Date of Learning: 12/05/23
Time: 09:30-16:30
Learning Activity 1: Introduction to Reflection Assignment
The learning outcome of todays class was to discuss the concept of reflection and reflective practice within healthcare. We explored reflective models and critically think about our assignment for this module. Reflection is critically analysing an experience in which I can learn and improve when it arises again. There are three different models of reflection we looked at today and I will be exploring and discussing further in this learning log.
In our assignment we are required to submit a reflective report based on an interaction with a service user where effective communication and professional relationship occur at my work practice. I am required to write a 2000 words reflective report where I must identify three elements of communication skills and be able to expand it further in my report. The class looked at different examples of elements of communication these are active listening, eye contact, body language, use of touch, social space, and tone of voice. The class tutor gave us tips and guidance during this class session and broke down each section of the assignment learning outcomes and what each section of assignments should contain. We also looked at three models of reflection during the class where the module convenor explained further on how to develop or create our reflection based on these models.
The three models of reflection we looked at was the What? So what? Now what? (Driscoll, 2007), Reflective Cycle (Kolb 1984) and Gibb’s Reflective Cycle. (Gibbs, 1988) Today we focused on Gibb’s reflective cycle because it was suggested to be used for my assignment. It is a cyclical model that contains six stages which are description, feelings, evaluation, analysis, conclusion, and an action plan. In our introduction I must discussed about the model of reflection that I am going to use, what type of interaction I will be reflecting on, how and why I am reflecting to that experience. The Gibb’s reflective cycle first stage is description, in this section I will provide a brief description of the interaction. The second stage is feelings and thoughts about the experiences. Then I must evaluate the interaction by critically thinking of what was good and bad about it. An analysis of the interaction is the next stage where I can expand more of what else can I or could have make of the situation. I can then apply academic literature in this section and reflect on barriers or factors that relates to the topic or interaction. To summarise the whole report, I must add a conclusion in which I can demonstrate what I learn from the experience and how I can improve in future when it arises once again. Towards the end of the reflective report, I must create an action plan. It was suggested to use SMART objectives to plan how it could be done differently if the similar experience arise again. Lastly, I am required to reference properly towards the end of my report.
In this class session, I am given clarity of what the assignment is about. It also reduced my anxiety as I was becoming anxious about the assignment. After this class I identified what my assignment is going to be and what interaction I am going to write about. Going through stages of the Gibb’s model of reflection gave me an understanding on where to section the information for my report. The tips and guidance of the module convenor has really helped me to understand how to construct my assignment.
Learning Activity 2: A-E Assessment and Managing Blood Glucose
An A-E assessment is used as a systematic assessment for patient’s vital system. The class consist of both theoretical and practical delivery. I learned how to undertake an A-E assessment, analyse case studies and practically assessing mannequins in the clinical simulation.
The A-E approach consist of assessing patient’s airway, breathing, circulation, disability, and exposure. When assessing a patient, the first approach is the airway. This can be open, at risk which is partially obstructed or completely obstructed. Effective way to assess the airway is by listening to patient breathing if there is a snoring, gurgling, wheezing or stridor sound which are indications of breathing difficulties. There are basic interventions when airway is obstructed such as tilting head and lifting the chin, jaw thrust, suctioning orally or through nasal airways or applying bag valve mask. Breathing is next approach that needs to be considered when conducting an a-e assessment. Respiratory rate and saturation should be checked and assessed, listening to the patient’s breaths and if any sound may indicate breathing difficulties and lastly assess by feeling the chest expansion or the central trachea. Circulation is assessed by the heart rate, blood pressure and capillary refill time. Disability is assessed by the neurological deterioration, ACVPU, pupil response, blood sugar and drug allergies or toxins. Any past medical history should also be explored. It is also important to know if a patient is diabetic. Testing the blood glucose in a safe and accurate manner is essential when conducting the a-e assessment. Exposure is another assessment approach which involves checking the patient from head to toe for any other rashes, bruises, wounds, infection etc.
After learning about the theoretical concept of the A-E assessment, the class went to the simulation centre where three mannequin was set up. In this class activity we were grouped into four and we discussed what abnormalities and normalities we identified to each mannequin. My group did the a-e assessment to the mannequin and did NEWs Score to have a clear understanding of each patient’s conditions. Each of the person in the team asked questions to each other and shared our own opinions and knowledge. The class convenor was answering all our questions which made it easier for us to understand certain procedures. I gained another fundamental skill and learned about A-E assessment during this class delivery.
