This essay will critique and reflect on my personal and professional development in my first years as a Trainee Nursing student. I will explain how I will continue to develop my knowledge and nursing skills once registered. The three standards of the NMC (2018a), which I will focus on, are: Being an accountable professional, promoting health and preventing ill health and working
in teams. I have chosen these three domains since I feel I have excelled more in them whilst working with patients, colleagues, and healthcare professionals. I will highlight some of the challenges I may have encountered in each and how I plan to deal with them as I continue to learn to improve my practice. As expected under the Nursing and Midwifery Council (NMC,2018b), I will not reveal the names of healthcare professionals. Where reference is made to any of these, I will use pseudonyms. I will also provide evidence for achieving the domains shown in my portfolio.
In the past one years, I have worked in several healthcare settings, including community and acute wards. Working in these settings involved applying skills and knowledge to
support patients’ healthcare outcomes and recovery from diseases and illnesses. Providing safe and quality patient care demands that nurses integrate several clinical skills whilst working with colleagues and patients. Such an opportunity offers a chance to learn and enhance one’s skills and knowledge (G Laser, 2017; Stonehouse, 2021). One of the responsibilities that I was involved in was promoting health and preventing ill health. Nurses are important in supporting patients to improve and maintain their overall health and well-being (Glasper, 2017). In the first years, I actively prevented and protected diseases and ill health by engaging patients, which allowed me to learn more from such interactions.
As part of our course, we were required to submit an essay on promoting health and
preventing ill health, which helped clarify how I executed this role. In the task that I
submitted. I explored the patient’s health needs relating to his physical, psychological, and social dimensions. I also considered how the patient’s holistic needs would be met to enhance the health and well-being of the patient. Some aspects I thought to promote health and prevent ill health were the social determinants of health and how these could be met. I educated the patient on medication, coping skills, and risks to his health, including how these could be overcome or minimised. (Glasper, 2017; Stonehouse, 2021). One of the things I learned was the need to integrate multiple health promotion approaches to support behaviour change. One of these was a behavioural change, which seeks to persuade individuals to take responsibility for their health using preventive services. I also learned about self-empowerment models that focus on enhancing one’s abilities using their strengths to control their health and the environment in
which they live.
I also learned that patients might have unique perspectives about their
healthcare needs. The role I assumed was supporting patients to make informed choices, and I realised this might not be an easy task. Respecting patient autonomy implies allowing them to make decisions I may disagree with based on my knowledge, understanding and current evidence. (Glasper, 2017; Stonehouse,2021). As patients exercise their autonomy, they can make choices that are not good for their health. However, I ensured that I provided them with all the information available while seeking help and support from other healthcare professionals to support patients make decisions that benefit them. The different standard that would be of interest is being an accountable professional.
Being an accountable professional requires nurse associates to communicate effectively using various skills and strategies with patients, colleagues, and other healthcare professionals (NMC,2018a). I have worked with different patients in healthcare settings and worked within the tenets of the NMC (2018b). One of the aspects of communication that I have embraced in the first year is maintaining confidentiality in line with the dictates of the NMC (2018b) code. Effective communication is integral in healthcare as it helps share information in ways that can be understood and acted upon as part of care provision (Bibi et al., 2022). However, before straining this course, I was Unaware of the important role of communication within teams or when working with patients. I also encountered problems in developing rapport with patients. I also faced challenges in communicating with members of the multidisciplinary team. However, I realised that my lack of communication skills was mainly based on a lack of confidence. Benner (1984) indicated that novice practitioners may not demonstrate mastery of key skills, but with learning and support, they can do so with time. Indeed, as part of the OSCA, we were taught the importance of using early appropriate communication tools such as the situation, background, and assessment.
During placement, I could also recognise signs of deterioration with the help of the NEWS 2chart (Royal College of Nursing, 2022). The NEWS 2 chart is a recognisable framework that can escalate care to senior healthcare professionals for quick action and response to minimise the risk of deterioration (Harris, 2021; Royal College of Nursing, 2022). Nurse associates can provide valuable data by using the NEWS 2 scores by escalating this using the SBAR communication tool as they fill the gap between registered nurses and support workers (Muller et al., 2018; Peate,2019).
On reflection, my communication knowledge has improved, making me more confident to practice effectively. I also appreciate that I have developed key skills in assessing patients using models such as the ABCDE approach advocated by the Royal College of Physicians (RCP) for evaluating critically ill patients. I have also learned more about relevant legislative
and ethical frameworks such as autonomy, beneficence, non-maleficence, and justice underpin safe and effective patient care. I have the confidence to deliver safe care to my patients while advocating for their needs.
The last domain that I settled on is working in teams. Whilst working as a healthcare assistant, I was paired with a nurse. Although the nurse’s student role is often underrated, they offer an important supportive role within multidisciplinary settings (Hickman and Leary, 2020). Nurse students are integral in interdisciplinary teams, collaborating and communicating effectively with other healthcare professionals to meet patient needs. This role includes demonstrating awareness of one’s position, responsibilities, scope of practice within the team and assigned duties and functions. During lectures, we were introduced to the importance of team working in healthcare. We were educated on the part of the team working to improve patient healthcare outcomes and reduce harm (Peate, 2019). Every time patients visit healthcare settings or are admitted, they expect quality care that meets their needs (Peate, 2021). Harris (2021) indicates that such consideration is impossible if healthcare professionals fail to collaborate as a team providing unique perspectives, ideas and skills that meet the patient’s needs. I demonstrated effective communication skills whilst working with diverse members or groups, which is vital in achieving the best patient outcomes (Peate, 2021).
In conclusion, this essay has provided a critique and reflection on my personal and professional development over the first year as a student nurse. After finishing my current course, I have explained how I will continue to develop in the key areas. I can note that the first year has provided me with a vital opportunity to provide care to patients that meet the tenets of the NMC (2018b) code. Specifically, I have demonstrated how I have communicated effectively, demonstrated my accountability in practice and the ability to work in teams. I have explored current evidence on why these domains and their preparation are critical in enhancing patient outcomes. I will continue strengthening my skills to demonstrate accountability and professionalism across these domains. I will improve these skills and competencies to deliver quality and safe patient care.