Reflection on Clinical Placement

Reflecting on clinical placement

Clinical Placement Reflection 1

1. Communication with others within the clinical setting – this may include staff members, patients and relatives.
   From working within in a team I have learnt that communication in health and social care underpins everything that professionals do and can determine the quality of service that patients receive. Poor communication between members of inter-professional teams affects the quality of care patients receive and can result in any number of bad experiences for the patients. I’ve noticed that some of the factors that contribute to poor communication include the use of professional jargon, abbreviations and poor handwriting. Thus I made it a personal objective try and avoid these behaviours and if I did for example, use jargon I made sure its universal so that there is no miscommunication.
    
2. Your ability to work within a team.
   During this time on placement I have been able to witness and participate in multidisciplinary team meetings and have also had the opportunity to work with different healthcare professionals such as physiotherapist and also have been involved in ward rounds with doctors and nurses. The ward I was placed had a great team. I always felt a part of the team, and that I was making a valuable contribution thanks to both my eagerness to take on anything they threw at me, and, their inclusiveness and supportiveness. I learnt that holding back and waiting for people to notice you is not a good strategy. Let everyone know that you’re interested every day, and opportunities will come your way.
    
3. Your role and relationship with others within the clinical practice
   My role and relationship with others within the clinical setting was very important to me. It was important for me to build the team member relationship with others as it helps to establish a mutual understanding and trust with other team members. When reflecting upon my own strengths and weaknesses, in relation to my role and relationship with others, I feel that whilst I am beginning to acquire an in depth understanding of the role of the nurse in the care of the patient, I feel that I lack substantial knowledge of the roles of the other healthcare professionals that I work alongside in the care of these same patients. I have listed the priority of this as being medium to high as I feel that it is not possible to become an effective collaborative healthcare member without having an understanding of the roles of others with whom I am are working with. If there is a lack of understanding of the roles of others, I feel that it would be difficult to see why they are involved in the care of my patient, or even when it is appropriate to involve other healthcare professionals, inevitably leading to the quality of the care for the patient to suffer. Thus I made it in my best interest to interact more with others during the placement so that I could work alongside them confidently and work towards the same goals.
    
4. Your problem solving skills. Where possible give examples of how you have used these.
   Being in acute care setting, the kind of problem-solving that I did tend to be solving were immediate problems rather long-term problems. For example, patients who can’t get up who needs to have a sponge and clean linens on their bed. However each patient is different and often I couldn’t just perform the task without thought. The process of problem solving has guided me in finding solutions to a problem. I have learnt that this process is effective and helps me make the right decisions. I have also learnt to reflect on my decision so that I can see if the decision was the best or not for the situation. To assist me in problem solving more complex situations, I asked my mentor to provide some problem solving stimulations to further develop my problem-solving skills which was very beneficial for my learning process.
    
5. Your time management skills
   I learnt the importance of time management a lot during this placement. On one of the days, I did not wash my patient before 8:00 am in order to prepare her for her family visit later on that day. My patient’s 10:00 am Parkinson’s’ medication administration was delayed by 45 minutes because she was being washed at that time. This event occurred because I did not prioritize the tasks I had to complete during the day properly, and therefore I learned the importance of time management. If I had obtained nursing knowledge and familiarize myself with the daily routine care of the patient I could have handle my time more efficiently. After this event, I learned effective time management strategies to handle my time on clinical and I will definitely utilize the time managing strategies step by step from knowing , planning , prioritizing tasks, gaining support from other nurses, and being flexible with my tasks.
    
6. Your ability to understand your competence and scope of practice
   It was important for me to have an understanding my own competence and scope of practice as it guides me to good clinical practice and the delivery of my care to my patients. As a student enrolled nurse, there were strict practice standards and regulations, especially when medication is involved and supervision from our mentor was required at all times. Reflecting back, there were situations where although the practice was within my scope of practice, the policy and procedures of the facility did not allow it thus it is important to understand and familiarize yourself with the policy and procedures of the hospital as well as working within your scope.
    
