The Code: Professional Standards Reflections 1
THE CODE: PROFESSIONAL STANDARDS REFLECTION
By (Name)
Course
Instructor’s Name
Institution
Location of Institution
Date
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The Code: Professional Standard Reflection
Introduction
A vital element of human education is a reflection that can be used to explain and
legitimize the information obtained from areas of practice. Reflective practice has been viewed
as an essential instrument for career growth. A reflective essay involves writing and nursing
experience to develop meditation on the topic and improve the learning process. Montagna and
Zannini believe that reflective writing was introduced to sustain the growth of nurses' clinical,
emotional and ethical competence and to encourage self-knowledge (2010, p.140-52). It is a
personal process that needs the nurse, to be honest, open, self-aware and willing to act on
criticism and recognizes that acts are affected by thoughts and emotions. It allows the nurse
student to make sense of what happened, circumstances and actions occurring at the hospital
(Oelofsen 2012, p.108). Mantzoukas and Jasper (2004, p.925-933) argued that the idea of
reflection helps the nurse to solve problems or learn from actions by actively reflecting about an
activity that will then encourage one to know about any assignment performed. This means that
as a nursing student, I should assess if my existing experience is still valid and should be able to
combine my new understanding into what I already learned in upgrading myself. Atkin’s and
Murphy’s model of reflection is on review and identification of the learning process and
intervention planned based on understanding and evaluation of this importance of knowledge.
The Experience
Students are advised to use a standardized reflection model to show their ability to focus
on their experiences during clinical practice. I will use the Atkin’s and Murphy’s model of
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reflection, and focus objectively on the event that illustrates my new findings. Finally, to
strengthen the patients' treatment, I will show what I learned from it (1994, p.49-56).
I was a nursing student working with my supervisor in the medical ward. My patient,
who I will call Mrs Smith to maintain patient confidentiality, is a 57-year-old who was escorted
to the hospital by her daughter. She owns a fast food joint. Mrs Smith is not prolinbbubjferent
speaker of English and her daughter acted as a translator. She was 92kg with a height of 158cm
and a BMI of 32.7, which indicated that she was obese. She was admitted to the hospital with
complaints of shortness of breath with she stated was getting worse daily. She says to have had
difficulty mostly at night and laid down to rest. She also experienced swelling of her legs up to
her thighs, malaise, insomnia and dizziness, which she suspected was due to the difficulty
breathing that worsened when she laid down.
She stated she was admitted to a hospital six months ago because of hypertension. She
had also diagnosed with hypertension for four years. She took amlodipine 10mg, frusemide
40mg, metoprolol 50mg, and simvastatin 40 mg for her hypertension and swollen legs and had
no allergy to any medication. Her family history showed that she has two sisters and a daughter
with hypertension, and her mother had died of congestive heart failure three years ago. In her
social history, she states to drink occasionally. She also consumes fast food frequently and said
she takes mainly fried chicken four times a week.
Examination conducted on Mrs Smith shows that she is attentive and active with pedal
oedema to her thighs. Her body temperature was average. She had elevated blood pressure on
admission with a record of 169/108 mmHg with an irregular pulse rate of 88beats/min. A chest
X-ray that conducted showed that Mrs Smith had Cardiomegaly. On further investigations, her
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echocardiogram showed the patient had sinus tachycardia with a T–wave inversion and had left
ventricle hypertrophy. She is then diagnosed with congestive cardiac failure and hypervolemia.
She was admitted to the ward, originally for overnight monitoring.
I was appointed to care and report to my supervisor, the nurse in charge. I did routine
observations, administered medication to Mrs Smith. She had a 2liters of oxygen for her dyspnea
through a nasal cannula. Even with the routine administration of her medication, her state was
deteriorating. She complained about difficulty breathing to be worsening and would refuse to lay
down, stating that she could not breathe. She developed lung congestion, abdominal swelling and
increased urination at night. I reported this to my supervisor immediately, and after further
evaluation was conducted.
Mrs Smith started getting reluctant to take the medication, saying that they made her feel
worse than before. She would sometimes vomit the drugs to which I reported. It was at this
difficult time that we developed a better nurse–patient relationship as I had to sit her down and
explained how each of the medications was helpful to her recovery. Mrs Smith’s daughter had to
be involved to improve her attitude to the care. She was in a better mood after her talk with her
daughter who she fully trusted. She was put on a healthier diet with less salt intake and
responded well to the meals after a while, her and fluid intake was reduced and physical exercise
was mandatory. Her lifestyle had to change greatly and she had to take sometimes to adjust to
that. Through these and her medication Mrs Smith’s health improved tremendously and her
breathing got better. She was finally discharged. Although it was difficult I had to maintain a
good attitude and maintain professionalism throughout Mrs Smith’s care for the better outcome.
