The Code: Professional Standards Reflections 1 THE CODE: PROFESSIONAL STANDARDS REFLECTION By (Name) Course Instructor’s Name Institution Location of Institution Date 1 The Code: Professional Standards Reflections 2 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 2 The Code: Professional Standards Reflections 3 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 3 The Code: Professional Standards Reflections 4 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 4 The Code: Professional Standards Reflections 5 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 5 The Code: Professional Standards Reflections 6 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) . 6 The Code: Professional Standards Reflections 7 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 7 The Code: Professional Standards Reflections 8 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 8