7. How you adapt and use new technology and reflect on historical changes in nursing
   As I was quite young and I didn’t have any problems adapting and using new technology. It was very exciting seeing new technology as I believe it will greatly improve nursing practice and make it more efficient. Some of the new technologies I had the opportunities to use include new vital signs machine, lifting machines and computer programs that included online hospital policy and procedures and mims. All documentation was still hand-written and stored in folders. Historically, nursing documentation has been a hand- written. However, today facilities are now introducing new technology aimed to improve efficiency and effectiveness.
    
8. Your competency in relation to your nursing skills
   Competency in relation to my nursing skills had a lot to do with my confidence. For me, confidence is an important aspect of the practice of nursing and plays a major role in development. After an incident, I recognised that despite my lack of confidence the skill set that required to be completed for a particular patient was within my scope of practice, within my ability and within my knowledge base. On reflection it is clear that my lack of confidence in my ability, when put ‘on the spot’ contributed to my feelings of inadequacy which affected my competency in relation to my nursing skills. Through reflection and use of a mentor I was able to clarify that my weakness was not my nursing skills or knowledge level but my inability to effectively perform when under close scrutiny, which in turn led to a lack of confidence in my skill level and clinical knowledge. To develop my confidence and communication skill I became proactive and requested the assistance of a senior clinical educator to critically assess my skills and knowledge base. By doing this I reinforced my knowledge and skills but more importantly developed self-confidence. My efforts in seeking assistance and assessment of my skills could be seen as a step in ‘becoming more independent’. By gaining input and validation from my clinical educator, I ensured that I was able to successfully utilize my nursing skills competently and independently.
    
9. An overall reflection of the day and how you can use your reflection to improve your practice
   Upon starting this placement I didn’t really know what to anticipate as it was my first time in a hospital setting, so when I was asked about my expectations all I could say was “That I wanted to learn all I can…” Thinking back on that not so confident response, now at the end of this placement, gives me good insight into how valuable this placement has been to my professional development. This placement gave me the opportunity to begin to see myself as a professional, as I gradually learnt how to think critically about the patient’s health and managing their care and needs. This led to my becoming increasingly confident in the role I was determined to fill. Although I feel that I have a long way to go in this endeavour and will always continue learning, I know that I have learnt a lot during my time at this placement. To further improve my practice, I will use reflection as it enables me to solve problems or learn from actions through thinking consciously about an activity which would then enable me learn and develop.

Clinical Placement Reflection 2

1. Communication with others within the clinical setting – this may include staff members, patients and relatives.
   During my placement I was in a stroke unit. Being on this unit, I worked with many clients who suffered from post-stoke symptoms and many had difficulty with speech. The experience helped me learn the importance of both verbal and non-verbal communication. As an aspiring nurse, I have to continuously sharpen my communication skills because I will be interacting with more diverse range of patients in the future. I have to be able to establish rapport with each new patient and I can do this by communicating with them. I must maximise my communication with my patients because I can do a lot of things by communicating such as motivate, empower, educate and understand my patients.
    
2. Your ability to work within a team.
   Working in a team provides me with a great satisfaction. From this teamwork experience, I strongly feel the importance of teamwork in providing consistent care for patients. It taught me to interact with others and as an individual in order to work towards the same goal. I had witnessed examples of both good and poor inter-professional collaboration and communication whilst in practice and have reflected on those incidents. Also, being self-aware I found was not only essential to nursing as a basis for reflection but it also contributed to how I communicate with others and assisted me in developing inter-personal skills with our colleagues so that I could work better in a team.
    
3. Your role and relationship with others within the clinical practice
   In order to work efficiently together, it was important to understand my role and the roles of others within the clinic setting. My professional relationships with others was good except with occupational therapist (OT) mainly because I never had a fully understand of their role. I felt more clarity was needed surrounding the role of the OT so I made the efforts to research and speak to some of the OT to find out about their roles. As a result I was able to witness some of their work and worked closely with them. Being professional relationships and understand the roles of others has also lead me to understanding about the unique qualities and skills that different professionals bring to the team. In learning about other team members roles, I was also able to enhance my own professional identity which made me comfortable in the clinical setting.
    
