If you using Gibbs model of Reflection, you can follow the headings below in writing your reflection. Headings are based on original essay instructions & incorporate the model.
1.Report (description & Feelings) an issue / experience/incident and explain why it is important to your professional practice. Give your initial response to the experience or issue.
Recount the experience or issue on which you have chosen to reflect. Explain what happened and in what context. Your initial response to the experience or issue can show where you stood before you started to analyse the situation. What were your feelings about the event/ experience/ incident?
2.Relate/ evaluate the issue / experience/incident to your own skills, professional experience or discipline knowledge.
Describe any similar or related experiences you've had and whether the conditions were the same or different. Make connections between this and your previous knowledge and experience of similar situations. Discuss how well you think things went. What was good and bad about the experience?
3.Reason about (discuss/ analyse) the issue /experience/ incident to show an understanding of how things work in this discipline or professional field.
You should highlight significant factors in the experience showing why they are important for a new understanding. Relate these back to the academic literature including theoretical or research-based literature as appropriate. Use qualitative and/or quantitative evidence where appropriate. Discuss different perspectives involved, e.g. ethical, social, legal, organisational, professional.
4.Reconstruct your understanding for future practice (Conclusion & Action Plan)
Outline the changes in your understanding and/or behaviour as a result of the experience and your reflection upon it. Explain the implications for this in your future professional practice. What actions will you take and why?
Description of the Incident
Occupational therapists are professionals who are seen to treat injured, ill as well as disabled patients through the therapeutic use of everyday activities. They are seen to help the patients develop, recover, improve as well as become capable of maintaining skills needed for daily living as well as working (Halloway and Galvin 2016). The main aim of the occupational therapist is to help people increase their functional independence in their daily lives at the same time of preventing and minimising disability. They usually treat different types of work related injuries, amputees, stroke cases, arthritis patients, mental health problems, head injuries, people suffering from burns. They have to follow professional conduct and ethical and legal guidelines so that they can not only provide high quality care to patients but also maintain their human and civil rights in the nation they reside (Zucker et al., 2018). Therefore, it is important for the healthcare professionals to reflect on their practices, identify the good part or wrong part about the experiences and analyse the experiences to develop the practice for the future. This assignment will portray one of my experiences that i went through while providing care in my placement sessions and how my reflecting on the incident had helped me evolve out as a better person and a better professional for the future.
During my clinical placement, I was assigned as an occupational therapist to Mrs. Lee who was a 65 year old woman living in the same community of our organisation. She had much difficulty in leading life as she used to stay alone in her house and her son and his family lives two other communities away. She had mobility issues and she was gradually losing her independence due to her chronic disorder of osteoarthritis. She used to face tremendous pain in her joints and bones and her muscles were gradually getting stiff making her living uncomfortable and dependable on others. She had always been of independent mind and never wanted to be a burden on any other members of the family. Therefore, she contacted the organisation and asked help to develop her mobility and her gain back her confidence and independence back. She was a gentle woman with whom I was able to engage in effective communication successfully and a therapeutic relationship was developed between her and me. She was very happy with my services and started to rely on me both emotionally and mentally. Due to her gain of trust, it become easier for me to provide high quality care and she was entirely complaint with me in every of my treatment plan. On one specific day, I had applied for leave to the organisation that I would be taking the next day. Therefore, the centre head asked me to take one of another member with me to Mrs. Lee’s home in order to help her understand the patient and her needs, as she would be working on my behalf with the patient the next day. My colleague Sarah is of curious nature and therefore she became quite surprised when she came to know that Mrs. Lees trusts me with her back documents as well. As Mrs. Lee has restricted mobility, she asks me to hand her bank documents from closet and keeps them accordingly after her work is over with the documents. She became quite anxious and repeatedly asked me the financial amount she has in her bank. Although I repeatedly denied, she continued to ask me and at one time she became so hard to handle that I declared her the amount verbally. She was quite shocked to hear the amount as she had high financial security. The next day when I was on leave, she was engaged in a communication with the patient and stated her “Wow! You are so rich! Did you have a business or is this savings throughout life”. This statement affected the patient immensely and the next day she called the centre and complained about me stating that I had breached her privacy and confidentiality.
