me was extremely anxious to think about what could have gone wrong. This incident has made me realize that I need to focus on my risk assessment skills ( Francis Coad et al 2018 ) . Even though I was relieved that patient was completely out of danger because nothing had actually happened to her, after putting her to sleep for a small nap the RN and I discussed the seriousness of the situation. I realized that despite her request, we should not have shut the door all the way through. I also felt guilty that because of this little makeover she could have been susceptible to so many injuries specifically, fractures of the hip, wrist, humerus, and pelvis in this age group result from the combined effects of falls (Liu et al 2017). I realize how no situation can be regarded as completely risk free. It has made me extremely conscious of ensuring that at no point is a patient of this category and age group left unattended (Han et al 2017). Usually, post lunch, I often spend a little time chatting with this particular patient when I help her change. But that afternoon I hadn’t been able to do that for some reason. This brought into light how my constant communication had acted as a very important assurance for her. I understand that there is no way to predict a situation but I also get the importance of realizing that as nurse, it is my duty to prevent any kind accidents by being thoroughly attentive to especially high-risk patients (Goel 2018).I had calmly reassured the patient that she was alright and also promised her that I would assist her every day after a physio therapy session in sitting and standing exercises. I also made her promise me that she will not attempt any of those exercises on her own, without my supervision. Now, because I had a personal equation with my patient, I cajoled her a little and made her laugh so as to ease her tension, this reminded of just how much building a personal equation the patient is the only thing that can help me (Noll et al 2016). Before falling asleep for the nap, she admitted that she had been feeling a little restless that day. I told her to not worry and we watched a bit of TV before she fell asleep.
Post that, the RN and I discussed at length about the measures we must take in ensuring that this never happens again. I have realised the significance of being extremely alert in these situations. As a nurse I have understood the importance of my duty as someone who has to prevent the further causation of harm and this requires me to not make any assumptions about the situation but to be present in every moment. I will also pay adequate attention to the shifts in moods of my patients to assess what they must be feeling. My risk management plan will need thorough communication and daily evaluation to understand the need of the hour. I have realized that my communication skills are good, but I need to work on them some more so that I can assure the patient and make them realize that they can talk to me about anything. Constant communication to understand the mood and needs of the elderly vulnerable patient can give us unbelievable insights that can be invaluable to the treatment plan (Shakerinia, 2018). It is clear that the patient had been feeling a little stressed and restless that day understanding her needs and moods is also an essential part of my job when caring for her. Safeguarding vulnerable patients will now be my top most priority and through experience I will learn how to conduct myself in such situations so as to help out the patient. I also understand that very nature of the job is very demanding and it is impossible for me to predict what will happen in every situation (Francis Coad et al 2018). So I must ensure that at each and every step I am alert, responsive and quick on my feet and in thinking. My aim is to form more of partnership with my patient that will help me empathise with her situation her situation and I understand how significant the role of empathy and attention is when caring for an elderly, vulnerable patient (Gholamzadeh, 2018). I will ensure that I continue to work on my risk assessment and communication skills so as to avoid such instance of risk in the future. With adequate attention to detail and a little more alertness, I will be able to fulfil my job for caring elderly patients in the most ideal manner possible.
Francis-Coad, J., Etherton-Beer, C., Burton, E., Naseri, C. and Hill, A.M., 2018. Effectiveness of complex falls prevention interventions in residential aged care settings: a systematic review. JBI database of systematic reviews and implementation reports, 16(4), pp.973-1002.
Goel, A., 2018. Falls research is coming of age. The National Medical Journal of India, 31(6), p.321..
Liu, Y. and Peng, G., 2017. Effect of a layered nursing intervention based on risk assessment strategies application in elderly patients with hip replacement. Chinese Journal of Practical Nursing, 33(9), pp.669-672.
Gholamzadeh, S., Khastavaneh, M., Khademian, Z. and Ghadakpour, S., 2018. The effects of empathy skills training on nursing students’ empathy and attitudes toward elderly people. BMC Medical Education, 18(1), p.198.
Shakerinia, I., 2018. Relationship between nursing students' communication skills with Perceived quality of care by elderly patients. Quarterly Journal of Geriatric Nursing, 2(4), pp.22-34.
Noll, D.R., Ginsberg, T., Elahi, A. and Cavalieri, T.A., 2016. Effective patient-physician communication based on osteopathic philosophy in caring for elderly patients. J Am Osteopath Assoc, 116(1), pp.42-7.
Han, J., Xu, L., Zhou, C., Wang, J., Li, J., Hao, X., Cui, J., Shao, S. and Yang, N., 2017. Stratify, Hendrich II fall risk model and Morse fall scale used in predicting the risk of falling for elderly in-patients.
Mirmoghtadaie, Z., Kohan, N. and Ahmady, S., 2019. An Interesting Result of a Qualitative Research: Academic Exhaustion Barrier to Professionalism in Medical Students.
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