Reflective Essay On Clinical Placement And Coping Strategies For Stressful Situations.

Patient Care and Deterioration

Discuss about the Emotional Exhaustion of Nursing Staff.

For this assignment I will be focusing on the clinical placement I had in the respiratory ward. I had been a student nurse, practicing under the supervision of a registered and an enrolled nurses taking care of patient suffering from chronic obstructive pulmonary disorder. In this context I would like to mention that the patient was a 50 year old woman who presented to the healthcare facilities with the complications of shortness of breath, high respiratory rate, extreme wheezing and crackles, and rhinorrhea. Upon arrival, the primary assessment carried out for the patient revealed that she had extreme bronchoconstriction due to respiratory airway blockages and a extreme rate of sputum production due to her infections. The nursing supervisors guided me to perform airway clearance and provide external oxygen therapy to the patient to relieve the symptoms of dyspnea. However, as the patient was being prepared for the clearance, suddenly the patient experienced exacerbation of shortness of breath and her vital signs deteriorated quickly. As a result, the patient was immediately shifted to the ICU and was given necessary life sustaining support to revive her condition. However as the nurses prepared to shift the patient to the ICU I became very nervous and stressed by experiencing the sudden change in the patient condition and the rapid deterioration.

First of all, I would like to mention that this experience has been turning point in my career and I had been very excited during the placement in the respiratory ward.  When I was given the chance for the first time to handle a patient in the respiratory ward I had felt ecstatic at my achievements till now. I had been interacting with the patient as I prepared her for respiratory clearance and I was feeling extremely helpful because I was actively engaged in therapeutic relationship with a patient, which is a key requirement for any nursing personnel (Manzano García, Calvo & Carlos, 2012). I feel everything was going excellently until suddenly the patient experienced acute shortness of breath. I would like to mention in this context that this has been my first experience handling a patient with acute problem and the sudden deterioration left me stunned and clueless, and the stress overwhelmed my better clinical judgment. However, the doctor and the rest of my supervisors where shooting orders at each other to prepare the patient and take her to ICU immediately, the urgency of the situation somehow helped me get my senses back and I invested all my resilience strategies  to help cope with the stress and be able to contribute my hundred percent to the scenario and helping the patient get better.

Evaluation and Analysis of Resilience Strategies

Evaluation can be considered as the next step of the Gibbs reflection cycle which provides the nursing profession with the opportunity to understand the good and bad parts about the experience (Davies, 2012). It has to be mentioned that in my case the good part about the experience was I was able to engage in therapeutic conversation with the patient and relax her while preparing her for the airway clearance. The bad part about the experience includes the sudden and rapid deterioration of the patient and acute stress it brought forward, and lastly how I handle the stressful situation. I would like to mention in this context that on reflection I understand that the unexpected deterioration of the first patient that I was given the chance to care for had been extremely stressful impact on my confidence. Along with that extreme pain and discomfort that the patient was under had also a significant impact on me, making me feel  helpless and incompetent to help the patient. Both of these stressors were acting on my competency and quick thinking while I was being instructed to prepare for the patient to be taken to the ICU. However the only thing that has helped me overcome these stresses were my resilience strategies. According to the Foureur et al. (2013), of resilience strategies on coping strategies can exponentially help the nursing professionals overcome stress and maintain functional competence in the wake of extremely stressful situations involving life and death. In my case as well, my coping strategies helped me overcome the professional and personal stress I was feeling and immediately slip into the role of a competent nurse to transport the patient to the ICU so that she can get the help that she desperately needed.

According to the McDonald et al. (2013), resilience can be defined as the capacity in a person to perceive a stressful situation positively and respond to it with optimistic and optimally productive manner. Researchers are of the opinion that resilience is a combination of different psychological factors. In my personal opinion few psychological on personality traits that has helped me develop resonance on coping strategies to overcome different stressful situations include mindfulness, compromise, compassion, commitment, and trust (Manzano García, Calvo & Carlos, 2012).