Feelings about the Experience
I was completely shattered after hearing the entire incident from my mentor in the organisation. I could not believe my ears that at such a tender age of my career, I have committed such serious crime by affecting the confidentiality of my client. I was going through a number of mixed emotions and feelings. Firstly, I felt low and bad because I could not keep the trust of my client who believed on me with closed eyes in every of my interventions that I planned for her. We shared a bond of trust, mutual respect, empathy and care for each other that in turn helped me to practice my skills fully while caring for her. Besides feeling low and bad, I also feel guilty that I could not keep the trust that was bestowed on me. I also felt shameful that even after knowing the ethical and legal guidelines for practicing occupational therapy, I could not follow all the ethical guidelines successfully. I started feeling loss of confidence in my approach as I felt that I failed miserably in providing ethically and legally competent care of the patient. Although i felt annoyed with my colleague initially for revealing the information, but later I did not held her guilty as it was me who had the responsibility of protecting her data and information.
In this step, I need to enlighten what was bad and good about the incident. The bad part of the incident was that in my very first placement experience, I was not able to provide an ethically and legally appropriate service. Confidentiality as well as privacy is one of the most important aspects of caring for patients in order to maintain their human rights and to protect them from any harmful or hazardous situations (Stojkovic et al. 2017). I failed miserably in protecting the confidentiality of the patient and my activity had exposed her to various number of risks. Passing of such information may become harmful for her as her money can be stolen or she can be harmed in order to grasp her money. Therefore, the bad part was that one small activity of mine resulted the patient in huge danger as her chance of being harmed is mainly due to the financial strengths that have been revealed by me. Besides putting the life of the patient in danger, another bad part of the incident was that I completely failed the expectation of my mentor who had huge trust on my capability and skills. He had discussed all important ethical guidelines and legal rules in details and had discussed the importance of maintaining them in the care settings. However, I also failed him. The centre complained that such activities affected the reputation of the healthcare centre and did not try to give me a second chance; however, since it is my first experience, they did not take any legal action against me. All these incidences affected my self-confidence and self-esteem and this in turn affected my zeal and enthusiasm in my profession (Azadi et al. 2018). However, there was one good part of the incident. The main good part was that at the very beginning of the career, I got a scope to understand the impact of each action that I take. I learnt one important thing that every action, irrespective of how small or big it is, it has the potential to impact patients in large ways and therefore, I need to be very careful about every of my action. I need to analyse critically my activities and the impact that it might have on patients and healthcare. Then only I need to take action. I also developed the knowledge that I still need to develop more skills and ability to handle such situations effectively so that similar mistakes do not take place in the future. This incident made me understand that I have to develop myself more to be an expert occupational therapist in the future.
Evaluation of the Experience
I have analysed the situation in details and have found out many evidence-based papers by which I could understand the intensity and impact of the mistake in made on the patient. Researchers are of the opinion that it is an ethical duty of the professionals to maintain confidentiality. It helps in providing a fundamental basis for the existence of development of trust in the client-professional relationship. Researchers have defined this aspect as the “the moral right to assist people in maintaining the privacy of what they entrust to others, who correlatively acquire the obligation to guard secrecy” (Nair and Ibrahim 2015). It has been found that respect of confidentiality is extremely important for safeguarding the well-being of the patient at the same time ensuring the confidence of the society in the client-professional relationship. It has been found that health information along with that of the information of personal use shared by the client not only remains based on objective observations test results as well as diagnosis but they also provide subjective impressions about the patient. Information about the lifestyle, habits, recreational activities, property, financial power are often discussed with professionals where patients expect them to guard their information and provide them with good solution for their health and social condition (Carey et al. 2015). Improper disclosure of such highly sensitive information can harm the reputation of the patients and result in loss of opportunities. It may result in personal humiliation or even may be hazardous and harm the life of the patient, his or her financial properties and many others. Codes of ethics and Professional conduct, which had been published by the College of Occupational therapists in the nation of United Kingdom in 2015, had also established confidentiality of clients as n important aspect that should be maintained by all professionals. They have stated under the point number 3.4 that every professionals are obliged to safeguard different types of confidential information relating to service users all the times (Nepal et al. 2015). They have stated that it is indeed an established law that confidential personal information must be protected under any circumstances and professional who would fail to do so would be fined or need to provide the service user the cause of action. The same laws are also applied to material stored or transferred electronically and even when communicating with others via any form of medium that would be including virtual as well as online communities and networks. I have not maintained this ethical guideline provided by them as I have shared the information which other professionals, which indeed is a breech in confidentiality. One must be aware of the legal responsibilities under the data protection act 1998 as well as the human rights act that come under the Parliament 1998b, 1998c. The Data Protection act 1998 is a United Kingdom act of Parliament that is designed for protecting the personal data stored on computers as well as the different organised paper filling system (Williams et al. 2017). I had breached this act and therefore I could have penalised heavily by the healthcare centre. Therefore, I had committed a crime that had the potential to make me involved in legal obligation that could have affected my career. Researchers also suggest that breaching of confidentiality fails to respect autonomy and dignity of patients and this makes them lose trust from the professional. This makes them anxious, heartbroken and disappointed that prevents them from complying with the treatment plan. Violation of patient confidentiality is a form of betrayal patients in deed has a right confidentiality, which had been frequently demonstrated in national and international laws and therefore patients and their family rights have the full capability to file lawsuit against professionals.