4. Your problem solving skills. Where possible give examples of how you have used these.
   I was quite a confident problem-solving however there are times where I’m faced with a situation where I can identify the problem but I’m not able to come up with a solution due to lack of experience. For example performing venepuncture; the patient had very poor vein and my first attempt failed and was very demotivated. We were never taught in school on how to deal with bad veins except to have two attempts and have someone else do it if you fail. Determined to do the venepuncture successful, I suggested to my mentor, if I was able to pull the vein downwards to minimise the movement of the vein. With the approval of my mentor, I went in and was successful on my second attempt.
    
5. Your time management skills
   Prioritizing is a necessary tool for effective time management thus I made sure I prioritize tasks from high to low priority order. However during this placement, a staff had questioned my time management skill because I choose to assist patient who was lying in a soiled bed over researching my medications that was due in half an hour. This experience made me question how I was prioritising my time management skills. I decided to reflect on experience, and I believe that the staff was wrong to question my time management skills. I had thought about which was the greater priority in this situation and I still believe that the patient was. If the same situation arose again I feel that I would not do anything different other than to speak up and justify my decisions. I recognize and knowledge Time management as an important skill in nursing and hope that my skills will further improve with practice.
    
6. Your ability to understand your competence and scope of practice
   My ability to understand my competence and scope of practice is demonstrated through my clinical practice to safely provide care that is in accordance to the competency standards and actively informing others of my scope of practice. I always clarified what the specific activity or task details were from my mentor and obtained any additional information that I may need, such as facility policies or procedures. I also I made sure I expressed the concern to my mentor or educator. An example of this was my knowledge of medication. Although it was in my scope to administer medication, it was important that I do it competently with full understanding of the drug use and why the patient is receiving it. While it was in my scope, I lacked knowledge of the drug therefore I felt incompetent to administer it safely. For this reason, I made it my goal to research the medications prior to administration.
    
7. How you adapt and use new technology and reflect on historical changes in nursing
   During my placement, I adapted well to the new technology. The ward I was on had new software integrated in their computers which allowed me to access patient results and continue my learning through web-based training programs and access to online medical dictionaries and mims. My experience using these was very positive and very efficient. Historically, nursing documentation has been a hand- written. This was still the case in the ward that I was working in. This form of documenting has provided good communication between health care professionals and plan of patient care for the patient for a long period however the increase of medical errors and miscommunication has driven facilities to introduce new technology aimed to improve this and the efficiency and effectiveness of clinical practice.
    
8. Your competency in relation to your nursing skills
   Nursing competency requires accumulation of evidence based knowledge and skills, understanding of cultural diversity and the care provided. During clinical practice I used the ANMC competency standards to reflect on my own practice. Areas that I felt competent in was my providing care in a safely manner and my ability to address the physiological, psychological, physical, emotional and spiritual needs of the patients and significant others. In addition, I continued professional education in order to build up knowledge and skills that will be necessary in coping with the dynamic changes in healthcare. Continuing education ensures that my knowledge is current and level of competency is maintained at a satisfactory level.
    
9. An overall reflection of the day and how you can use your reflection to improve your practice
   My last placement has proved to be a huge progress. Through observations and clinical practice, I managed to develop my nursing skills both as an independent learner, but also as a member of the health team. Having been assigned patient loads, research medications and or reflecting on how I went, I was able to employ a range of skills that could not have found a better environment to develop in; critical thinking and problem solving, working with others and time management are just few examples. I will continue to do reflective practice to evaluate any clinical incident, positive or negative to attempt to better understand and contemplate the events which have taken place, and the behaviour, emotions and actions of not only myself, but the patient and others involved at that time In doing so, It will increase knowledge surrounding that situation and my professional development.