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Essay: Nursing and midwifery reflection

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  • Published: 2 November 2022*
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(1). Critically reflects on appropriate, sensitive, compassionate and effective interpersonal and communication skills with a variety of people and settings.

The key to our survival as human being is communication. We need to communicate everyday. Communication can be made in different forms, which could be verbal, or no verbal. In human communication, appropriateness is very important because communication can be interpreted positively or negatively based on the settings or scenario at the given moment.

Communication is the act or reciprocal process of imparting or interchanging thought, attitudes, emotions, opinions or information by speech, writing or signs. Nurses can use this dynamic and interactive process to motivate, influence, educate, facilitate mutual support and acquire essential information necessary for survival, growth and overall sense of well being (Howells, 1975; Kleinman, 2004).

Past research identified that poor communication between the nurse and the physician has a negative impact on staff morale, staff and client satisfaction, treatment outcomes and quality of care (Larson, 1999; Rosenstein & O’Daniel, 2005).

More so some research findings in the past indicated that effective communication between the nurse and the physician enhances problem solving and decision-making and improves treatment outcomes (Boyle & Kochinda, 2004; Schimdt & Svarstad, 2002)

In an instance whereby the receptionist in a GP announced the name of a patient using the public address system while in the waiting area to come forward for his STD test result. This is a breach of data protection and communication done wrongly. Communicating sensitive information must be done privately to protect the dignity of the patient. According to the Caldicott Six (6) principles which states that you must

(i) Justify the purpose of using confidential information

(ii) Only use it when absolutely necessary

(iii) Use the minimum that is required

(iv) Access should be on strict need to know basis

(v) Everyone must understand his/her responsibilities

(vi) Understand and comply with the law.

According to Pindar, 500BC “The best of healers is a good cheer”. Research in the past revealed that patients recover quicker in an environment where staffs and nurses are cheerful and compassionate. As humans we all yearn to be loved, and being loved gives us a sense of belonging, which encourages our body to produce oxytocin, which is a “feel good” hormone.

Communicating effectively is very important as a mental health nurse and how we communicate with this people is very important because whatever we say and how we say it, and what we mean by it are extremely important, and can be life changing for patients.

When dealing with mentally ill patient, I always choose my words carefully and I think about the contextual meaning and how patients might interpret it before I say it. I always stay positive and say positive things around my patient because being negative and saying negative things could impart on patients mental health.

Consequences of ineffective interpersonal communication can lead to chaos, confusion, disorder, fear, conflict, inefficient systems, and wasted resources.

Poor team communication has been cited as the number one cause of unnecessary patient deaths related to medical error since the 1990s (Institute of Medicine, 1999).

(2) Critically analyses the role of lifelong learning and personal development as an essential precursor to developing honesty, integrity and competent professional practice.

Lifelong learning is the continuous learning you participate in after a formal education. Formal education is fine but when it comes to the real world and real life challenges we face at work place and in our daily lives we would realize that life long learning has more benefits and it makes our life more interesting by enriching our lives with new ideas, activities, new information that opens our mind and makes us better employees because of the new skills and activities we are engaging in which keeps our mind and brain sharp.

(Jarvis 2002) described Lifelong leaning as transforming experience into knowledge, skills, attitudes, values, emotions, beliefs and the senses”.

It is agreeable that Lifelong learning will improve our professional practice but sadly Life long learning and personal development is not an essential precursor to developing integrity.

Integrity is an internal state of being that guides us towards making morally wise choices (Killinger 2007). This shows that integrity is a personal choice by which we hold ourselves to consistent moral and ethical standards by acting with honor and truthfulness in every situation we find ourselves. Integrity and honesty are personal choices we make as humans.

“Integrity is the courage to meet the demands of reality (Cloud 2006)”. If integrity according to (Cloud 2006) is the courage to meet the demands of the reality, this shows that to have integrity we need to have courage and the courage to do something is based on individual’s personal choice whether to take action or not.

A high ranking civil servant who was tasked to recruit a new graduate into a department in the council decided to employ a particular applicant based on the fact that this applicant graduated from the same university he graduated from thereby becoming biased based on his sense of attachment he felt towards his alma mater.

Another top government official in South-West Nigeria became aware of a very crucial information about government plans to set up a new state of the art hospital facility in a particular environment and this government official passed this information to his very successful business associate who decided to buy a huge portion of land in such area and then sold it back to the government making a huge profit, these acts can best be defined as lack of integrity on the part of the government officials despite the fact that these individuals have been involved in lifelong learning and personal development. This shows that we all make choices in life and we all decide to either follow our internal conscience to do what is morally or ethically right or do what is morally or ethically wrong.

In the 21st century, we as individuals need to be lifelong learners. Our world is changing fast around us due to technology and if we do not continue to grow and develop; we could be left behind. We need to continually keep our skills up to date so that we have an edge in all we do (Eggelmeyer, S. 2010)

It is agreeable that life long learning has it benefits according to (Hildebrand D.S 2008) “Lifelong learning sharpens the mind, sharpens the confidence, sharpens the interpersonal skills, sharpens the career opportunities and sharpens the ability to communicate.”

