Critical reflection on learning experience from placement Please follow the eassy structure as in table of content which is very important also there is an example to give a better idea Introduction...

In this essay, I will be writing a critical reflective account detailing the importance of continuing education in practice, and it will explore my role and responsibilities for promoting it in my career. This will be achieved through the use of Gibbs reflective model (1988) and will be given examples from practice. The rational for choosing this model of learning is that it allows me to learn from my past experience and make changes for my future career. Furthermore Gibbs has six stages of reflective cycle such as description, evaluation, analysis, and conclusion and action plan. In line with Nursing and Midwifery Council and nursing Associate (NMC) 2018 code of conduct which states that nurses owe a duty of confidentiality to all those who are receiving care; hence, the identity of patient cites in this reflection will remain anonymous. He will be given a pseudonym and will merely be referred to as Tim.

According to Jasper (2013), reflective practice is the process of learning through and from an experience or activity to gain new understandings of self and or training. While (Oelofsen, 2012, Boros, 2009) defined reflective practice can be defined as the process of making sense of events, situations and actions that occur in the workplace. However reflective practice is used in nursing to increase their knowledge and understanding and assist them to develop a portfolio of evidence for revalidation (NMC, 2015a). It is also used to ensure that nurses’ knowledge and skills are up to date for continuing education and development (NMC, 2015b).

. In my nursing field as a student nurse, I have used reflection to express my emotion and feelings to understand better why I felt in a certain way. During my clinical placement and I when writing my assignment, I have used reflective practice to know my strength and weakness and the area to improve on. For example, after working with my mentor or any nurses assigned to me to work with, at the end of the shift, I will request feedback because it will help me to know my strength and weakness and areas to improve on next time. It also helps me to increase my critical thinking ability. However Rolfe (2014), for example, argues that reflective practice has had a disappointing impact upon nurse education and practice, suggesting that it is the poor interpretation and implementation of reflective practise that has resulted in this lack of progress. Likewise, Nelson (2012) suggests that the present wide acceptance of ‘institutionally governed’ reflection is ironic given Schön and other’s original intentions for the use of reflection

Education is a continuous process, and the importance of learning to human beings cannot be overemphasized. Continuing education in the nursing profession is essential to safe and effective nursing practice. The amount of knowledge needed to care for the critically ill patient cannot be obtained simply through experience at the bedside or the unit (News, Health and Continuing education 2019).

More over World health Organization (WHO, 2015) affirmed continuing education for nurses provides an educated and informed workforce that offers the best health service to the population

WHY Continuing education for nurses provides an educated and informed workforce that offers the best health services to the population (World Health Organization, 2015). WHY THIS IS IMPORTANT It also stated WHAT STATED , WHO STATED IT

that further education prevents skills and knowledge deterioration and prevents professional obsolescence by staying current with new developments in theory and practice.

Continue education offered nurses the opportunity to learn and advance their own techniques in safe patient care.

. Reflective practice is used by nurses to revalidate their registration every three years according to the Nursing and Midwifery Council

of nurse revalidation.

. In my nursing field as a student nurse, I have used reflection to express my emotion and feelings to understand better why I felt in a certain way. During my clinical placement and I when writing my assignment, I have used reflective practice to know my strength and weakness and the area to improve on. For example, after working with my mentor or any nurses assigned to me to work with, at the end of the shift, I will request feedback because it will help me to know my strength and weakness and areas to improve on next time. It also helps me to increase my critical thinking ability. However Rolfe (2014), for example, argues that reflective practice has had a disappointing impact upon nurse education and practice, suggesting that it is the poor interpretation and implementation of reflective practise that has resulted in this lack of progress. Likewise, Nelson (2012) suggests that the present wide acceptance of ‘institutionally governed’ reflection is ironic given Schön and other’s original intentions for the use of reflection.

Description

During my last placement in hospice, I have learnt how to set a syringe driver on an 82-year-old patient who was receiving palliative care that I encountered during my one-week community placement with my mentor. I was assigned to work in the community with my mentor to care for a patient who was diagnosed with lung cancer along with liver and kidney metastases and it was in the final phase of the illness. The patient received palliative care and required symptom control to help him maintain his quality of life and his family. He was cared at home by his wife, children and carers who visited him at home three times a day to help him with his daily activities such as getting him up, feeding, washing, dressing and helping him back to bed. The district nursing

When I was going into the community with my mentor, I was scared to visit patients in their home as I was unsure as to the type of patient I was going to meet. I felt that community placement would not be good for me in general and certainly not at the moment. My mentor noticed that I was uncomfortable; she tried to encourage me not to be scared

Presently when I heard about the prognosis and diagnosis, I was intrigued and wanted to find out more about the patient condition. When I met the patient in his house, he said that his main concern was how to control his pain, nausea and vomiting. I felt sympathetic towards him and his family. During his discussion, he revealed that he told his doctor to prescribe fort juice or fort sip since he cannot be able to eat food. After words, he said that he felt like ‘giving up’ and ends it all. In my mind, I was struggling to understand what he meant. However, I couldn’t understand why he would want to give up, and the reason was that he was feeling pain, nauseous and vomiting. When my mentor and I discussed the pain control options and the anti-emetics, he appeared to be more positive about the situation, felt sorry and apologized for what he had said. Then I and my mentor decided that it would be a suitable learning opportunity for me. On the first day I observed my mentor when setting of a syringe driver. On the second day, I was asked to set syringe with minimal supervision from my mentor. On the three day, I was too excited about setting up new syringe driver and replaced the old battle with the new one by myself. The next day my mentor asked me to check the battle life, time and remaining medication and the volume infuse (VI) in the syringe driver I felt very excited. I carried out the instruction correctly without supervision.

