Apprentice Activity log
Date: 06/10/2023
Time: 09:30 to 12:30
Learning outcomes:
- To understand the rationale behind helping individuals make healthy lifestyle choices.
- To gain some knowledge of the definitions of behavioural changed and how models help explain this.
- To gain an understanding of how as nurses can influence behaviour change using motivational interviewing techniques.
- To practice these skills using scenarios provided.
We started the lesson on giving feedback on our poster assignment, a lot of good examples was shown but needing improvement to follow the learning outcomes required for the poster assignment.
We discussed about what NMC required as a future nurse
We had an opportunity to practice these skills using scenarios and we presented our scenarios. I used the techniques of motivational interviewing, I follow the open ended questions, affirmations, reflective listening and summarizing but I jumped into recommending a solution to the service user (pretend) and learned that I should have supported the service user to come up a solution that they are comfortable. I should have not suggested it without consulting the service user.
transactional analysis
It is important to how to treat patients, build relationships, and be in partnership with the patients. Treat them the same and never talk down to them.
KBS addressed:
| K | 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 |
| K24 | Know how to support people with commonly encountered symptoms including anxiety, confusion, discomfort and pain |
| K30 | Understand the principles of health and safety legislation and regulations and maintain safe work and care environments |
| K33 | Understand when to seek appropriate advice to manage a risk and avoid compromising quality of care and health outcomes |
| K36 | Understand the roles of the different providers of health and care |
| 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 |
| S | 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 |
| 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) |
| 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 |
| 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 |
| S35 | Accurately undertake risk assessments, using contemporary assessment tools |
| B | Behaviours |
| 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 |
Date: 06/10/2023
Time: 13:30 to 16:30
Title of the Activity: Clinical Judgement and Shared Decision Making
Learning outcomes:
- Define clinical judgement and discuss its use in practice
- Understand the influences on our ability to make clinical decisions
- Identify ethical considerations in the decision-making process
- Identify the principles of shared decision making and apply these to practice
- Explore the barriers and facilitators to shared decision making
- Identify how shared decision making is advocated through policy and regulated by law.
I have learned that clinical judgment and decision-making are essential skills and key processes in nursing. Clinical judgment requires accurate assessments in order to deliver safe and effective nursing interventions. However, assessment, clinical judgment, and decision-making are all subject to change. The lesson covered the following patterns; assess, systematic nursing diagnosis, plan, implement, recheck, and evaluate.
Intuition is a sixth sense or feeling that a nurse uses to empathize with and communicate with service users. It is also important to reflect on experiences and determine the best course of action based on them. In the discussion of ethical sensitivity, autonomy, beneficence, justice, and nonmaleficence were discussed. There was a discussion about accountability and responsibility, as well as their differences.
As a health professional, I learned that shared decision-making involves providing different choices to the service user, supporting them, and working with them to decide on the treatment plan for the service user, making sure they are at the center of the decision-making process for their treatment. It is beneficial to gain an understanding of what’s important to the service user. They will feel supported and empowered to make informed choices or decisions. And in an ethical and legal perspective, shared decision-making will respect the service user’s autonomy, we as a healthcare professionals are not causing any harm but doing good instead, it is a legal requirement and also it requires healthcare professionals to take reasonable care to ensure the service users are aware of any material risk involved in any recommended treatment or any alternative treatments. Shared decision-making is like a partnership that enable service users and healthcare professionals to work together and share expertise equally in the decision-making process.
I have learned what to know before informing the service user including decision support, decision aids, and recording decisions. Barriers to shared decision-making were also included in this lesson which are: time, resource, standardized approach to practice, attitude, lack of decision aids, service users not wanting to be involved, service users unable to be involved, and decision-making capacity.
This lesson enables me to understand clinical judgment and decision-making and understand the importance of providing quality care to service users.
KBS addressed:
| 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 |
| 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 |
| 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 |
| K27 | Understand the principles of safe and effective administration and optimisation of medicines in accordance with local and national policies |
| K28 | Understand the effects of medicines, allergies, drug sensitivity, side effects, contraindications and adverse reactions |
| K29 | Understand the different ways by which medicines can be prescribed |
| K30 | Understand the principles of health and safety legislation and regulations and maintain safe work and care environments |
| K33 | Understand when to seek appropriate advice to manage a risk and avoid compromising quality of care and health outcomes |
| K36 | Understand the roles of the different providers of health and care |
| 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 |
| S | 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 |
| 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) |
| 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 |
| S21 | Monitor the effectiveness of care in partnership with people, families and carers, documenting progress and reporting outcomes |
| 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 |
| 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 |
| S30 | Recognise when a person’s condition has improved or deteriorated by undertaking health monitoring, interpreting, promptly responding, sharing findings and escalating as needed |
| S32 | Work collaboratively and in partnership with professionals from different agencies in interdisciplinary teams |
| S35 | Accurately undertake risk assessments, using contemporary assessment tools |
| B | Behaviours |
| 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 |