Elaborating more, in any stressful situation paying attention or being mindful about the situation can help district the individuals from the different stages and focus on the issue at hand and act accordingly. Similarly compassion and commitment both are extremely important traits for a nursing profession as it helps the nurses to look past the professionalism of the situation and act with empathy and dedication while providing care to the patients to ensure utmost safety and effectiveness of the interventions (Hart, Brannan & De Chesnay, 2014). Lastly the ability to compromise personal wishes and demands when caring for a patient or prioritizing the care needs of a patient is also very important aspect of overcoming stressful situations in emergency departments. And along with that being able to achieve the trust of the patient to care for them the best is also based on resilient and compassionate approaches by the care professional so that the patient can feel comfortable and relaxed leaving the decision making in the hands of the competent care providers (Manzano García, Calvo & Carlos, 2012). In this case when I was overwhelmed with the pain of the patient and feeling incompetent to release the pain and discomfort of the patient I used strategies of mindfulness, commitment, compromise, and compassion to overcome the impact of the stressors. I attempted to pay attention to the issue at hand with complete mindfulness and commitment which help distract me from the impact of the stresses on my confidence and decision making. I also used my strategy of compromise to focus on the issues of the patient rather than my own issues facilitated by the impact of the stress. As a result I was able to overcome this stress that over well today for a moment and I could easily step back to my role of a nursing profession and help my other team members and supervisor to successfully and safety transport the patient to the ICU where she can be given the life sustaining oxygen therapy to overcome the acute shortness of breath.

Psychological Traits for Developing Resilience

Conclusion:

This assignment has been a perfect opportunity for me to utilize the Gibbs reflective cycle in order to understand the clinical placement that I have been under.  This assignment utilized sections of Gibbs reflection such as description, feelings, evaluation, and analysis to export the different factors associated with a stressful situation I had experienced in my place went with a patient and how I used my coping strategies and understanding of resilience practice to overcome the stress and two justice to my profession. However they still are a few issues that I would like to be working on so that I can avoid such situations from happening again.

It is very important for a nursing professional to understand the implications of errors or mistakes and be able to enhance the skill and competency so that such errors do not affect their future competence and professional skills (Foureur et al., 2013). In this case I have understood from the reflection that my greatest inadequacy had been that I was very easily overwhelmed by the stress after seeing the patient tutorial it so rapidly and was feeling out of place and really incompetent to be able to help the patient. My lack of confidence and experience has been the most important factors that facilitated the problem I experienced. Hence I would like to enroll for different skin enhancement program under the provision of continuous professional development finances in order to enhance my competence of skills and build more resilient strategies so that I do not lose confidence when facing a similar situation again. Along with that I would also like to join a few emergency department care skills and competence for shops to enhance my ability to immediately and effectively address different situations and applying mindfulness-based coping strategies to overcome stress with much lesser time involved as compared to this past experience.

Reference:

Davies, S. (2012). Embracing reflective practice. Education for Primary Care, 23(1), 9-12.

Foureur, M., Besley, K., Burton, G., Yu, N., & Crisp, J. (2013). Enhancing the resilience of nurses and midwives: Pilot of a mindfulnessbased program for increased health, sense of coherence and decreased depression, anxiety and stress. Contemporary nurse, 45(1), 114-125.

Hart, P. L., Brannan, J. D., & De Chesnay, M. (2014). Resilience in nurses: an integrative review. Journal of Nursing Management, 22(6), 720-734.

Manzano García, G., Calvo, A., & Carlos, J. (2012). Emotional exhaustion of nursing staff: influence of emotional annoyance and resilience. International Nursing Review, 59(1), 101-107.

McDonald, G., Jackson, D., Wilkes, L., & Vickers, M. (2013). Personal resilience in nurses and midwives: effects of a work-based educational intervention. Contemporary nurse, 45(1), 134-143.