Description
The ethical and legal framework of nursing practice provides the nurses with the set guideline mistaken following step by step function to other to each of the legal principles and legislative elements of clinical practice (Kumaran & Carney, 2014). the registered nurse practice standards developed by the nursing and midwifery board of Australia or NMBA provides one such exceptional tractors pain but which helps the nurses inform their practice and added to the legal guidelines successfully. in this essay I will attempt to discuss this particular practice Framework with respect to a personal experience that I have had in my place which help me understand the importance of practice standards and also guide me to use the standard into practice.
I was assigned to communicate with the patient who had been admitted for hip replacement surgery and engage with her and informing her about the procedures that is going to be followed before and after the surgery and the precaution that are needed to be maintained. This was my first encounter with a patient and even though the activity only encompassed patient education and sharing of information, it was my first opportunity to therapeutically engage with the patient and I had been extremely excited as well as nervous while communicating with her. I attempted to communicate with the patient following all the theoretical knowledge of effective therapeutic communication however the patient has been very depressed and anxious about having to stay in the sterile empowerment of the facility and not being able to communicate with her daughter of a husband during the stay. Even though I tried my best to communicate with her about the need of the operation and how it will benefit for health eventually, she seemed distracted and anxious throughout. However, post the patient education period I was required to carry out a thorough physical and vital signs assessment. In this case when I attempted to assess her she became agitated and stopped cooperating completely. She did not want to be participating in the assessment procedure, and soon started screaming to which my supervisors had to step in and calm the patient down. Although it has been an embarrassing moment for me in my career and reflecting on the issue later I understood that I had made a few errors in practice which left to these restricted challenge (Fry et al., 2015).
I would like to mention that this has been the first opportunity for me to engage with the patient and a real-world care giving scenario and I have been ecstatic about finally being able to put all my political knowledge and skills into real applicative practice. However, along with the excitement and Euphoria of being able to participate in hands on practice, the nervousness and fear of committing errors unintentionally had been running havoc on my mind. When I first started communicating with the patient I felt extremely nervous and burdened by the fear of committing a mistake and when I observe the patient to be distressed and disengage even after me trying to engage her in the patient education session I felt extremely demotivated and defeated. My confidence was even decreased when the patient started screaming. I felt modified and embarrassed when my supervisor to step in and come the patient down. This had been a learning milestone for me and I have gathered wealth of knowledge in cities in handling patients in Real world case scenarios (Forsberg et al., 2016 ).
Feelings
Considering what has worked in this experience, I would like to mention that I had been able to implement effective verbal cues of communication by engaging the patient in the patient education session. According to the standard 2 of registered nurse practice standard NMBA, which is the first standard that has been chosen to be reflected on for this essay, engaging in therapeutic and professional relationships taking the age of effective communication skills, Both verbal and nonverbal (Nursingmidwiferyboard.gov.au, 2018). According to this standard, nurses are required to establish sustain in therapeutic relationship that differentiates the boundary between professional relationship interpersonal relationship by communicating effectively and being respectful to the dignity value cultural beliefs and rights of the patient. In this case I have been very respectful to the cultural identity and personality of the patient and had been extremely respectful in my communication approach as well (Chang, 2015). However, my error had been taking the mental state of the patient into consideration. She has been distracted and distressed due to the impending operation and separation from her family. On the other hand, another thing that was positively for me in this experience has been conducting the comprehensive assessment for which I follow each and every step thoroughly with proper documentation. Although, I did not ask for informed consent and did not prioritize the patient needs before commencing the process, which violated the standard 4 of the NMBA registered nurse practice standards (Nursingmidwiferyboard.gov.au, 2018).
