Category Archives: Reflections: Year 2

Reflection on Ensuring Confidentiality is Maintained

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Promoting the development of professionalism and trust is a fundamental element of the NMC. I consistently adhere to community policies and all directives on protecting patients’ privacy in the community. My approach and demeanour must demonstrate to others that I am a professional. To maintain a tone of professionalism and ensure that others reflect my conduct and perception, I regard each individual with the utmost respect and decency. Establishing clear boundaries is paramount when interacting with patients, their families, the community staff I work with, and the general public. I must maintain confidentiality and adopt a positive attitude when visiting patients in the community, following the collection of patient information. For instance, most patients I visit in the community with my supervisor have limited mobility; therefore, we always carry their keycode with us. I am not authorised to disclose the patient’s confidential information or secure keycode unless specifically requested to do so by the relevant members of the multidisciplinary team. Upon coming out of their homes I make sure the doors are properly locked and secured to prevent anyone from entering. Once more, upon our return from the patients’ home visits, I make sure I thoroughly review all pertinent documents and dispose of any unnecessary ones in the designated confidential waste after handing over.

Maintaining confidentiality and obtaining informed consent are critical components within the health and social care environment. These practices foster trust and enable patients to make informed decisions about their health. The absence of trust poses a significant obstacle to the health professional’s work, rendering it nearly impossible. The patients have a legal right to have any information entrusted to a healthcare practitioner utilised exclusively for the patient’s advantage to preserve or improve their health, safety, and overall welfare.

Reflection on Progress (2nd Year)

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Knowledge

Community nursing teams deliver essential healthcare services within or in nearby areas of individuals’ residences. Their profound understanding, clinical knowledge, and adept leadership empower them to support individuals in effectively managing immediate and chronic ailments, thereby optimising their independence.

Their profound expertise, clinical prowess, and knowledge empower individuals to autonomously oversee their healthcare with dignity and respect while remaining in the convenience of their residences.

Skills

In the community, I must consistently exhibit and cultivate abilities that will enable me to provide optimal treatment for the patients under my care. For me to establish a meaningful professional relationship with staff, the patient, and their families I must maintain effective communication. For instance, speak carefully and precisely to ensure that others can comprehend what I am communicating to them. In nursing, social awareness is the capacity to perceive, understand, and ascertain the sentiments of others. Possessing a heightened level of social awareness as a student in the community alongside district nurses signifies that I have practical, active listening abilities and the capacity to discern the emotions of every patient in the community setting. In addition to effective communication is handover and telephone communication. Handing over and telephone communication is one thing that I have learned in the community that will help me in my next placement and my career as a nurse

Practical time management skills are essential in the community. My supervisor and I will identify the most critical patients and prioritise the most essential items required to support them before the commencement of the shaft. I am more proactive and manage my time efficiently when it comes to patient care. I can confidently say my communication has improved more when I am doing handover and that is also busting my self-esteem level.

Attitudes and values

From my very first day, I felt like a valuable team member. The team was small, so I quickly got to know everyone, who was extremely welcoming and helpful. In the community, we work as a team, so the lead team member often handles fast-paced situations that require decisions that require specific skills. When my supervisor and I are out and about in the community, I give patients that respect, for example, the wearing of shoe covers before stepping into a patient’s house. One of the most essential values of nursing is to respect the patient’s dignity. I ensure that my attitude and behavior influence how others see and treat me so I always treat patients, their families, staff, and people with that I come into contact with respect and dignity

REFLECTION (Ensure Confidentiality is Maintained)

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As a student nurse, my learning environment encompasses not just the traditional classroom setting on campus but also extends to the patient’s bedside and in the community. This necessitates the prioritisation of ensuring the safety, privacy, and dignity of the individuals who have entrusted me with their care. I spent time with patients in the community clinic and in the hospital today with support from my assessor/supervisor. Ensuring safety and promoting comfort are crucial factors to be taken into account for patients with certain conditions, such as diabetes. After introducing myself or sometimes my assessor introduced me to them, I ensured I gained consent from the patient before doing any observations. My assessor and I started to explain to the patients the reason for their being in the hospital and or the community clinic being in the community clinic. Explaining to newly diagnosed patients what type one and type 2 diabetes. For individuals with type 1 diabetes, the pancreas is not producing insulin at all or if they have type 2 diabetes the pancreas is not producing enough to not use insulin according to the blood test/. My assessor and I explained to the patients how to monitor their blood glucose (sugar) levels. Maintaining a certain blood glucose level so that the patients do not go into hypoglycemia or hyperglycemia according to their age. What hypoglycemia simply means is the glucose (sugar) level in the blood dropping below 4. If it does drop then the patient needs to treat the hypoglycemia with glucose gels or 150 to 200ml apple or orange juice. What they needed to do was to follow the advice that had been given by checking their blood glucose regularly and administering insulin at the right time and other medications they are taking any. One of the patient had a lot of questions about his diabetes and wanted to know what was going to happen to his work. He does not want anybody to know he have diabetes. We assured him that it is incumbent upon us to respect his entitlement to his own life and convictions. This is stipulated under the NMC’s Code of Ethics. Maintaining secrecy is crucial due to data protection law that safeguards individuals’ rights to have their personal information secured, that I with the support of my assessor assure him that the team is there to give him the support and encourage him to call the numbers in case of any difficulty or for any clarification with issues concerning his diabetes. As healthcare providers, it is crucial for us to ensure that patients are well-informed about their treatment and that all relevant information is correctly communicated with the relevant parties. The patient was told to contact his GP if his insulin medication finishes, the GP will provide him with a new one. keeping sensitive information and sharing it with the appropriate person who needs to know is one of the fundamentals of the NMC. This information may also guide the optimal approach to address both general and specialised needs, considering the patient’s stage of development. As a student nurse, I am responsible for my learning especially on placement. It is vital for me to reflect on the days clinic and ask myself questions if I have effectively delivered care for my parents.