All this benefits are necessary to be successful in any environment we find ourselves but it takes the willingness of any individual to use this acquired knowledge applicably in their daily lives for the benefit of themselves and for the progress of the community and the human race in general.

We now live in a world whereby every individual needs to be technology savvy to keep abreast of new developments in their professional fields. It is agreeable that competent professional practice can be achieved and maintained by lifelong learning and personal development. With my knowledge and background in computer science, I believe I have a strong knowledge of technology and how technology works both in nursing, medicine and robotics technology in medicine.

(3) Critically Evaluates and reflect on own ability to demonstrate a professional image in behavior and appearance.

“Nothing succeeds like the appearance of success,” says Christopher Lasch. Making a good first impression and as well as ongoing interactions is very vital for success in today’s world. Every professional must be able to display professionalism in appearance and manners because projecting this professional image tells the world that we are confident, credible, trustworthy and approachable.

There is a saying that “Dress the way you want to be addressed” by Bianca Frazier. Our professional image can never be underestimated because it tells the world who we are.

I have learned through lifetime learning and experiences that my appearance and self image matters a lot in life and this I have always used as an advantage that as always given me the opportunity to be treated well and respectfully everywhere I find myself. I also discovered that I earn patient’s respect and trust quickly within minutes of interaction due to the positive and sharp professional image I project at all times.

“As much as we would like to think that looks don’t matter, we are wrong. They do matter. And because we are professional nurses, we take pride (yes, pride) in our appearance. It tells the world that we are indeed professionals. We care about our patients and our interaction with them. And last but not least, we help build a positive self-esteem, whether among our patients or ourselves. General appearance and hygiene are indicators of that.” (Janet Izzo, Online).

According to Maureen Costello, Principal of Image Launch, she emphasized deeply in her online Publication (Professional Image in the Workplace: Is it Important?) that our appearance says something about who we are, whether or not we focus on it, and whether or not what it says about us is accurate. Given that, we may as well use it to our advantage.

I have in the past seen a patient in a psychiatric hospital in Hampshire County, South East of England behaved very rudely and abusive to a particular member of staff who the patient accused of smelling badly due to body odor. This particular member of staff is known for turning up to work unshaved, hair fairly tidy, clothes fairly clean and smells of sweat. The management of the psychiatric hospital decided to intervene and had a closed door meeting with this staff member, few days after, everyone noticed a huge improvement in this staff member’s professional image and his relationship with patients improved and to the astonishment of everyone this patient who insulted this member of staff weeks earlier later apologized to this member of staff regarding the incident. This experience confirmed to me that the saying by Bianca Fazier “Dress how you want to be addressed” is very true and this message has always been at the back of my mind whenever am preparing to go to work or going out on daily basis, I always ensure that I am projecting the right image of a professional, confident, trustworthy and approachable person I am.

Due to the negative media depiction of Nurses, according to a research by Kalisch and Kalisch (1981, 1982a,b,c, 1983) who conducted extensive research on the image of nursing in the media (newspapers, TV, films, novels). They identified six images of nurses corresponding to six different periods: (1) Angel of Mercy (1854–1919); (2) Girl Friday (1920–1929); (3) Heroine (1930–1945); (4) Mother (1946–1965); (5) Sex Object (1960–1982); and (6) Careerist (1983–Present).

Extensive research in the past has confirmed that the public has different and varied views toward Nurses and the nursing profession which is influenced based on the media perception of nurses over the years, which includes Nursing being viewed as a feminine, caring but not autonomous profession.

The media\’s projection of images of nurses, in ways that neglect the official requirements of the profession, also has an impact on the view of the public on nursing (Takase et al. 2001, Dahlborg-Lyckhage & Pilhammar-Anderson 2009). Several other researches in the past confirmed more about how nurses were being portrayed in the media from different centuries and decades. This is a very good reason why nurses need to always project a stronger professional image and strong self-image.

How nurses view the profession itself is very important. Over time we have learnt that how we view ourselves as individuals affects our self image and confidence, this is more elaborated by a research which confirmed that Congruence exists between the public image and nurses\’ self-concept: nurses who perceive their public image to be negative are likely to develop low self-concept (Öhlén & Segesten 1998, Gregg & Magilvy 2001, Takase et al. 2002).

This further confirms that our appearance, behavior and professional image have impact on how the public views the nursing profession.

(4). Critically evaluates previous learning experiences that have sought to provide evidence-based solutions to problems or questions.

I had a good learning experience when I took a distance learning course in Life coaching, this course opened my eyes to the importance of effective time management and how not having a well balanced and planned daily life can easily impact on our mental health as individuals.

A Survey by the Corporate Executive Board revealed that one of the things that makes people feel positive at work is work-life balance, it further stressed that people who feel they have good work-life balance work 21% harder than those who don’t. This made me arrive at the question; Work-life Balance, does this affect our mental health? Yes I strongly believe based on my previous learning experience and evidence based on previous research.

