Gibbs Reflection Model
Discuss about the Metalizing And Epistemic Trust In The Therapeutic.
Reflective practice can be defined as the procedure by which healthcare professionals are seen to make sense of events as well as different situations and actions in the workplace (Ware, 2017). This reflective mode of practice helps nurses to learn from their mistakes and thereby try their best to develop the skills that would help them to excel in their professional lives (Jones et al., 2017). In this assignment, I will use the Gibbs model of reflection in order to reflect on the video that has been provided in the assignment and critique about the care that has been provided to the patient by the nursing student.
I was provided with a reflective assignment where I needed to watch a video and thereby reflect upon the skills that were portrayed by a nurse during his interaction with the patient. The assignment was mainly based on evaluation of our understanding of the two important standards mentioned in the NMBA codes of conduct of nurses that are standard number 2. I had watched the video and analysed the entire situation. The video has shown a nurse who had successfully been able to establish a therapeutic relationship with the patient and both of them were comfortable in each other’s presence. The video has clearly shown the nurse to take permission from the patient before conducting his vital signs and the patient had been compliant with the nurse and helped him to take the measurements accurately. While communicating, the nurse had been successfully able to engage the patient in an interactive session that had made the patient quite comfortable in his presence. However according to my view, I believe that the nurse could have shown more empathy and compassion to the patient while communication was being carried on. When the patient was discussing about the stay in the hospital and his condition presently, the nurse was only seen to reply in “ok” and continue with his vital sign measurement. The nurse could have handled this portion more successfully. However, he had been able to communicate with the patient and develop a therapeutic relationship by his effective communication skills.
I feel that the video was helpful as it shows the procedure by which a nursing professional should be following the standard 2 of NMBA codes of conduct. The nursing professional had been successfully able to engage the patient in an effective communication with him. I was quite overwhelmed to see how effectively the nurse was able to interact with the patient and at the same time conduct his assessments successfully together. This video was indeed an extraordinary one as it exactly showed how a nursing professional should have a professional behaviour and attitude that helps the patient to rely on the nursing professional and thereby be comfortable in the presence of the nursing professional. The nurse was not only gentle and calm in his approach; he was also confident and approached the patient in a respectable manner. This made me develop respect for the nursing professional, as he had been able to engage the patient and develop a therapeutic relationship with him.
Evaluation
The good part was that the nurse was kind and gentle with the patient throughout the entire phase of communication. .The standard 2 of in NMBA standards of professional practice of nurse’s state that every nurse should communicate effectively with the patient in a respectful manner so that the dignity, culture, values, beliefs and rights of the patients are given importance (NMBA, Standards of Practice, 2016). The nurse had followed this and therefore while taking the assessment, he has rightly taken consent from the patient. He had made him understand what he was going to do with him. He was seen to maintain a proper boundary between the professional and personal relationship. The interaction he had with the patient was entirely professional and he maintained the boundary in a way that prevented him from entering into his personal circle and asking him anything which is informal, unprofessional, and did not have any significance. The only bad part of the incident was that the nurse was seen to be not enough empathetic and compassionate towards the patient. When the patient had disclosed to him about his stay in the hospital and his feeling, he only replied the patient with an “ok” and did not ask him about the initiatives that he can take to make him feel better. However, this was only one of the negative aspects, as the nurse was quite professional with the patient and tried to make the patient as much comfortable as he can. The moment of light discussion about the duration of his professional career as was helpful in establishing a therapeutic relationship with the patient, making the patient feel more included in the treatment (Waheedi et al., 2015). Moreover, the nurse started the conversation by introducing him properly and ending the conversations with a proper ‘thank you’. This had helped the patient to feel that he is respected and cared for by the professional.
