PART 3 – PLACEMENT 1 – 2024 SEPT – Time Management and Prioritisation in Primary Care

NMC Reflective Account Form

Reflective account:

What was the nature of the CPD activity and/or practice-related feedback and/or event or experience in your practice?
During my GP placement (October 2024), I faced multiple time-sensitive tasks, requiring me to balance patient consultations, administrative duties, and vaccine preparation. These experiences tested my ability to prioritise workload efficiently while maintaining high standards of patient care.

What did you learn from the CPD activity and/or feedback and/or event or experience in your practice?
I learned that effective time management is crucial in primary care. Applying Covey’s Time Management Matrix (1989), I categorised tasks based on urgency and importance, ensuring that high-priority patient needs were addressed first. Additionally, I gained insight into delegation and workload structuring, as advised by my practice assessor.

How did you change or improve your practice as a result?
I implemented structured approaches to managing tasks, such as setting time allocations for each consultation and using checklists to track progress. This experience enhanced my ability to work under pressure while maintaining safe and patient-centred care. Moving forward, I plan to further develop these skills through time management workshops and structured clinical training.

How is this relevant to the Code?

• Practise effectively: Managing workload efficiently ensures timely patient care.
• Preserve safety: Prioritising tasks appropriately reduces errors and delays.
• Promote professionalism and trust: Demonstrating organisational skills enhances confidence in my professional capability.

This reflection highlights the importance of structured time management, prioritisation, and professional efficiency in nursing practice.

SOURCES USED:

The following documents contributed to the reflection:

1. Leadership and Supervision in Nursing – A Reflective Analysis.pdf
   • Time management strategies, including Covey’s Time Management Matrix.
   • Reflection on prioritisation in workload management.
   • the importance of delegation and structured workflows.
   • Feedback from practice assessors on workload efficiency.
2. PART 1 – PLACEMENT 1 – 2022 DEC – Final Interview – Student Reflection.pdf
   • Workload management during placement and how tasks were structured.
   • Reflection on how clinical prioritisation was developed over time.
3. PART 1 – PLACEMENT 1 – 2022 DEC – Reflection on meeting Professional Values.pdf
   • Experiences in handling multiple responsibilities and prioritising effectively.
   • The importance of structured delegation and efficiency in primary care settings.

PART 3 – PLACEMENT 1 – 2024 SEPT – Managing Complex Patient Needs in Primary Care

NMC Reflective Account Form

Reflective account:

What was the nature of the CPD activity and/or practice-related feedback and/or event or experience in your practice?
During my GP placement (October 2024), I encountered patients with multiple comorbidities and complex care needs. Some patients required comprehensive assessments, multi-disciplinary team (MDT) involvement, and long-term management planning. Engaging with these cases helped me develop a broader understanding of holistic patient care, integrating clinical, psychological, and social aspects.

What did you learn from the CPD activity and/or feedback and/or event or experience in your practice?
I learned that managing complex patient needs requires a structured, patient-centred approach. Applying Miller’s Pyramid of Clinical Competence (1990), I developed confidence in synthesising patient histories, applying clinical reasoning, and recognising when to escalate care. Additionally, collaborating with other healthcare professionals, including practice nurses, pharmacists, and GPs, highlighted the importance of interdisciplinary teamwork in long-term patient management.

How did you change or improve your practice as a result?
Following this experience, I became more methodical in patient assessments, ensuring a comprehensive evaluation of physical, emotional, and social needs. I also improved my ability to prioritise care and communicate effectively with the MDT. Moving forward, I plan to develop my skills in chronic disease management, particularly in diabetes and cardiovascular health.

How is this relevant to the Code?

• Practise effectively: Managing patients holistically ensures comprehensive, high-quality care.
• Preserve safety: Recognising when to escalate complex cases improves patient outcomes and prevents complications.
• Promote professionalism and trust: Coordinating effectively with the MDT enhances collaboration and ensures seamless care delivery.

This reflection highlights the importance of structured clinical assessment, interdisciplinary collaboration, and long-term patient management in primary care.

SOURCES USED:

1. Leadership and Supervision in Nursing – A Reflective Analysis
   • Miller’s Pyramid of Clinical Competence (1990) and structured patient assessment.
   • Emphasis on the importance of interdisciplinary collaboration in primary care​.
   • Structured delegation and long-term management planning in complex patient care.
2. PART 3 – PLACEMENT 1 – 2024 SEPT – Reflection on Learning from Others
   • Reflection from GP Placement on learning from a Diabetic Nurse Specialist Team in an MDT setting.
   • Holistic patient-centred care and structured patient assessments.
3. PART 2 – PLACEMENT 1 – 2023 NOV – Episode of Care 1 (Part 2)
   • Reflection on Outpatients Department (HH) experience, emphasising risk assessments and care planning for complex patient needs​.