KSB Addressed:
Knowledge
| K1 | Understand the code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC 2018), and how to fulfill all registration requirements |
| K2 | Understand the demands of professional practice and demonstrate how to recognise signs of vulnerability in themselves or their colleagues and the action required to minimise risks to health |
| K3 | Understand the professional responsibility to adopt a healthy lifestyle to maintain the level of personal fitness and well-being required to meet people’s needs for mental and physical care |
| K4 | Understand the principles of research and how research findings are used to inform evidence-based practice |
| K5 | Understand the meaning of resilience and emotional intelligence, and their influence on an individual’s ability to provide care |
| K6 | Understand and apply relevant legal, regulatory and governance requirements, policies, and ethical frameworks, including any mandatory reporting duties, to all areas of practice |
| K7 | Understand the importance of courage and transparency and apply the Duty of Candour |
| K8 | Understand how discriminatory behaviour is exhibited |
| K9 | Understand the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people |
| K10 | Understand the principles of epidemiology, demography, and genomics and how these may influence health and well-being outcomes |
| K11 | Understand the factors that may lead to inequalities in health outcomes |
| K12 | Understand the importance of early years and childhood experiences and the possible impact on life choices, mental, physical and behavioural health and well-being |
| K13 | Understand the contribution of social influences, health literacy, individual circumstances, behaviours and lifestyle choices to mental, physical and behavioural health outcomes |
| K14 | Understand the importance of health screening |
| K15 | Understand human development from conception to death, to enable delivery of person-centred safe and effective care |
| K16 | Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care |
| K17 | Understand commonly encountered mental, physical, behavioural and cognitive health conditions as applied to delivery of care |
| K18 | Understand and apply the principles and processes for making reasonable adjustments |
| K19 | Know how and when to escalate to the appropriate professional for expert help and advice |
| K20 | Know how people’s needs for safety, dignity, privacy, comfort and sleep can be met |
| K21 | Understand co-morbidities and the demands of meeting people’s holistic needs when prioritising care |
| K22 | Know how to meet people’s needs related to nutrition, hydration and bladder and bowel health |
| K23 | Know how to meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity |
| K24 | Know how to support people with commonly encountered symptoms including anxiety, confusion, discomfort and pain |
| K25 | Know how to deliver sensitive and compassionate end of life care to support people to plan for their end of life |
| K26 | Understand where and how to seek guidance and support from others to ensure that the best interests of those receiving care are upheld |
| K30 | Understand the principles of health and safety legislation and regulations and maintain safe work and care environments |
| K32 | Understand what constitutes a near miss, a serious adverse event, a critical incident and a major incident |
| K33 | Understand when to seek appropriate advice to manage a risk and avoid compromising quality of care and health outcomes |
| K34 | Know and understand strategies to develop resilience in self and know how to seek support to help deal with uncertain situations |
| K35 | Understand own role and the roles of all other staff at different levels of experience and seniority in the event of a major incident |
| K36 | Understand the roles of the different providers of health and care |
| K37 | Understand the challenges of providing safe nursing care for people with complex co-morbidities and complex care needs |
| K38 | Understand the complexities of providing mental, cognitive, behavioural and physical care needs across a wide range of integrated care settings |
| K39 | Understand the principles and processes involved in supporting people and families with a range of care needs to maintain optimal independence and avoid unnecessary interventions and disruptions to their lives |
| K40 | Understand own role and contribution when involved in the care of a person who is undergoing discharge or a transition of care between professionals, settings or services |
| K41 | Know the roles, responsibilities and scope of practice of different members of the nursing and interdisciplinary team, and own role within it |
| K42 | Understand and apply the principles of human factors and environmental factors when working in teams |
Skills
| S1 | Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC, 2018), and fulfil all registration requirements |
| S2 | Keep complete, clear, accurate and timely records |
| S3 | Recognise and report any factors that may adversely impact safe and effective care provision |
| S4 | Take responsibility for continuous self-reflection, seeking and responding to support and feedback to develop professional knowledge and skills |
| S5 | Safely demonstrate evidence-based practice in all skills and procedures required for entry to the register: Standards of proficiency for nursing associates Annex A & B (NMC 2018) |
| S6 | Act as an ambassador for their profession and promote public confidence in health and care services |