According to Health and Safety Executive (Online Survey) In Britain, work related stress, anxiety and depression cost Britain a total of 11.7 million days between 2015/2016. It was reported that the total number of cases of work related stress, depression or anxiety in 2015/16 was 488,000 cases, a prevalence rate of 1510 per 100,000 workers. Work-related stress is costing the UK economy around £6.5 Billion a year (Recruitment Buzz Online, 2015).

Physical effects of failing to have a good work-life balance include weak immune system whereby the body has very low ability to fight infections. Other physical effects includes sexual health problems such as low sex drive in men and women, cardiovascular diseases whereby the circulatory system and the heart are stressed and this causes high blood pressure and strain on the muscles supplying blood to the heart.

Effects on mental health include addictive behavior such as binge drinking, over-eating, feeling inefficient and useless, lack of sleep, poor coping skills, irritable behaviors etc.

Effect on work includes a high number of employees being off sick from work, low in productivity among staffs because employees are likely to perform less at work when feeling physically and mentally unwell.

Effect on Home life includes arguing with partner due to fatigue, feeling extremely tired at home and unmotivated, lack of sexual activity.

Pondering over this statistics and reports I asked myself, why are employees stressed?

Research shows that employees are stressed due to high workloads and unrealistic deadlines making staffs feel rushed and under pressure. Some employees reported poor working relationships leading to a sense of isolation. Pointing accusation fingers at work, Poor management or ineffective management whereby employees feel there is no sense of direction within the organization. Some reported poor working environment and bad communication between management and staffs whereby staffs are totally isolated from significant changes causing employees to be worried and uncertain about their future.

How to create a good work-life balance

(1) Look after your self. By taking breaks at work and staying well dehydrated, never skipping lunch and spending some time in the fresh air outside of work during your break period. Having a long soak in the bath after a long day at work can help you de-stress.

(2) Discussing your workload with your employers or manager and any complains you have.

(3) Setting up a cut-off time each day to switch off work smart phones and tablets to avoid taking calls and checking emails when at home.

(4) Scheduling time together with loved ones whereby you spend time with your loved ones, watching movies, going to the cinema or meals out, or going for a family day out and stick to this timetable.

(5) Avoid being a perfectionist in every area of your life. Don’t spend time trying to put everything right use scale of priorities.

(6) Limit time wasting activities.

(7) Schedule at least one thing you look forward to each day. This activity could be an hour or less, could be a game of table tennis or lawn tennis with a friend, golf, a nice book to read and so on.

This learning experience exposed the dangers employees face when there is no proper work-life balance. From this experience I have learned how to create a proper balance between my personal life, work and University study that I will be embarking on in the nearest future.

(5) Construct a development plan to address identified learning needs, reflecting on limitations of own knowledge.

Understanding the limits of my own knowledge is very important in the nursing profession due to the fatal errors that could be made while working beyond the limits of one’s knowledge. It is very essential to regularly reflect on my practice and identify areas where I feel unsure or uncomfortable. Identifying this area will enable me to know which areas to focus on and improve my knowledge in such areas.

I understand that some of my learning needs would be in the areas of Effective communication, Medication, Assessment and evaluation of patients, Admitting, transfer and discharge of patients, Creating effective care plans, Scientific processes in nursing, the use of medication for treating different types of mental health problems, administering subcutaneous or intramuscular injections, role modeling, Performing head-toe-assessments, putting in intravenous line and professional practices in Nursing and health care as a whole.

In other to address my learning needs I would work closely with my mentor and use my placement opportunities to acquire a huge knowledge base and good understanding of social, behavioral, emotional and cognitive aspects of nursing and how to work with the MDT teams, crisis teams, the pharmacy and other external agencies such as the councils, housing associations and the police who often get involved with patients.

By using the University library resources both online and onsite, I will undertake a lot of personal learning and development and always seek the knowledge of my module leader whenever I feel I need it.

By identifying my learning needs, I will construct a development plan, which will address areas of deficit in the areas of cognitive, affective and psychomotor domains. Then, prioritize my learning needs based on the most important first and the less important after. By identifying learning needs that has critical performance deficiencies that may affect the safety of the patient as the most important and should be given the highest priority. I would then create a learning plan, which will include;

(1) The learning objective – what to learn.

(2) The learning task – how I plan to learn.

(3) Start the learning either by taking a formal course, seminars or workshops, attending professional conferences or independent study.

(4) Target completion date.

(5) Reflect on acquired knowledge by asking these questions.

(i) Were my learning needs met? Yes or No?

(ii) How well sere my learning needs met?

(iii) Perform a self-assessment.

Every learning will be well documented for easy access for future references.

I understand the learning need to always Project professional values according to; The code: Professional standards of practice and behavior for nurses and midwives (NMC 2015) as a source of knowledge while working with patients in a ethical, personal centered respectful and sensitive manner. Understanding the roles of other health and social care professionals, good understanding of working within the legal and professional frameworks and local policies and I understand the need to always share information with colleagues and seek advice from appropriate sources when there is a concern or uncertainty.

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