PART 3 – PLACEMENT 1 – 2024 SEPT – Enhancing Communication and Patient-Centred Care in Primary Care

NMC Reflective Account Form

Reflective account:

What was the nature of the CPD activity and/or practice-related feedback and/or event or experience in your practice?
During my GP placement (October 2024), I engaged in patient consultations, explaining treatment plans, addressing concerns, and ensuring patients felt heard and involved in their care. I observed that some patients required extra reassurance or tailored communication approaches to fully understand their treatment plans. This experience helped me refine my verbal and non-verbal communication skills to enhance patient engagement.

What did you learn from the CPD activity and/or feedback and/or event or experience in your practice?
I learned that effective communication is central to patient-centred care. Applying Silverman, Kurtz, and Draper’s Calgary-Cambridge Model (2005), I developed a better understanding of active listening, responding empathetically, and ensuring patient concerns were addressed clearly. Additionally, my supervisor provided feedback on how I could improve my approach when explaining medical concepts in a more patient-friendly manner.

How did you change or improve your practice as a result?
Following this experience, I focused on improving clarity in patient interactions, adjusting my communication style based on individual patient needs, and ensuring patients felt empowered to ask questions. Moving forward, I plan to engage in further communication training, particularly in shared decision-making and motivational interviewing.

How is this relevant to the Code?

• Practise effectively: Clear and empathetic communication ensures patients understand their treatment and feel involved in their care.
• Preserve safety: Encouraging patient engagement reduces misunderstandings and improves adherence to care plans.
• Promote professionalism and trust: Communicating respectfully and transparently builds patient confidence and enhances therapeutic relationships.

This reflection highlights the importance of effective communication, patient-centred care, and professional interactions within a primary care setting.

SOURCES USED:

1. PART 3 – PLACEMENT 1 – 2024 SEPT – Reflection on Learning from Others 1
   • Observations on patient interactions, patient education, and addressing concerns
   • Reflection on communication skills and patient engagement.
2. PART 3 – PLACEMENT 1 – 2024 SEPT – Mid-point Interview – Student Reflection
   • Insights into patient interactions and communication in a GP setting
   • Application of communication techniques during consultations.
3. PART 3 – PLACEMENT 1 – 2024 SEPT – Final Interview – Student Reflection
   • Developing patient-centred communication and responding to patient concerns
   • Feedback on explaining medical concepts in a patient-friendly manner​.

PART 3 – PLACEMENT 1 – 2024 SEPT – Developing Confidence in Clinical Decision-Making

NMC Reflective Account Form

Reflective account:

What was the nature of the CPD activity and/or practice-related feedback and/or event or experience in your practice?
During my GP placement (October 2024), I encountered situations requiring me to apply clinical reasoning and make independent decisions within my scope of practice. This included identifying patient concerns, determining when escalation was necessary, and discussing findings with my supervisor. This experience helped me develop confidence in clinical decision-making and professional accountability.

What did you learn from the CPD activity and/or feedback and/or event or experience in your practice?
I learned that effective decision-making requires critical thinking, pattern recognition, and structured assessment. Applying Tanner’s Clinical Judgement Model (2006), I improved my ability to interpret patient symptoms, anticipate potential complications, and formulate appropriate responses. Additionally, my supervisor provided feedback on how to refine my clinical reasoning by integrating both theoretical knowledge and practical experience.

How did you change or improve your practice as a result?
As a result of this experience, I became more proactive in assessing patients, asking relevant clinical questions, and synthesising information efficiently. I also improved my ability to articulate my reasoning when presenting cases to senior staff, ensuring clarity and professionalism. Moving forward, I plan to engage in structured clinical decision-making training and mentorship opportunities to further refine this skill.

How is this relevant to the Code?

• Practise effectively: Enhancing clinical judgement ensures safe and effective patient care.
• Preserve safety: Developing confidence in decision-making helps reduce errors and improve patient outcomes.
• Promote professionalism and trust: Sound clinical judgement fosters trust with both colleagues and patients.

This reflection highlights the importance of clinical reasoning, structured decision-making, and confidence in professional nursing practice.