| S7 | Communicate effectively using a range of skills and strategies with colleagues and people at all stages of life and with a range of mental, physical, cognitive and behavioural health challenges |
| S8 | Recognise signs of vulnerability in self or colleagues and the action required to minimise risks to health |
| S9 | Develop, manage and maintain appropriate relationships with people, their families, carers and colleagues |
| S10 | Provide, promote, and where appropriate advocate for, non-discriminatory, person-centred and sensitive care at all times, reflecting on people’s values and beliefs, diverse backgrounds, cultural characteristics, language requirements, needs and preferences, taking account of any need for adjustments |
| S11 | Report any situations, behaviours or errors that could result in poor care outcomes |
| S12 | Challenge or report discriminatory behaviour |
| S13 | Apply the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people |
| S14 | Promote preventive health behaviours and provide information to support people to make informed choices to improve their mental, physical, behavioural health and wellbeing |
| S15 | Identify people who are eligible for health screening |
| S16 | Promote health and prevent ill health by understanding the evidence base for immunisation, vaccination and herd immunity |
| S17 | Protect health through understanding and applying the principles of infection prevention and control, including communicable disease surveillance and antimicrobial stewardship and resistance |
| S18 | Apply knowledge, communication and relationship management skills required to provide people, families and carers with accurate information that meets their needs before, during and after a range of interventions |
| S19 | Recognise when capacity has changed recognise and how a person’s capacity affects their ability to make decisions about their own care and to give or withhold consent |
| S20 | Recognise people at risk of abuse, self-harm and/or suicidal ideation and the situations that may put them and others at risk |
| S21 | Monitor the effectiveness of care in partnership with people, families and carers, documenting progress and reporting outcomes |
| S22 | Take personal responsibility to ensure that relevant information is shared according to local policy and appropriate immediate action is taken to provide adequate safeguarding and that concerns are escalated |
| S23 | Work in partnership with people, to encourage shared decision making, in order to support individuals, their families and carers to manage their own care when appropriate |
| S24 | Perform a range of nursing procedures and manage devices, to meet people’s need for safe, effective and person-centred care |
| S25 | Meet people’s needs for safety, dignity, privacy, comfort and sleep |
| S26 | Meet people’s needs related to nutrition, hydration and bladder and bowel health |
| S27 | Meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity |
| S28 | Support people with commonly encountered symptoms including anxiety, confusion, discomfort and pain |
| S29 | Give information and support to people who are dying, their families and the bereaved and provide care to the deceased |
| S30 | Recognise when a person’s condition has improved or deteriorated by undertaking health monitoring, interpreting, promptly responding, sharing findings and escalating as needed |
| S31 | Act in line with any end of life decisions and orders, organ and tissue donation protocols, infection protocols, advanced planning decisions, living wills and lasting powers of attorney for health |
| S32 | Work collaboratively and in partnership with professionals from different agencies in interdisciplinary teams |
| S33 | Maintain safe work and care environments |
| S34 | Act in line with local and national organisational frameworks, legislation and regulations to report risks, and implement actions as instructed, following up and escalating as required |
| S35 | Accurately undertake risk assessments, using contemporary assessment tools |
| S36 | Respond to and escalate potential hazards that may affect the safety of people |
| S37 | Participate in data collection to support audit activity, and contribute to the implementation of quality improvement strategies |
| S38 | Prioritise and manage own workload, and recognise where elements of care can safely be delegated to other colleagues, carers and family members |
| S39 | Recognise when people need help to facilitate equitable access to care, support and escalate concerns appropriately |
| S40 | Support and motivate other members of the care team and interact confidently with them |
| S41 | Monitor and review the quality of care delivered, providing challenge and constructive feedback when an aspect of care has been delegated to others |
| S42 | Support, supervise and act as a role model to nursing associate students, health care support workers and those new to care roles, review the quality of the care they provide, promoting reflection and providing constructive feedback |
| S43 | Contribute to team reflection activities to promote improvements in practice and services |
| S44 | Access, input, and apply information and data using a range of methods including digital technologies, and share appropriately within interdisciplinary teams |
Behaviour
| B1 | Treat people with dignity, respecting individual’s diversity, beliefs, culture, needs, values, privacy and preferences |
| B2 | Show respect and empathy for those you work with, have the courage to challenge areas of concern and work to evidence based best practice |
| B3 | Be adaptable, reliable and consistent, show discretion, resilience and self-awareness |