Reflective Practice In Nursing - A Patient Experience

Online discussion forum activity posts

Case Scenario Reflection task using an essay style

1.Description:  Describe the patient’s experience. Aim to focus on a particular relevant aspect, identify key themes and justify these themes of care focus.

Write in third person here.
Write one paragraph here
This first sentence of your paragraph should provide the main point.
The remaining sentences – describe the patient experience, identify the key themes and include a justification for these themes of care focus.

2.Feelings and Thoughts: Describe and examine your feelings and thoughts in response to your description. Identify the values and beliefs that connect you to your feelings and thoughts and evaluate your response to the patient’s experience in terms of those feelings and thoughts. For example, why did you feel that way? (Link your response back to stage 1)

Write in first person here.
Write one paragraph here
This first sentence of your paragraph should provide the main point.
The remaining sentences – describe and examine your feelings and thoughts in response to your description. Identify the values and beliefs that connect you to your feelings and thoughts and evaluate your response to the patient’s experience in terms of those feelings and thoughts.
3.Values and Beliefs: Describe some values and beliefs of yours that may have impacted on your feelings and thoughts about what went on. After reflecting about the ‘values and beliefs’ that connect to your feelings and thoughts, identify where these values and beliefs originate from? Why are these values and beliefs important? Who are they important to and why? Are they important to you, the patient and the patient’s family?
Write in first person and in third person as applicable
Write one paragraph here (no dot points)
This first sentence of your paragraph should provide the main point.
The remaining sentences - describe some values and beliefs of yours that may have impacted on your feelings and thoughts about what went on. Identify the ‘values and beliefs’ that connect to your feelings and thoughts. Identify where these values and beliefs originate from and justify why they are important to you as a person and nurse as one, the patient and the patient’s family.

Description

The ability of one to reflect their actions with the aim of improving nursing practice is called reflective practice. Mr Taylor’s reflection on his experience on two medical events and this provides the nurses tools to assess the quality of care they provide to their patients. This essay is going to reflect on the experiences of the 75 years patient, in two different scenarios, the feelings and outcome after each, using the Gibbs reflective model. The main theory that I am to use is that of patient satisfaction, while using the framework of patient satisfaction evaluation (‘Nursing and Midwifery Board of Australia’, 2017).

Description

This part provides insight on Mr Taylor’s experience both scenarios at a public facility and working with a personal doctor. The main theme as in this scenario is time. Time spent waiting to be attended to in both scenarios. It is evident that time creates a huge difference in the experience and thus affecting the quality of care being provided by an institution. It’s when the patients like Mr Taylor share their experiences do we get patient experience. Schlesinger, Grob and Shaller (2015) discuss that for patients to get most value then the public policies should be attentive to their perspectives.

Feelings and Thoughts

A feeling is a kind of mental state that arises from the brain processing the physical state of things in a place (Schindler et al., 2017). After Mr Taylor fell, he explained that he felt a lot of pain on the right shoulder. There was a major injury since he explains losing use of the right arm. I was very sorry for him having undergone 11 hours without getting help and pain from the right shoulder was so excruciating. He also explains several falls while in the house before he was diagnosed with double whammy with anaemia   . I was also extremely sorrowful that he had to spend the whole night in pain because he didn’t want to be taken to hospital.

Values and Beliefs

I draw my values and beliefs from previous experience. If a patient were to come to the hospital with severe pain, then it should be considered a matter of urgency and be addressed as soon as possible. Leaving a patient for 11 hours in excruciating pain would not be considered as providing a secure environment. He even had to go for pain killers after 3-4 hours to help him ease the pain. Kronemyer and Bystristky, (2014) believe in a psychological intervention which they refer to as cognitive behavioural therapy which would reinforce and motivate new behaviour. It is necessary to make a decision of attending to the patient as such decision is important to the patient, their family and myself (Johnson et al., 2016).

Feelings and Thoughts

Analysis

In analysis, Taylor had to wait for long hours 11 hours to be specific to be attended to. In the scenario, the patient experience in public hospital has been horrible. This illustrates that in some instances enough is done while in others it’s not. In the facility that Mr Taylor went when she was experiencing kidney stones did almost nothing. So in that scenario it can’t be really concluded if they did enough or not because in real sense leaving a patient for 11 hours is not something to be allowed. In my opinion the care was inadequate. Ward et al., (2017) discuss that the duration of waiting at hospital for treatment, appointments and even surgery has become too long and unbearable. Also, in the context, there is no proper electronic health record maintained for the patient and no education given to the Taylor for keeping track of the illness using electronic health record.  Mr Taylor explains that his experience at the public hospital wasn’t one to encourage one to go back. He also explains several falls afterwards and this shows that the standard 10 of NSQHS, which are fall prevention and harm, were not followed.

Contrary to public hospitals there is enough care that has been given to Mr Taylor.  At least there is enough care that is provided in private hospitals this is expressed by therapies given to Taylor. In addition to that, the waiting time is small or minimal thus the patient is able to be attended to in the shortest time possible. This care was adequate. Kruse, Stadhouders, Adang, Groenewoud and Jeurissen, (2018) discuss that the privation of hospitals has been done majorly to improve the level or quality of healthcare being provided in the health sector. So according to his reflection, enough was done during the second experience.