Analysis of the Issue
This step discusses what else I could have done in the situation. In this situation, I should not have entertained my colleague at all. I should have made her understand that my revealing of the information would result in breaching of confidentiality. I should have made her to understand that revealing of such information is against professional conduct guidelines and are not supported by the ethical and legal guidelines developed for occupational therapists. I needed to be calm and composed and made her understand this with empathy. I got irritated and revealed her the information to make her stop nagging. That was not the right approach. Even after making her understand all the consciences that might have taken, she was adamant, then i should have exported it to the healthcare centre as caring for the patients’ confidentiality would have been my first priority. If I had handled the situation maturely, there would have been less chances of any confidentiality breaches and the patient would have been free from any chances of harm and hazardous impact.
Being an occupational therapist and undertaking services where I visit homes for caring for patients, I might come across many situations in future where chances of confidentiality breach may occur. As I will be working with patients as well as family members, I might be asked to reveal information about family members regarding the health or other aspects of clients (Black 2015). Not only that, when I will be working in multi-disciplinary teams as occupational therapist, there may be many experts who would be of different mentality and might force me to reveal different information. In such situations, I have to be extremely careful about handling the privacy and confidentiality. I have to critically analyse the situation and find out solutions by which I can not only protect information of patients but also prevent myself from engaging in any conflicts with other professionals who want to misuse the information. I would follow all the ethical guidelines properly and would go through different evidence based readings that will help me to develop knowledge and skills to handle such situations effectively. I would protect the human rights and civil right of my client as the first priority and thereby practice my skills effectively.
Through the above reflection writing, I got the scope of reflecting on one of the experience during the placement months. I realised the issues that are associated with the breaking of confidentiality and understood the negative impacts that mu activity could have had on the patient. I also realised that the patient completely lost trust from me and did not want to take treatment from me. I could have also been legally penalised as I broke two important laws due to revealing information of the patient to the colleague of mine. One of the laws was the Data Protection Act Law 1998 and the other was the Human Rights Act Law of 1998. Therefore, I have to be extra careful while handling the information of patient from the next time. In the future as well, I might be exposed to different challenging situations that might force me to reveal different information about patients. I have to be adamant with the ethical guidelines and i need to critically analyse handle the situation so that I can overcome the challenges and effectively and provide best care to patients.
Azadi, M., Zare, H. and Zare, M.J., 2018. Confidentiality, Integrity and Availability in Electronic Health Records: An Integrative Review. In Information Technology-New Generations (pp. 745-748). Springer, Cham.
Black, G.S., 2015. Confidentiality... some practical suggestions: practice matters. SA Pharmaceutical Journal, 82(6), pp.47-50.
Carey, L.B., Willis, M.A., Krikheli, L. and O’Brien, A., 2015. Religion, health and confidentiality: An exploratory review of the role of chaplains. Journal of religion and health, 54(2), pp.676-692.
Holloway, I. and Galvin, K., 2016. Qualitative research in nursing and healthcare. John Wiley & Sons.
Nair, S.C. and Ibrahim, H., 2015. Assessing subject privacy and data confidentiality in an emerging region for clinical trials: United Arab Emirates. Accountability in research, 22(4), pp.205-221.
Nepal, S., Ranjan, R. and Choo, K.K.R., 2015. Trustworthy processing of healthcare big data in hybrid clouds. IEEE Cloud Computing, 2(2), pp.78-84.
Stojkovic, V.J. and Matejic, B., 2017. Confidentiality in adolescent reproductive healthcare: attitudes and practices of Serbian physicians. The European Journal of Public Health, 27(suppl_3).
Williams, G. and Pigeot, I., 2017. Consent and confidentiality in the light of recent demands for data sharing. Biometrical Journal, 59(2), pp.240-250.
Zucker, N.A., Schmitt, C., Nichols, L.P., Plegue, M.A. and Chang, T., 2018. Confidentiality in the Doctor-Patient Relationship: Perspectives of Youth Ages 14–24. Journal of Adolescent Health, 62(2), p.S92.
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