SOURCES USED:

The following reflections and feedback documents were used to develop this NMC reflection:

1. Leadership and Supervision in Nursing – A Reflective Analysis
   • Tanner’s Clinical Judgement Model (2006) and its role in clinical decision-making and structured assessments​.
   • Highlights the need for proactive patient assessment and pattern recognition​.
2. PART 3 – PLACEMENT 1 – 2024 SEPT – Episode of Care 1 (Part 3)
   • Describes experiences of assessing patient needs independently.
   • Provides insight into how feedback from the practice assessor helped refine clinical decision-making skills.
3. PART 3 – PLACEMENT 1 – 2024 SEPT – Managing Patient Expectations and Difficult Conversations in GP Practice
   • Supports development in professional accountability and handling complex patient interactions​.
   • Demonstrates how structured communication enhanced decision-making capabilities.

PART 3 – PLACEMENT 1 – 2024 SEPT – Leadership and Autonomy in Primary Care

NMC Reflective Account Form

Reflective account:

What was the nature of the CPD activity and/or practice-related feedback and/or event or experience in your practice?
During my GP placement (October 2024), I was given increasing responsibilities in managing my workload independently. While still under supervision, I was expected to prioritise tasks, make clinical decisions within my scope, and support the wider team. This included assisting with patient assessments, preparing vaccinations, and responding to queries efficiently.

What did you learn from the CPD activity and/or feedback and/or event or experience in your practice?
I learned that leadership in primary care involves both clinical decision-making and effective time management. Applying Hersey and Blanchard’s Situational Leadership Model (1969), I adapted my approach depending on the complexity of tasks and the level of supervision required. I also recognised that autonomy comes with accountability, and decision-making must align with evidence-based practice and patient safety principles.

How did you change or improve your practice as a result?
Following this experience, I became more confident in handling low-risk clinical tasks independently, while also knowing when to escalate concerns. I refined my prioritisation skills and learned to manage competing demands effectively. Moving forward, I plan to develop my leadership further by engaging in structured mentorship and management training programmes.

How is this relevant to the Code?

• Practise effectively: Managing tasks autonomously while ensuring high standards of patient care.
• Preserve safety: Recognising the limits of my competence and escalating appropriately when needed.
• Promote professionalism and trust: Developing leadership skills that contribute to a well-functioning, patient-centred healthcare environment.

This reflection highlights the importance of leadership, autonomy, and decision-making in nursing practice within a primary care setting.

SOURCES USED:

1. Leadership and Supervision in Nursing – A Reflective Analysis.pdf
   • Decision-Making Under Pressure: The Clinical Decision-Making Model (Tanner, 2006) suggests that clinical judgement is enhanced through reflective practice, situational awareness, and pattern recognition. This was applied during the placement experience in primary care, where leadership decisions were required in fast-paced settings​.
   • Balancing Responsibilities: Managing workload and prioritising tasks were key aspects of the GP placement, aligning with Covey’s Time Management Matrix (1989) for structured prioritisation.
   • Aligning Future Leadership Goals with Career Progression: The guidance provided on career planning (qualifying, gaining high-acuity experience, and enrolling in GPN courses) was a major component of leadership development​.
2. PART 3 – PLACEMENT 1 – 2024 SEPT – Reflection on Meeting Professional Values.pdf
   • Autonomy in Clinical Practice: Decision-making autonomy was exercised during the placement, including vaccine administration choices and handling patient concerns in a way that ensured safe and effective patient care.
3. PART 3 – PLACEMENT 1 – 2024 SEPT – Mid-point Interview.pdf
   • Situational Leadership in Nursing: Developing autonomy and prioritising tasks in a primary care setting was discussed in the student self-assessment and learning objectives.

PART 3 – PLACEMENT 1 – 2024 SEPT – Multi-Disciplinary Collaboration and Interprofessional Working in Primary Care

NMC Reflective Account Form

Reflective account:

What was the nature of the CPD activity and/or practice-related feedback and/or event or experience in your practice?
During my GP placement (October 2024), I worked closely with a multi-disciplinary team (MDT) that included GPs, practice nurses, pharmacists, and healthcare assistants (HCAs). I observed how effective collaboration between different professionals improved patient outcomes, particularly for complex cases involving chronic disease management and medication reviews.

What did you learn from the CPD activity and/or feedback and/or event or experience in your practice?
I learned that clear communication, shared decision-making, and defined roles are essential for effective interprofessional working. Applying West’s Teamwork Model (2012), I recognised how structured collaboration enhances efficiency and ensures patients receive holistic care. Additionally, I observed how different specialities within the MDT contributed unique expertise to patient assessments, reinforcing the importance of interprofessional respect and cooperation.

