The main important thing that I write this essay is to discuss about my first ever experience that I had as a student nurse during my first clinical placement. The objective of this essay is to highlight the most important skills as a health profession which is communication skills even though I am not qualified yet. I know it’s sound simplest thing to done it but believe me it’s require lots of knowledge and confidence to do so. This explain the structure of knowledge, clinical work and social communication (Raya A. 2006). Communication is an essential element in Nursing world in all areas of activity and in all its involvement such as prevention, treatment, therapy, rehabilitation, education and health promotion (Fakhr-Movahedi A, 2011). By the guidance of the Gibbs Cycle Model of Reflection (Gibbs, 1998), it helps me to write my reflective essay more understandable on what I did during this clinical placement and how I could do better in the future. As a student nurse, there are limitations on what we do because there are lot of things we must learn and get enough practice to do it.
During my second day of clinical placement in male medical ward, P.M.M.P.M.H.A.M.B Hospital, Tutong. I was instructed by the staff nurse which is my mentor, to take BMI which is mean tables of desirable weight for height, as well as the tables used to define people who were underweight or overweight (Metropolitan Life Insurance Company,1959) and of course Vital signs, it reflect essential body functions, including your heartbeat, breathing rate, temperature, and blood pressure. The health care provider such as nurse or doctor may measure, or monitor your vital signs to check patient level of physical functioning (Ball JW, 2019). This two is the most important things to do when there is a patient admitted into the ward. This was my first ever experience to deal with the patient, then my nurse in charge asked me to do the job with her supervision. As the time goes by, waiting for the first patient to be sent from the accident and emergency department to our ward, I got butterflies in my stomach since it was my first task to do during this clinical placement. A few moments later, the patient arrived to our receptionist, then my mentor and I straightaway brought the patient to bed 7B since the nurse in charge already registered the patient details on Bru-HIMS, which is Brunei healthcare information for every person in this country who have been to the hospital. When I moved the patient to other trolley, I did not speak a word because I was too nervous and forgot to ask if he was comfortable on the bed. After that, I just took the necessary information about the person as what have been required on the patient admission paper. When doing this interview, I felt like my brain has stopped working during that time since I encounter problems thinking on how to ask properly, what word to be used. I was panicked and just questioned it very simple without explaining further more to the patient on why we need this detail. After the interviewing and vital signs taken, I got suspicious on my mentor the way she stared at me, afterwards she asked “Did you ask consent to the patient on what you are doing? Why did not you have a small conversation with him? So that he feels cared by us”, I just remain silent and lowered my head did not know how to respond to it, I just looked down and had a thought about it for a while then excused with apology. The discussion with the patient should leave no suspicions, doubts and misunderstandings. For example, if the patient suspects that while chatting with him we are making gestures to an escort, he/she will suspect that we are not telling him the whole truth (Papagiannis A, 2010). She then advised me and taught me on how to have a good communication skill with patient, health professions or anyone politely.
During the incident I faced many different emotions due to my actions. In the beginning, before I deal with my patient, I was genuinely excited since it was my debut to carry out the procedure. But when I was waiting for the patient, the feeling of nervous kept ghosting myself as the nurse told me to get ready before the patient arrived. To be honest, I was shaking like a leaf when I did the interview while carried out the procedure which is taking vital signs. As the process done, I felt so guilty on myself since I forgot to ask consent and not having a little chit chat with him. This can lead to miscommunication between the patient and myself due to my troubled. Not only that, I also felt that the patient will get upset on me due to my action by not treating him so well. I knew it was my first time in clinical placement but it is not the reason I can make mistake. I have learnt and practiced the skills so much at school but when facing the real patient, it felt so different and hard for me to handle. I felt so embarrassed and ashamed when the nurse approached and told me my problems for not asking it so nicely, when I know it is very important to do so.
After evaluating my action, there is always positive and negative impact reflection on my performance. Although my action was not very satisfying, I could see some benefits and positive aspects in my action but at the same time, it can be so difficult and challenging (Papp I, 2003). It took one failure to learn that lesson. I managed to get a good relationship with the nurses from that day by making sure I really do understand the instruction and procedure before doing the job. The negative impacts where I did not really make any conversation with the patient even though I knew it was very important. The caregivers should avoid silence when doing the procedure or else the patient will leave disappointed (Moussas GI, 2010). It shows that communication play an important role as he need to know and well-prepared for the procedure.
Asking patient consent is crucial since one person voluntarily agrees to the proposal or desires of another (Oxford English Dictionary, 2016). The failure to recognize the two-way communication capability, quite often leads to negative conclusions and attitudes (Kourkouta L, 2011). Not only that, as a student nurse or health profession I must respect patient privacy where I have been taught before. By this, I should really have a good sense on how to use words when interviewing the patient so that he feels comfortable and not be offended with my question and the way I treat the patient.
As the first-year student nurse, the most important thing before doing anything to the patient I must introduce myself to the patient politely so that they can feel appreciated and cared. I realized that when I do my job so sincerely, the patient can feel the vibe then it helps me doing my task more comfortable since he gave full cooperation and they can expect on what I am going to do. Another alternative way to learn communication is by observing how the doctor or nurses speak to their patient rather than leaving him straightaway.
In the near future, I should need to remember to take this communication skills more seriously, even though it is the most common things to do but it has many outcomes. I do not want the same mistakes to ever happen again because it is felt so unpleasant. The way I approach, handling and safety to my patient also need to be better than this first clinical placement so that I can minimize the danger and or making another problem. Improve my verbal consent to patient before proceed any action to maintaining their privacy and my standard as a student. Moreover, enhance my knowledge on medication or clinical words so that the patient can understand me clearly on what I explained to him. By doing this, it also can attract their trust to the student nurse since some people did not trust me to handle the job have been instructed without the supervision of nurses.
With the help of The Gibbs Cycle of reflection (Gibbs, 1998), it assists me explain my reflective essay effortlessly. This clinical placement offer myself a real-life environment experience where I can apply most of the knowledge and skills that have learned in nursing skill practice classes (Esmaeili M, 2011).
Furthermore, I have been taught on how handling the patient, how to treat them correctly and how to overcome the difficulties when doing the procedure by the staff nurses, this show that during clinical placement as a first-year student. On top of that, I learned that communication skills are important in this job, because it is the only way the health profession and patients be in touch.