Mid-Point Reflection With The Diabetes Team

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Knowledge

As a second-year adult student nurse, I have gained experience in placement with the diabetes team both in the hospital and the community. When I received the email telling me I would be with the diabetes team I was expecting to be in the community. Little did I know that it was the specialist team I would be working with. So my six-week placement is both in the hospital and the community with the diabetes specialist team and both teams were very welcoming. I feel like part of the team. After my orientation and the initial interview, we kicked off with reading patient’s notes and ward visitation. During the placement and my self-study, I have come to realise that most diabetes treatment is self-care, necessitating the patient’s active participation in their care, and decision-making, with multi-disciplinary team meetings, goal establishment, and daily management. Effective management of diabetes and attainment of a goal, diabetes control needs the implementation of many behavioural changes by patients. Establishing and maintaining the behavioural changes by the patient is necessary for diabetes self-management and requires a collaborative effort between patients and healthcare practitioners to develop a relevant and effective strategy. The diabetes nurses played a significant role in enhancing the quality of care delivered to individuals with diabetes. Spending time with my assessor and supervisor has made me realise that the primary responsibility of nurses in the context of diabetes care is to promote patient empowerment and foster self-care behaviours by providing information and support. However, if the patient is too unwell, elderly, or frail then the district nurses, family members or career needs to administer their medication for them and keep records of the blood glucose for review. Then again if the patient is running late to a clinic appointment in the community there is an opportunity for a telephone call to run the clinic so the patient will not miss out any information that the nurses needs to give. Sometimes the appointment has to be rearranged for another time. Sitting in the clinic and listening to the diabetes team, have learned that diabetes specialise nurses maintain sufficient knowledge and possess fundamental communication skills to establish a sense of comfort and effectively convey information throughout their educational and clinical sections. In most of the clinics, the nurses give advice on medication and how to check blood glucose. It is with no doubt that a comprehensive understanding of diabetes and its care is vital to educating people with diabetes successfully. The care for diabetes patients are individually based on their needs and what type of diabetes they may have. Diabetes nurses not only work in hospitals but also in the community, making changes in patients’ care and referrals to their General practices and the community.

Skills

As a student nurse with diabetes specialise team, I realise that the management of diabetes demands a broad range of professional skills which includes communication. I have had the opportunity to participate in patient education in the wards under the supervision of my assessor. Educate patients to understand the use of medication and how to check their blood sugar levels when they have been discharged from the hospital. I use short sentences, keep the message simple, and allow the patients to repeat what they heard in their own words to demonstrate or confirm what has been said. I have a sense of belonging and active engagement within the team, finding value in collaborative efforts with other members. I have developed a diverse range of communication skills and obtained knowledge about the provision of care for individuals with diabetes. I am gradually familiarising myself with various diabetic drugs, as well as the rationale and methods of their administration among patients.

Under the supervision of my assessor, I successfully and safely took blood with her support. I managed to do this in the first attempt and the patient was very pleased with me. Blood glucose monitoring, Insulin administrations, Injection techniques, Assessment of lypohypertrophy, Hypoglycaemia management in the hospital and community. I have also done eLearning online diabetes training for health and social care under the Cambridge Diabetes Education Programme. My certificates and Reflection forms are Hypos at Home, driving with diabetes, hospital Hypos, blood Glucose and Ketone Monitoring

Attitudes and values

I was originally nervous to start my placement on the diabetes unit. I felt the first few days were a bit confusing for me as I was expecting to be in the community and dressing wounds. I was worried that it was going to take a while to adjust but, I was able to adapt quickly and I feel like my attitude has changed. I no longer feel worried and I feel like am part of the team. I feel like I have an enthusiastic attitude towards diabetes and express it to my supervisor. As a student nurse, I possess an understanding that the establishment of trust with the patient is regarded as a fundamental value within the nursing profession. This approach facilitates the ability to prioritise the patient’s perspective and maintain a non-judgmental stance. I possess a strong inclination towards optimism. Furthermore, I ensure that throughout our visits to the wards or in clinical settings to review patients, I consistently demonstrate a demeanour characterised by respect and decency. As a diligent student nurse, I adhere to instructions and regulations while also valuing effective treatment plans and strategies that promote the well-being of patients.