How did you change or improve your practice as a result?
Following this experience, I became more proactive in seeking guidance from other professionals and contributing effectively in team discussions. I also improved my communication skills by ensuring I provided clear, concise patient updates during MDT meetings. Moving forward, I plan to develop my knowledge of multi-disciplinary care frameworks and seek further opportunities to enhance my interprofessional collaboration skills.

How is this relevant to the Code?

• Practise effectively: Working collaboratively ensures patient-centred care and optimises outcomes.
• Preserve safety: Sharing expertise within an MDT minimises errors and enhances patient safety.
• Promote professionalism and trust: Effective teamwork fosters a culture of mutual respect and accountability in healthcare settings.

This reflection highlights the importance of teamwork, interprofessional collaboration, and communication in providing holistic patient care within a primary care setting.

SOURCES USED:

1. “PART 3 – PLACEMENT 1 – 2024 SEPT – Reflection on Learning from Others 1.pdf”
   • Observation of multidisciplinary teams (MDTs) and collaborative patient-centred care.
   • Importance of interprofessional teamwork in diabetes management and holistic care​.
2. “PART 3 – PLACEMENT 1 – 2024 SEPT.pdf”
   • Reflections on working alongside a multi-disciplinary team during primary care placements.
   • Experiences engaging with different professionals such as practice nurses, GPs, and diabetic specialists​.
3. “PART 3 – PLACEMENT 1 – 2024 SEPT – Mid-point Interview – Student Reflection.pdf”
   • My reflection on interprofessional collaboration and teamwork in clinical settings.
   • Learning from the experiences of other healthcare professionals, including wound care specialists and asthma nurse reviews​.

PART 3 – PLACEMENT 1 – 2024 SEPT – Handling Time-Sensitive Situations and Urgent Decision-Making in Primary Care

NMC Reflective Account Form

Reflective account:

What was the nature of the CPD activity and/or practice-related feedback and/or event or experience in your practice?
During my GP placement (October 2024), I encountered situations where I had to identify patients requiring urgent escalation and communicate concerns to my assessor and senior colleagues. This included recognising potential clinical deterioration, assisting with patient triage, and ensuring timely intervention in high-risk cases. The experience tested my clinical judgement, prioritisation, and ability to escalate concerns effectively.

What did you learn from the CPD activity and/or feedback and/or event or experience in your practice?
I learned that early recognition of clinical warning signs and prompt communication are essential in primary care. Applying Tanner’s Clinical Judgement Model (2006), I became more aware of subtle cues indicating patient deterioration and the importance of relaying information concisely to the GP or senior nurse. Additionally, observing how experienced clinicians assessed and triaged urgent cases reinforced the importance of structured assessment tools like NEWS2 (National Early Warning Score 2) in decision-making.

How did you change or improve your practice as a result?
Following these experiences, I became more confident in identifying at-risk patients and effectively escalating concerns. I refined my clinical observation skills and learned how to communicate urgency while providing relevant clinical details. Moving forward, I plan to engage in additional training in early recognition of deterioration and emergency response protocols to enhance my ability to contribute effectively in urgent situations.

How is this relevant to the Code?

• Practise effectively: Ensuring that deteriorating patients are identified and escalated appropriately.
• Preserve safety: Recognising early warning signs and acting promptly helps to prevent adverse patient outcomes.
• Promote professionalism and trust: Communicating urgent concerns clearly and efficiently strengthens team collaboration and patient confidence.

This reflection highlights the importance of clinical observation, effective escalation, and decision-making in time-sensitive patient care scenarios.

Sources Used:

1️⃣ PART 3 – PLACEMENT 1 – 2024 SEPT – Reflection on Learning from Others 2.pdf

• Observations of senior staff handling urgent cases and how structured frameworks like NEWS2 guided decision-making.
• Identified best practices in clinical assessment and escalation.

2️⃣ PART 3 – PLACEMENT 1 – 2024 SEPT – Mid-point Interview – Student Reflection.pdf

• Reflected on experiences where patients required escalation and how communication with senior colleagues played a role.
• Supervisor feedback encouraged refining clinical observation skills for early warning signs.

3️⃣ PART 3 – PLACEMENT 1 – 2024 SEPT – Final Interview – Student Reflection.pdf

• Feedback from assessors regarding effective escalation and communication in urgent situations.
• Identified areas for further learning, including emergency response protocols.