Therapeutic engagement with patients has a significant impact on the care experience of the patient and also establishes the first point of contact with the care delivery system. It has to mention for the care service to be optimal and accelerating the recovery of the patient is very important for the patient be equally participating and cooperative with the procedure (Webster, 2014). Proper therapeutic communication and engagement with a patient in colleges the collaboration and cooperation from the patients and also in cells sense of value and respect is the patient which further enhance is the satisfaction from the care experience and accelerates the process of recovery. As per the second standard of NMBA, engaging with the patient is a crucial responsibility of the nurses (Nursingmidwiferyboard.gov.au, 2018). Lorié et al. (2017) have opined, the therapeutic engagement relies both on verbal and non verbal communication. As a nurse, taking account of the emotional state of the patient and addressing her emotional needs is a crucial requirement of effective non verbal communication. I should have reassured her and listened to her fears as a nurse while establishing the therapeutic connection on a priority basis.
Evaluation
Similarly, for the assessment, holistic and culturally appropriate techniques are needed to be followed under all circumstances. In this case, not respectfully asking permission from Emily before starting the assessment had violated the 4th NMBA standard effectively. Although, I had been flustered by confusion, lack of practice knowledge and the patients disengagement. Barksby, Butcher and Whysall, (2015) discussed that fear, confusion and lack of practice oriented knowledge is the main contributing factor leading to errors in clinical practice which has the potential to harm the patients. Hence, there is need for efforts to improve my skills so that it does not affect my future practice (Levett-Jones, Reid-Searl & Bourgeois, 2018).
From the experience, lack of non verbal communication, lack of proper patient engagement skills, nervousness and lack of confidence was identified as key drawbacks in my competence. Hence, I will reach out to my supervisor for her suggestions and enroll in professional skill development programs to enhance my professional clinical practice skills. For my personality traits and soft skills, I will be taking the aid of online courses and workshops to build the skills. Lastly, I would attempt to document my progress through reflective journals to keep a track of the progress (Levett-Jones et al., 2015).
Conclusion:
On a concluding note, this experience provided me the chance to revisit my personal and professional skills and competences which has the potential to affect my clinical practice in the future. This had also helped me assess my first encounter with a patient and participating in the care journey which helped me discover my strengths and weaknesses along with certain key performance expertise. I firmly believe that the knowledge and expertise gained from this experience would benefit me immensely in my future practice.
References:
Barksby, J., Butcher, N., & Whysall, A. (2015). A new model of reflection for clinical practice. Nursing Time, 111, 34-35.
Chang, E. (2015). Transitions in nursing: Preparing for professional practice. Elsevier Health Sciences.
Forsberg, E., Ziegert, K., Hult, H., &Fors, U. (2016). Assessing progression of clinical reasoning through virtual patients: An exploratory study. Nurse education in practice, 16(1), 97-103.
Fry, M., MacGregor, C., Hyland, S., Payne, B., & Chenoweth, L. (2015). Emergency nurses’ perceptions of the role of confidence, self?efficacy and reflexivity in managing the cognitively impaired older person in pain. Journal of clinical nursing, 24(11-12), 1622-1629.
Kumaran, S., & Carney, M. (2014). Role transition from student nurse to staff nurse: Facilitating the transition period. Nurse education in practice, 14(6), 605-611.
Levett-Jones, T., Pitt, V., Courtney-Pratt, H., Harbrow, G., &Rossiter, R. (2015). What are the primary concerns of nursing students as they prepare for and contemplate their first clinical placement experience?. Nurse Education in Practice, 15(4), 304-309.
Levett-Jones, T., Reid-Searl, K., & Bourgeois, S. (2018). The clinical placement: An essential guide for nursing students. Elsevier Health Sciences.
Lorié, Á., Reinero, D. A., Phillips, M., Zhang, L., & Riess, H. (2017). Culture and nonverbal expressions of empathy in clinical settings: A systematic review. Patient education and counseling, 100(3), 411-424.
Nursingmidwiferyboard.gov.au, (2018). Nursing and Midwifery Board of Australia – Professional standards. Australian Health Practitioner Regulation Agency. [Online] .Retrieved from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards.aspx. [Accessed on 4th Oct.]
Webster, D. (2014). Using standardized patients to teach therapeutic communication in psychiatric nursing. Clinical Simulation in Nursing, 10(2), e81-e86.
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