Type: Evaluation Essays
Sample donated: Mable Fuller
Last updated: October 1, 2019
I will use the Gibbs Reflective Cycle (Gibbs, 1988) to present mycritical incident.
This is because I consider the model to be simple and easyto follow, which is important given that I am new to reflecting. This model allows me to concisely describe the incident,as well as discussing my feelings, evaluating the situation, concluding theincident and finally, acting upon how I can improve or adapt to a similarsituation better. Describe the Incident – 349 Words My clinical practice placement was based in anursing home, located within my local health board. Clients of this nursinghome receive nursing care, residential care, incurable care and end of lifecare; therefore privacy, dignity, consent and independence is paramount. I cameacross a range of incidents throughout my placement, however, the incidentwhich affected me the most was taking a gentlemen’s blood pressure, who I willrefer to as Mr. Jones.Firstly, I prepared all needed equipment andwashed my hands, prior to entering Mr.
Jones’ room. I knocked on Mr. Jones’door, introducing myself as I walked in, ensuring he knew I was there due to ahearing impairment. I explained to Mr. Jones that I needed to take his bloodpressure and that I am a student nurse, gaining consent to do so.
Mr. Jones waswearing a jumper on top of a t-shirt, therefore, I had to explain that the cuffneeded to be placed on his bare skin, gaining consent to remove his jumper.However, due to Mr. Jones suffering from dementia, he was confused and agitatedas to why I was taking his jumper off.
After I explained and reassured Mr.Jones as to why I removed his jumper, I was able to tighten the cuff, beginningthe process of taking his blood pressure. As the cuff became tighter, Mr. Jones beganto panic, shouting that it was painful and uncomfortable, making it difficultto get an accurate reading. I asked Mr.
Jones if I could try once more, gainingconsent, ensuring the reading was accurate. However, this time round, Ireassured Mr. Jones, communicating with him throughout the process. Thisdistracted Mr. Jones, allowing him to remain calm, showing no sign of pain oragitation.
Once I had noted down the result, passing the reading onto mymentor, I removed the cuff from Mr. Jones’ arm. Before leaving, I asked Mr.Jones if he would like his jumper on or off, ensuring he was comfortable andwarm enough. I said goodbye to Mr. Jones, leaving the door open as he likes.
Feelings – 233 Words This was the first time I had taken apatient’s blood pressure and therefore prior to the procedure I was feelingnervous, but also excited to complete another milestone in my learning. Thefeelings of nervousness heightened when Mr. Jones started to panic and becomeagitated. I could feel myself getting warmer and internally I could feel myselfstarting to panic too and worry that I might have been doing something wrong.
Ihad practiced taking blood pressure numerous times on family and staff membersand therefore I reassured myself that I was doing everything correct and Isimply needed to remain calm and reassure Mr. Jones that everything was okay. I felt like my mentor was looking at me,thinking I was unable to take blood pressure without upsetting a patient andtherefore I could feel my self-confidence starting to dip. I became so focusedon the task, I forgot about the patient. I felt an overwhelming sense of just wantingthe procedure to be over.
After the procedure, I felt a sense of negativity aswell as relief. I spoke with my mentor who reassured me that all patients reactdifferently, boosting my confidence as no major mistakes were made. That night,the incident played on my mind, however, I reflected upon the event, identifyingwhat mistakes were made and what I would do in a similar situation in thefuture. Evaluation – 209 Words During the incident, I was able to acknowledge the goodthings that happened, however, I am aware of the things that didn’t go so welltoo.
A positive to this event was that although this was the first time I hadtaken a patient’s blood pressure, and there were challenges throughout, I wasable to obtain an accurate reading whilst engaging in conversation with thepatient. As well as this, I was confident enough to recognize that the firstreading I took was not accurate. As a result of this, I persevered and gainedconsent to repeat the procedure, ensuring that an accurate reading was taken. Taking this into consideration, a negative tothis incident was that no patient should feel upset or frightened, thereforegiving me the impression that Mr. Jones had been put off this procedure, makinghim anxious and agitated. As a result of Mr. Jones’ emotions, I had to repeatthe procedure in order for me to gain an accurate reading, however, I foundthat through communication with the patient, Mr.