Feelings and Thoughts
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As a nurse it is impossible to provide exclusive care to only one patient around the clock.
I had a difficult time dealing with Mrs Smith. I felt frustrated that Mrs Smith was in discomfort
and that she doubted if the medications were being given. It was difficult convincing her that it
was all for her benefit. It was frustrating trying to gain her confidence and build a strong bond
with her which I had finally gained after her improvement and she became more open.
Communication had also been difficult as she knew only a few words in English. She could not
fully describe how she felt without her daughter. She could easily understand what I was saying
but expressing herself was difficult. I was relieved when her attitude become better and her
health began to improve and finally happy when she was discharged.
Evaluation
Mrs Smith was helped and supported by all health professionals involved in her
care and I was contented by her recovery. I noted that her mood was low, and she would question
the relevance of her medication, and I would explain each medicine and what it did to her. Mrs
Smith often got tearful at night and asked questions on the condition. She stated that she felt
unfortable in the hospital as did not have people listened and talked to her. It reassured Mrs
Smith and always made sure she was relaxing at nights especially when she was tearful.
Although there was difficulty in communication she was able to address her issues and
her discomforts and it was handled professionally which prevented any negative outcome. Her
care after her change in attitude was successful in her recovery and discharge. She was positive
to the lifestyle changes and was determined to get back to her normal health.
Occurrence of Learning
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Each part of her admission to treatment at the initial stage of her recovery was discussed
in adequate detail above. The was poor communication with the patient that limited the provision
of the best care to the patient, however, we were able to communicate through her using gestures
and the few words she knew in English. Better ways of communication should be available
where there is a language barrier. It can be though availability of interpreters and encouragement
of nursing student to learn other common languages used in hospital settings that are not their
first language (Meuter et al. 2015, p. 371)
I learn how beneficial the nurse-patient relationship is to a patient. Although difficult Mrs
Smith opened up and explained her fears about her medications. Only through the trust we
formed, I was able to convince her to go on with her treatment and reassure her that they were
helping her. As a nurse I must understands that a healthy relationship enhances the quality and
recovery efficiency of the patient ( Molina-Mula, 2020). The experience showed the importance
of the relationship to the patient's progress and the relevance of the support to deal better with
patient’s emotional distress as a nurse.
I learnt the benefits of involving the family in a patient’s health. A massive improvement
in Mrs Smith’s attitude was seen after her talk with her daughter. She became more willing to
take her medication and live a healthier life. Incorporation of family into nursing care is critical
reflection intervention practices by nurses allowing them to improve the patient's behaviors
about care, and strengthened their communication and desire to establish a positive relationship
with nurses and appreciating family values (Peden-McAlpine et al, 2005) .
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reflective practice is a valuable technique that can be used to improve clinical practice.
The time spent on contemplation was said to have improved logical thought, professionalism,
making decisions and being able to criticize anything they were not in complete agreement with
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References
Atkins, S. and Murphy, K. (1994) Reflective Practice. Nursing Standard 8(39) 49-56
Mantzoukas, Stefanos & Jasper, Melanie. 2004. Reflective practice and daily ward reality: A
covert power game. Journal of clinical nursing. 13. 925-33.
Meuter, R. F., Gallois, C., Segalowitz, N. S., Ryder, A. G., & Hocking, J. 2015. Overcoming
language barriers in healthcare: A protocol for investigating safe and effective
communication when patients or clinicians use a second language. BMC health services
research, 15, 371. https://doi.org/10.1186/s12913-015-1024-8
Molina-Mula, J., & Gallo-Estrada, J. (2020). Impact of Nurse-Patient Relationship on Quality of
Care and Patient Autonomy in Decision-Making. International journal of environmental
research and public health, 17(3), 835. https://doi.org/10.3390/ijerph17030835
Montagna, L., Benaglio, C., & Zannini, L. 2010. La scrittura riflessiva nella formazione
infermieristica: background, esperienze e metodi [Reflective writing in nursing
education: background, experiences and methods]. Assistenza infermieristica e ricerca :
AIR, 29(3), 140–152.
Oelofsen N. 2012. Using reflective practice in frontline nursing. Nursing times, 108(24), 22–24.
Peden-McAlpine, C., Tomlinson, P. S., Forneris, S. G., Genck, G., & Meiers, S. J. 2005.
Evaluation of a reflective practice intervention to enhance family care. Journal of
advanced nursing, 49(5), 494–501. https://doi.org/10.1111/j.1365-2648.2004.03322.x
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