Evaluation

I have positive experience because with the help of continued education I build up my confidence and able to support patient with minimal support. I was impressed because I set up the syringe driver without support. I was very impressed as I noticed that the nursing team had built an excellent professional relationship with the patient and his family. Moreover, the patient had plenty of time to discuss any concerns that he had. The issues discussed, such as pain and symptom management with nausea and vomiting were assessed and prioritized well. The patients’ wellbeing and how he is feeling was taken into consideration. We also discussed it with his wife and children alone to find out how they are feeling and how to support them. During the discussion, we found out that the feeling of giving up related to his pain management and that is why syringe driver is essential for his pain control.

However, I was hugely disappointed because the doctor would have prescribed nutritional supplements such as fort juice or fort sips since he is unable to eat food. In line with Francis and Neuberger (2013) Staff must meet the primary care need without delay and provide hygienic conditions, access nutrition and hydration while helping those unable to eat and drink unaided. Moreover, NICE guidance issued in 2015 made clear recommendations on hydration and prescribing medicine, how to communicate with people at the end of life, and recognize that death is imminent.

Analysis

In my last placement with continue education, I have learnt how to carry out a holistic assessment on palliative care patient and the five priorities when a person approaches the end of life. The five priorities focus on recognizing that someone is dying, communicating sensitively with them and their family, involving them in decision making, supporting them and their family, and creating an individual care plan that includes adequate nutrition and hydration. With the help of my mentor, I have learnt the anti-emetic used to control nausea and vomiting in cancer patient such as metoclopramide, cyclizing, levomepromazine and ondansetron etc.

The World Health Organization (WHO, 2013) defined Palliative Care as an approach to improves the quality of life of patients and their families facing problems associated with a life-threatening illness, through the prevention and relief of suffering using early identification and impeccable assessment and treatment of pain and other physical, psychosocial and spiritual needs.

It prevents and relieves suffering through the early identification, correct assessment and treatment of pain and other problems, whether physical, psychosocial or spiritual. ‘’Caring for patients receiving palliative care in the community during the end of life requires an extraordinary commitment from the nursing team, not only human resources but also competence, compassion and focus in anticipating the needs of the patient family.

To managed and control his pain Syringe driver was prescribed by Dr to administer morphine sulphate and haloperidol (antiemetic’s) over 24 hours that could be increased or decreased as required. However using syringe driver improves symptom management with minimal inconvenience, although complications can occur, nurses should be able to recognize these quickly and solve the problem effectively (Lugton, 2002). The disadvantages of using this equipment are the painful injection site, risk of infection and problem of infusion rate. (Thompson, 2004).

Conclusion

Looking back, during my learning experience, I could have called the Doctor earlier to prescribe a syringe driver and nutrition for him since the patient cannot eat food.

Action Plan

In future, I was to encounter a similar patient requiring syringe driver and symptom control in future, I will not be scared because, with my experience, I would be able to set syringe driver if the patient demands it as soon as possible. Because I can understand that patients with cancer have different complications and need symptoms management and medication in their conditions. For these reasons, assessment is very important to ensure that appropriate treatment and symptom management is in place.

In this essay, I have critically reflected on continuing education in practice and set of setting syringe driver. I have used a variety of reference to back up and inform my discussions and learning as a nurse.

Reference

Francis R (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. London: The Stationery Office. Tinyurl.com/HMSO-Francis2

Gibbs G (1988) Learning by Doing: A Guide to Teaching and Learning Methods. Oxford: Oxford Brookes University Further Education Unit.

McDonald, L. (2001). Florence Nightingale and the early origins of evidence-based nursing.Evidence-Based Nursing, 4(3), pp.68-69.

Nelson, S. (2012) The lost path to emancipatory practise: towards a history of reflective practise in nursing. Nursing Philosophy. 13(3) 202-213

Neuberger J (2013) More Care, Less Pathway: a Review of the Liverpool Care Pathway. London: DH. Bit.ly/NeubergerLCP

News, N., Health, H. and Continuing..., P. (2019).Nursing Professional

Development: Continuing Education. [Online] Rn.com. Available at:
https://www.rn.com/nursing-news/nursing-professional-development-continuing- HYPERLINK "https://www.rn.com/nursing-news/nursing-professional-development-continuing-education/"education/
[Accessed 24 Nov. 2019]

Nursing and Midwifery Council ( 2018 ) The Code: Professional Standards of

Practice and Behaviour for Nurses, Midwives and Nursing Associates, NMC, London

Nursing and Midwifery Council (2015a) Revalidation.www.nmc.org.uk/standards/revalidation(accessed 10 /3/2010

Nursing and Midwifery Council (2015b) The Code. Professional Standards of Practice and Behaviour for Nurses and Midwives.tinyurl.com/k5mlard(

The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates, NMC, 2018

Nursing and Midwifery Council (2015a) How to revalidate With the NMC.

Oelofsen N (2012) Developing Reflective Practice: A Guide for Health and Social Care Students and Practitioners. Banbury: Lantern Publishing

Rolfe, G. (2014) Rethinking reflective education: What would Dewey have done? Nurse Education Today. 34 (8) 1179 – 1183

World Health Organization. (2013). WHO Definition of Palliative Care. Retrieved from
http://www.w HYPERLINK "http://www.who.in/"ho.in
. and required management of symptoms to help him maintain his quality of life for him and his family.

.