One of the most important standards that need to be maintained while providing care is the engagement of the therapeutic as well as professional relationships. Every nursing professional are expected to engage themselves in effective therapeutic as well as professional relationships. This would be based on the context of mutual trust and respect. Researchers are of the opinion that effective communication has the capability of developing therapeutic relationship with the patient. This bonding ensures development of trust among the patients. This makes the patient feel better and in turn makes the patient compliant with the care intervention plan developed for the patient by the nurses (Totura et al., 2017). The standard also supports effective communication as an important part of therapeutic and professional relationship. The patient should feel that his culture, autonomy and dignity are provided importance. When a patient feels that these aspects are neglected and the nursing professionals are not providing importance to them, patients might become depressed and lose trust over the healthcare professionals. In such situation, they become non-compliant as they feel that their self –esteem is affected. This has negative outcomes on their health (Waheeda et al., 2017). Therefore when the patient saw that the nursing professional is providing importance to taking consents from him and is maintaining his respect and dignity and at the same time, he became compliant and developed a sense of connection with him (Fonagy&Allison, 2015). Following the standard 2, it can be seen that “actively fosters a culture of safety and learning that includes engaging with health professionals and others, to share knowledge and practice that supports person-centred care” (NMBA, Standards of Practice, 2016). The nurse had followed this standard and with the help of the effective professionalism, gentle but confident behaviour and with effective verbal and non-verbal communication skills, he able to gain trust in the patient.
Analysis
Conclusion:
When I have to take vital signs or other assessments of the patient in future, I would try to be quite and calm in my approach. I should not become nervous and stressed. If I become stressed and start panicking, I would not be able to handle the patient effectively and the patient would become nervous. I would be confident in my approach and would ensure that I engage him in the communication where I can exhibit respect for the culture of the patient. I would try to know whether the patient is having any issues or not so that the clinical assessments that I would take not only help me to assess his health but also provides him effective care and solve his issues. I would be sensitive to his issues, needs,and try to be compassionate and empathetic towards him. I would try to follow every of the instructions given by NMBA in the standard 2 so that I can provide proper care and handle the situations in an expert way in future.
In order to develop my skills for developing therapeutic relationship with patient, I would go through different evidence-based practices so that recommendations provided by the researchers would help to develop ideas (Reeder & Morris, 2018). I would also go through different internet articles so that I can develop ideas about challenges that arise. In order to develop my emotional intelligence as well as communication skills, I would join workshops for a period of 6 months. This would also help me to provide effective ideas while handling different challenges (Denneson et al., 2017).
Conclusion:
Gibbs reflectionmodel helped me to reflect on one of the incident presented in the video and gave me an idea about challenges I may face while completing objective and accurate clinical assessment. I developed the ideas about the strategies I need to take so that I can develop as an expert professional and ensure patient satisfaction.
References:
Denneson, L. M., Cromer, R., Williams, H. B., Pisciotta, M., &Dobscha, S. K. (2017). A qualitative analysis of how online access to mental health notes is changing clinician perceptions of power and the therapeutic relationship. Journal of medical Internet research,Vol 19(6).doi: 10.2196/jmir.6915
Fonagy, P., & Allison, E. (2014). The role of mentalizing and epistemic trust in the therapeutic relationship. Psychotherapy, Vol51(3), pp 372.https://dx.doi.org/10.1037/a0036505
Jones, E. S., & Wright, K. M. (2017). “They’re Really PD Today” An Exploration of Mental Health Nursing Students’ Perceptions of Developing a Therapeutic Relationship With Patients With a Diagnosis of Antisocial Personality Disorder. International journal of offender therapy and comparative criminology, Vol61(5), pp 526-543.https://doi.org/10.1177/0306624X15594838
Nursing and Midwifery Board of Australia – Registered nurse standards for practice. (2016). Nursingmidwiferyboard.gov.au. Retrieved 25 May 2018, from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx
Reeder, J., & Morris, J. (2018). The importance of the therapeutic relationship when providing information to parents of children with long-term disabilities: The views and experiences of UK paediatric therapists. Journal of Child Health Care, 1367493518759239.https://doi.org/10.1177/1367493518759239
Totura, C. M. W., Fields, S. A., &Karver, M. S. (2017). The Role of the Therapeutic Relationship in Psychopharmacological Treatment Outcomes: A Meta-analyticReview. Psychiatric Services, Vol69(1), pp 41-47.https://doi.org/10.1176/appi.ps.201700114
Waheedi, M., Awad, A., Hatoum, H. T., &Enlund, H. (2017). The relationship between patients’ knowledge of diabetes therapeutic goals and self-management behaviour, including adherence. International journal of clinical pharmacy, Vol39(1),pp 45-51.https://doi.org/10.1007/s11096-016-0375-5
Ware, D. (2017). The therapeutic relationship between nurse and patient in the endoscopy setting: a literature review. Gastrointestinal Nursing, Vol 15(10), pp 34-44.https://doi.org/10.12968/gasn.2017.15.10.34
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