Conclusions drawn

The following conclusions can be drawn from Mr Taylor’s patient experience; the negative conclusions include the fact that the waiting time in public health facilities is very long has a negative impact. When dealing with values and beliefs it would be important to make better judgements bearing in mind why they are important and who they are important to. Also it’s visible that there is no effort to explain to the patient the presence of electronic health record and how important it could be in monitoring his health. As Johnson et al. (2016) states, values that nurses or an institution holds will impact on their feelings. For instance in the scenario, at the public hospital there were nurses but none was there to attend to this one person who in my opinion didn’t need much time. But because there was no nurse to attend to him, he suffered and in the long run they lost his trust. Mr Bill feels that his experience at physiotherapy was amazing that he even had to add the number of visits.  

Values and Beliefs

According to Ogden, Barr and Greenfield (2017), the requirements for a patient-centred care in which they argue that stakeholders have a collective responsibility to ensure that patient centred care is progressively improved. Another positive conclusion is that the time spent waiting to be attended is not enough. Thus to improve this there has to be systems implemented to ensure that the patient is attended to in the shortest time. In this case they include even the system in which both public and other institutions are involved. The nurses and doctors have to include their feelings and by this they will be expressing empathy and this goes a long way in improving patient experience. This way the patient feels cared for thus would improve patient experience.

Action Plan:

Collins and al., 2014 did a research on clinical work observations with the aim of identifying opportunities in which the patients and nurses are able to share a patient centred plan of care. They go on to explain the need of involving the family in providing high quality care especially in crucial cases. The best action plan in this scenario would be to partner with older patients to get more of their reflection on their experience. This would help the nurses improve the quality of care being provided as it boosts their experience even without actually experiencing such as Taylor’s scenario in the field. For the patient experience to be smooth it would really help if the family comes in to take care of the patient even in a scenario where there are enough nurses or doctors (Shegog & Begley, 2017).

Conclusion:

In conclusion, patient experiences as seen does not only rely on the nurses but also tickles down to the family to help and improve it. When patients like Mr Taylor reflect on their experiences, the nurses need to learn and get tools by which they will use to evaluate their quality (Bayliss et al., 2017). Nurses can apply their experience from past and as said in the scenario, never be left behind in new developments in the field of medicine. They should keep learning and make sure they improve as there’s nothing as bad being left behind (Covington et al., 2016).

References

Bayliss, K., Prince, R., Dewhurst, H., Parsons, S., Holmes, L., & Brown, P. (2017). Working with public contributors to improve the patient experience at the Manchester Clinical Research Facility: an evaluation of the Experience Based Design approach. Research   Involvement and Engagement, 3, 10. https://doi.org/10.1186/s40900-017-0059-x

Collins, S. A., Gazarian, P., Stade, D., McNally, K., Morrison, C., Ohashi, K., … Dykes, P. (2014). Clinical Workflow Observations to Identify Opportunities for Nurse,  Physicians and Patients to Share a Patient-centered Plan of Care. AMIA Annual Symposium Proceedings, 2014, 414–423.

Covington, E. L., Chen, X., Younge, K. C., Lee, C., Matuszak, M. M., Kessler, M. L., …  Moran, J. M. (2016). Improving treatment plan evaluation with automation. Journal of  applied Clinical Medical Physics, 17(6), 16–31.  https://doi.org/10.1120/jacmp.v17i6.6322

Johnson, K. E., Mroz, T. M., Abraham, M., Figueroa Gray, M., Minniti, M., Nickel, W., … Hsu, C. (2016). Promoting Patient and Family Partnerships in Ambulatory Care  Improvement: A Narrative Review and Focus Group Findings. Advances in Therapy, 33, 1417–1439. https://doi.org/10.1007/s12325-016-0364-z

Kronemyer, D., & Bystritsky, A. (2014). A non-linear dynamical approach to belief revision in cognitive behavioral therapy. Frontiers in Computational Neuroscience, 8, 55.  https://doi.org/10.3389/fncom.2014.00055

Kruse, F. M., Stadhouders, N. W., Adang, E. M., Groenewoud, S., & Jeurissen, P. P. T. (2018). Do private hospitals outperform public hospitals regarding efficiency,   accessibility, and quality of care in the European Union? A literature review. The International Journal of Health Planning and Management, 33(2), e434–e453. https://doi.org/10.1002/hpm.2502

Nursing and Midwifery Board of Australia - 2017...https://www.nursingmidwiferyboard.gov.au/registration-and.../international.aspx

Ogden, K., Barr, J., & Greenfield, D. (2017). Determining requirements for patient-centred care: a participatory concept mapping study. BMC Health Services Research, 17, 780. https://doi.org/10.1186/s12913-017-2741-y

Schindler, I., Hosoya, G., Menninghaus, W., Beermann, U., Wagner, V., Eid, M., & Scherer, R. (2017). Measuring aesthetic emotions: A review of the literature and a new assessment tool. PLoS ONE, 12(6), e0178899.   https://doi.org/10.1371/journal.pone.0178899

Schlesinger, M., Grob, R., & Shaller, D. (2015). Using Patient?Reported Information to Improve Clinical Practice. Health Services Research, 50(Suppl Suppl 2), 2116–2154.  Shegog, R., & Begley, C. E. (2017). Clinic-Based Mobile Health Decision Support to  Enhance Adult Epilepsy Self-Management: An Intervention Mapping Approach. Frontiers in Public Health, 5, 256.

 https://doi.org/10.3389/fpubh.2017.00256  

Ward, P. R., Rokkas, P., Cenko, C., Pulvirenti, M., Dean, N., Carney, A. S., & Meyer, S.  (2017). “Waiting for” and “waiting in” public and private hospitals: a qualitative study of patient trust in South Australia. BMC Health Services Research, 17, 333. https://doi.org/10.1186/s12913-017-2281-5