Student Nurse Reflection Examples

Introduction This essay aims to critically reflect on an experience where a patient was encountered during clinical placement. The real name of the patient in this reflective essay has been changed for confidentiality reasons as it is the patient’s right (Kentucky Board of Nursing, 2018). The Gibbs’ Reflective Cycle (Gibbs, 1988) will be used to analyse the incidence for its effectiveness in offering a way of sequencing learning situations in order to learn the most from experience. The essay describes the setting where the incident occurred and the incident involving the patient. The feelings evoked by the encounter as well as a professional evaluation of the experience will be discussed. The encounter will be analysed and conclusions on the need for nursing professional conduct will be drawn. Description I was placed in a private ward during clinical placement as a student nurse. It was a busy wing so I was asked to assist the nurses by answering call bells, assist patients with personal hygiene, check patients’ vital signs and promptly report observations to my mentor nurse. Just before lunch break, a patient’s call bell rung and I quickly went to her aid because she had just returned from surgery. According to the Trust’s policy, patients who have just returned from surgery must be monitored carefully and vital signs checked frequently in order to quickly observe and correct complications arising from surgery (Whitlock, 2018). Having arrived at the patient’s bed, she was quite distressed. I read her notes and discovered her name was Mrs Williams – a 52 year-old who had recently had carotid endarterectomy surgery to correct ischemic stroke (Mcintosh, 2017). I checked her vital signs and they were not within range. I used the National Early Warning Score (NEWS) (Bilben et al., 2016) to determine her degree of illness and she had a score of 4, signifying the need for care intervention. I immediately called the attention of the nurse in charge and informed her 1 about the NEWS score. The nurse observed the patient and later requested for a team. I had just stepped out of the room to proceed for lunch when I heard the emergency crash bell ringing and more people rushing to the private ward where Mrs Williams was admitted. I returned to the ward and learned that Mrs Williams had just had a sudden cardiac arrest while a team of doctors and nurses were trying to revive and stabilize her. She had suddenly collapsed and was unconscious with no pulse. After about three minutes, Mrs Williams became conscious and started breathing again. She was stabilised and different tests were requested to be conducted on her. Feelings Before the incident, I was mindful of the fact that I had only being working at the ward for four months and I was a student nurse with little practical experience. Invariably, I did not feel confident enough to fully evaluate and determine what may be wrong with Mrs Williams. Although I did not act slowly in involving the assigned nurse about Mrs Williams’ condition, it was however clear that the nurse and I should have acted more swiftly by calling in the doctor immediately the distress was observed. In The Code, professional conduct includes practicing effectively through giving preventative care without delay (Nursing and Midwifery Council, 2015). Although this was done, I felt it may not have been swift enough. Evaluation In retrospect, the incident was quite challenging especially that if action was not taken fast enough, Mrs Williams may have lost her life during the incidence. The initial evaluation given to the patient was swift and a call to the nurse to deal with the arisen medical situation after a debriefing was done. However, the nurse did not act proactively in assessing the severity 2 of Mrs Williams’ condition and called in the doctor early enough. The response time from evaluation to involving the patient’s doctor was not good enough thereby leading to the situation escalating and almost led to possible death of Mrs Williams following her cardiac arrest. Analysis A patient’s physical, social and psychological needs must be constantly assessed by paying attention to promoting the patient’s wellbeing (Nursing and Midwifery Council, 2015). In The Code, professional conduct includes practicing effectively through giving preventative care without delay while the best and right information is communicated clearly and evidencebased (Nursing and Midwifery Council, 2015). According to the Nursing and Midwifery Council, It is important to work cohesively with colleagues in a manner as to preserve the safety of those receiving care and also share information to identify and reduce risk (Nursing and Midwifery Council, 2015). The Code dictates that in order to preserve safety as a nurse, one must recognise and work within the limits of one’s competence (Delves-Yates, 2018). The nurse must accurately identify, observe and assess signs of normal or worsening condition in the patient receiving care (Nursing and Midwifery Council, 2015). The Code states that a nurse must display a personal commitment to the standards of practice and behaviour which must lead to trust from patients, other health professionals and the general public. Being able to build rapport with a patient being cared for as well as other people in the nursing profession help to ensure the delivery of holistic care and bring about better patient outcomes during and after care. Placement experience such as the one illustrated in this essay helps inexperienced student nurses understand the importance of accountability in nursing practice (Battié and 3 Steelman, 2014) and the need to give care with priorities given to the patient and safety upheld. Conclusion From the recounted incident, it is very clear that nurses must perform a task within their competency level. There is the need to quickly evaluate a patient under care and promptly report any concerns in the patient health before the concern escalates. Also, patients recovering from surgery must not be left alone. If such a situation arise in the near future, the insights gained during this experience will be used to deliver better healthcare through prompt reporting and enforcing accountability. Action Plan The experience gives hands-on knowledge that the life of a patient is sometimes dependent on how professionally a nurse acts in a critical situation. Nurses must be more proactive and swift in evaluating a patient’s condition and involving the key professional needed to give urgent care to the patient under observation. Alarm must be raised immediately when a distressed patient in post-surgery is involved even while carrying out evaluation of the patient. Continuous implementation of reflective practice and delivery of quality healthcare must always be practiced. 4