I asked the wife if she felt she needed any support but she refused. I suggested that the district nurses call over the weekend to check he was okay but his wife refused saying she could cope.
I talked through with his wife what to do in an emergency and that I would call again first thing Monday morning. I contacted the district nursing team leader who was working that weekend so she was aware of the situation should his wife call. I sent a fax to the consultant to let her know of the outcome of my visit. I documented the consultation in his notes. As a nurse I did not feel comfortable with Sydney refusing treatment when not in the terminal phase of his life limiting condition.
As a nurse, I feel I have a responsibility to improve my patients health and well being. As a health care professional, I have to take these areas in to consideration when deciding what is in the best interests of my patients and making a clinical decision.
I have always been taught as a nurse that I need to be able to justify my decision with confidence should I ever be asked to. However, what is important is to assess risk whilst providing the patient with all the information without prejudice and agree with them on an outcome that is in their best interests whilst respecting their autonomy and acting where necessary as their advocate.
I felt that the consultation went well. I felt able to communicate effectively with Sydney as we had a good relationship prior to this incident. A part of developing a relationship with patients and their families, nurses develop a greater respect for their autonomy and choice over their own care. As a district nurse I had experience with similar situations, and had previously reflected on these and therefore felt more comfortable dealing with this incident.
I felt confident that Sydney had capacity as I was familiar with the mental capacity act. However, I have since attended a training update on the mental capacity act so that I can make evidence based decisions. I felt that Sydney had been given all the information he required to make an informed decision. He was given the potential outcome of not going to hospital and he was prepared for that.
Sydney and his wife were offered all available community services but refused. I did, however, feel that I would have benefited from some counseling skills. I was aware that Sydney was frightened and I felt like a novice in counseling him.
I felt that the way I communicated with Sydney may not have been effective in him opening up about his fears. I feel that attending further sessions on behaviour change and counselling skills would be helpful and to do some reading around these areas. I also feel that doing some joint visits with the psychologist would be helpful in gaining experience. I would make sure that the consultations were documented so that I could prove that Sydney was given all the relevant and necessary information and to uphold my professional code of conduct and accountability.
I had also offered to attend any further hospital out-patient appointments in the future so that Sydney feels supported, so that I had the relevant information and options could be discussed jointly as a team. I also feel that I would benefit from looking at some tools of decision making to help me in the future and continue to reflect on my experiences. September 14, Our Sites: This describes the difference between: At this point it was realised by a clinician who checked his medical notes, that Mr Smith had had a previous incidence of a gastrointestinal GI Haemorrhage bleed but this information had not been passed on during the handover report which I felt was vital in this case and could have been detrimental to his outcome.
This is calculated by totalling abnormalities of vital signs which are below or above normal parameters. Scoring, triggers nurses to take appropriate action and referrals to clinicians, Odell. However it has been suggested there is scope for error using EWS if scoring is not carried out properly and factors such as knowing the patient and pattern; recognising deterioration; appropriate referral; time of day and day of the week may be causes for error, Odell et all, However the SBAR tool is not always followed properly and can result in communication errors, increasing risk of harm to patients Royal College of Nursing, It was unclear whether history of his previous GI haemorrhage had been known at this point but it was not highlighted at the hand over report.
By the time I had reached Mr Smith, whilst carrying out routine vital signs on patients, it was obvious by observing a pattern of his vital signs, EWS score, pallor and pain level that he was deteriorating.
The surgical team were informed, and blood was sent to haematology. The EWS system allows for any adverse reactions to be detected early, as severe reactions are more likely to occur within the first 15 minutes of infusion and in the case of an adverse reaction the infusion would be stopped; medical staff and haematology informed Ackley et al, I remained with Mr Smith and monitored his vital signs closely, checking for changes.
He was becoming increasingly agitated because he wanted to be left alone. A short time later staff came from radiology to escort Mr Smith for his ultrasound scan, he was scoring 1 , although his abdomen was very distended and painful.
The Scottish Government established targets which aim to reduce avoidable harm to patients. One of the key elements is to enhance communication skills between inter-professional practitioners in all departments, through education, Scottish Government, However with the use of the EWS system his deterioration was identified and protocols were followed accordingly, reducing further harm.
Although there was not a diagnosis for Mr Smith initially, his symptoms on admission should have triggered regular observations using the EWS system, checking his past medical history and the use of effective clinical judgement. Reflecting on this personal experience has given me a good understanding on the importance of communication in relation to the care delivered to patients.
I have learned that it is important to have as much background information about patients as it may influence decisions regarding appropriate care planning. I have identified that importance should be placed on patients without a diagnosis and closer observation given.
Sharing important information and concerns regarding patients with relevant multi-disciplinary team members is vital for patient outcome and also for my personal learning. I have a good understanding of the EWS system and the benefits it has in identifying deterioration or improvement of patients, however I have learned observational skills are also a good tool in clinical judgement, which I will use.
Overall I have learned in order to deliver safe practice I must use a combination off all the skills I have learned. It has taught me that although practical skills such as observing vital signs is important, observational skills, communication skills and clinical judgement must be considered for patient safety.
I found by reflecting on this personal experience I have learned the importance of reflection and plan to use it in future practice as it has helped me gain insight into how to develop all my skills further in the nursing role. Data Protection Act [Online] Available: Odell et al Detecting Deterioration [Online] Available:
Student Nurse Reflective Essay In order to help me with my reflection I have chosen Gibbs (), as the model to help guide my reflective process. This model comprises of a process that helps the individual look at a situation and think about their thoughts and feelings at the time of the incident.
Reflection Of Clinical Practice Nursing Essay. Print Disclaimer: This essay has been submitted by a student. This is not an example of the work written by our professional essay writers. You can view samples M., Gerrish, K., and Ermami, A. Student nurse's experiences of communication in cross cultural care encounters.
Nursing Reflection as a Student Nurse Words 3 Pages The following essay is a reflective account on an event that I, a student nurse encountered whilst . Reflective: Patient and Student Nurse. Topics: Nursing, This is a reflective essay which will address a recent experience gained from the Intensive Treatment Unit (ITU) that occurred during my placement and while under the Overseas Nurses Programme. This will utilize John’s Model for Structured Reflection (MSR).
Student nurse tips: Learning and moving on, ending your reflective essay neatly Ok, so you’ve talked about the ethics of care, and the importance of the 6Cs. You’ve applied these to your experience, and you know why you felt like you did. Database of FREE nursing essays - We have thousands of free essays across a wide range of subject areas. Sample nursing essays!