Jones began to relax andremain calm. From this reaction, I am able to take away that communication is avital part of clinical practice, allowing a relationship to form betweenPractioners and patients. Analysis– Consent– 310 Words To analyze effectively, I must break down my incidentinto sections, considering consent, communication, respect and dignity to thepatient. Therefore, analyzing whether I acted in the best interest of thepatient at all times, (NMC Nursing & Midwifery Council, 2015).
The Nursing and Midwifery Council’s professional standards state, to act in thebest interest of the patient, you must have a valid form of consent from thepatient before carrying out any action, (NMC Nursing & Midwifery Council, 2015).To ensure this happens, the law requires that all patients must consent totreatment and care, and if no valid form of consent is given, a patient couldtake legal action, (Nursing, Consent). Consent can beexpressed in many ways, for example, written consent, verbal consent orrefusal, all in which must be documented, (General Medical Council, 2008). BeforeI began the procedure on Mr. Jones, I ensured that I received consent to enterhis room, allowing me to explain what I was there to do. I explained thoroughlywhat the procedure entails, ensuring that the patient understood exactly what Iwas going to do. Once I had explained, I asked Mr.
Jones clearly if I couldcheck his blood pressure, to which I gained verbal consent, complying with the Lawand NMC Code (Welsh Assembly Government, 2015). Due to Mr. Joneswearing a jumper, I had to ask if I could remove it, gaining verbal consent, allowingme to access his brachial artery. As I didn’t obtain an accurate reading firsttime round, I ensured that I re-explained the procedure to the patient,explaining why I had to re-attempt. Mr.
Jones gave me valid verbal consent tore-take his blood pressure a second time, to which I then got an accuratereading. I learnt from gaining consent, you also gain respect from the patient,improving mine and Mr. Jones’ relationship. Communication– 224 Words Communication is considered a two-way process, includingmembers of staff and patients, (Papathanasiou, 2014). To communicateclearly, section 7 within The NMC Code states that all terms within care mustbe understood, language assistance wherever possible must be encouraged, verbaland non-verbal communication methods must be used, cultural sensitivities mustbe considered and patients understanding of care provided must be addressedregularly, (NMC Nursing & Midwifery Council, 2015). Duringmy incident, I found that getting to know patients prior to carrying outprocedures is important.
This allows me to adapt my communication style to meetthe patient’s needs, for example, Mr. Jones suffers from a hearing impairmentand therefore I needed to speak loudly, slowly and clearly, ensuring he hadheard me entering the room. If I wasn’t aware of Mr. Jones’ hearing impairment,I may have disrupted the patient, consequently frightening Mr.
Jones in his ownliving space. Similar to this, I avoided using jargon whilst explaining to Mr.Jones what the procedure entails, ensuring the patient felt comfortable with mecarrying out the procedure.
This incident has allowed me to understand that allpatients communicate differently and that worries and reactions vary betweenpatients. Respect– Dignity– ReflectiveConclusion – 229 Words On reflection, there are a number of things that I couldhave done differently in this situation. For example, before starting theprocedure, I could have taken a few minutes to have a general chat with Mr.Jones, putting him at ease before discussing the procedure and what entailed.Additionally, once I had explained what I was going to do, I could have askedMr. Jones if he fully understood what I was going to do and whether he had anyquestions before starting. PreventingMr.
Jones from miss-understanding, as well as giving him the opportunity toaddress any anxieties. I could have also considered discussing with my mentor aplan of action before proceeding with the procedure as it was my first time. Bydoing this I would have been not only physically, but mentally prepared for theevent. Similarly, I could have also considered refreshing my memory of the NMCCode, by doing this, I could have focused more on the patient, rather than thetask.
Ihave learnt that engaging with the patients and communicating with them clearlyis critical within every situation. Similarly, by respecting the patient andmaintain their dignity, the relationship develops, allowing person centeredcare to be delivered. This was demonstrated in my incident as Mr. Jones becamecalm and settled once I had taken the time to communicate clearly with him.