The author will use reflection to demonstrate her involvement in an episode of care to a patient during a clinical placement focusing on the significance of inter-professional working. Reflection is an integral part of nursing training and is also a legal requirement in (NMC code, 2015) to improve practice. Inter-professional practice is the collaboration that occurs when all healthcare providers work with colleagues alongside patients and their families. Consequently, inter-professional collaboration in health and social care is constantly changing the overall face for service delivery (O’Carroll et al. 2016).
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In compliance with Nursing and Midwifery Council code (2015) no names are mentioned in order to mention confidentiality. The author uses Gibbs reflective model (1988) to elaborate on her experience and highlight what happened in practice, how I understood the event was understood, the importance of nursing interventions and what I have learnt from the event.
I participated in the provision of care for Mrs B, a 69 year old care home resident who presented with dehydration and recurrent (UTIs) urinary tract infection on hospital ward X. “Urinary tract infections (UTIs) are common infections that can affect the bladder, the kidneys and the tubes connected to them” (NHS online). Mrs B was placed on a 4 bedde-bay where I worked alongside my mentor. I was responsible for taking care of Mrs B by assisting her in personal care, taking her observations and ensuring that she had good fluid intake as prescribed. I gained consent from Mrs B prior to undertaking her care.
I found her to appear confused, therefore will require close monitoring. On taking her vital signs; including blood pressure, temperature, heart rate, respiratory rate, saturation rate and AVPUC (alert, voice, pain, unconscious and confusion). Her observations appeared normal although she spikes temperature at 38.7. According to NEWS 2, the normal temperature should be around 36.1-38.0. So, oral paracetamol was administered as prescribed under the supervision of my mentor, to lower her temperature. Although Mrs B was confused she was able to communicate her needs and drank occasionally when prompted. Bearing in mind my limitations I wanted to inform my mentor that Mrs B was not drinking enough but she was on break. Then, I went to speak to a nutritionist on the ward, who advised me to give her shakes since it taste better. Mrs B was more receptive of the shakes. As a result, working alongside the multidisciplinary team (MTD) guided me through assisting my patient.
My main purpose was ensuring that my patient is comfortable and improving. Although I felt uncomfortable seeing her lying in bed helpless, I always reassure her of a positive outcome. I could see Mrs B was exasperated when she tries to communicate her needs to me which made me distraught. Additionally, work could become very busy, that time constraints would disallow me interacting with other health professionals for support. This would compound my own frustration. As stated in (Hilliard et al. 2017) Inter-professional working demands an individual to communicate with other professionals and also with carers of patient as well. This enables a holistic approach to patient care.
I found that Mrs B living in a care-home may predispose her to poor personal hygiene and infection control causing recurrent UTIs. As UTIs make elderly patients confused sometimes, it was difficult for me to communicate with her when encouraging her to drink or eat. NHS (online) ‘advices drinking plenty of fluids will help to relieve any symptoms of fever and prevent dehydration in patients with UTIs’. Therefore encouraging my patient to take good amount of fluid can be very helpful in eliminating her infection. Also I made a proper documentation of fluid input and output to monitor her progress. On subsequent shifts I found that my patient’s health has improved as a result of her compliance to treatment. She was no longer confused and I could see her interacting to other patients. Upon reflection, I realised that the support I and other members of staff gave Mrs B has helped in managing her illness.
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I have become knowledgeable about Urinary Tract Infection and it’s symptoms including ‘confusion/agitation in older people, tiredness, pain in lower abdomen, increased in urination, high temperature and smelly or cloudy urine’ (NHS online). More importantly hydration can aid with flushing the toxins that cause UTI. Therefore keeping my patient hydrated has improved her recovery process alongside antibiotics and other medications. With this knowledge in mind, I got more familiar with the idea of how to meet the standards of competencies which are related to the role of nursing. Moreover, the holistic approach of nursing mainly requires a nurse to work collaboratively with other health professionals and families of the patients. However, as with Mrs B, with my help, my mentor’s support and other health professionals, I can see the important role of nursing in inter-professional working. I was able to put smile on my patient face and this made me very happy and elated.
I firmly believe that I became more knowledgeable in managing UTI. The overall experience that I gained made me feel more comfortable although challenging initially but eventually rewarding. Through, the support of my colleagues and my mentor who guided me through, I could see that I have gained many new opportunities and skills which will help me to deal with the similar situation in future. Furthermore, I must ensure that I maintain and communicate effectively with other health professionals to enhance my training. Thus, I found that I need to continue to update my skills as to enable me to deliver better care services to patients.
I aim to explore other strategies improving my communication skills around inter-professional working. I will continue to seek for the support of senior staff in challenging situations. And I will also continue to use reflection as the NMC code demands to improve my experience and training.
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- Gibbs, G (1988). The reflective cycle. Oxford: Education Unit, Oxford Polytechnic.
- Hilliard, D., James, K. and Batt, A.M., 2017. An Introduction to Reflective Practice for Paramedics and Student Paramedics.
- O’Carroll, V., McSwiggan, L. and Campbell, M., 2016. Health and social care professionals’ attitudes to interprofessional working and interprofessional education: A literature review. Journal of Interprofessional Care, 30(1), pp.42-49.
- Standards for competence for registered nurses-NMC, (2018), Available [Online] at:https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-standards-for-competence-for-registered-nurses.pdf [Accessed 31/7/2019]
- Nursing and Midwifery Council (NMC 2015) The Code: Professional Standards of Practice and Behaviour for Nurses Midwives. UK.
- NHS. Urinary Tract Infections (UTIs) available online at: https://www.nhs.uk/conditions/urinary-tract-infections-utis/ [accessed 10/8/19]
- NHS. Urinary Tract infections. Available online at: http://www.uhs.nhs.uk/Media/Controlleddocuments/Patientinformation/Generalmedicine/Urinary-tract-infection-patient-information.pdf [accessed 10/8/19]
- Royal College of Physician (2017) National Early Warning Score (NEWS 2) Available at:https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2 [accessed 10/8/19]
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