Discuss about the Integrating Nursing Practice for Gibbs Reflective Cycle.
The following assignment is an analysis of a nursing scenario, shown on a video titled “NRSG139 Ax3 TPRVignette”, using the GIBBS reflective cycle (Description, Feelings, Evaluation, Analysis, Conclusion and Action Plan) (Emery & Chang, 2017). The analysis of the video will be conducted based on the reflective cycle, and how the practice related to the standard 2 of Nursing and Midwifery Board of Australia (NMBA). The NMBA implements nursing standards as a part of Nursing Competency Assessment Schedule (NCAS) which is required to be followed by all registered nurses in Australia (nursingmidwiferyboard.gov.au, 2018). It involves s set of 7 Standards that informs the nursing practice, and includes:
Standard 1: critical thinking and analysis, Standard 2: engaging in therapeutic and professional relationship, Standard 3: maintaining the capacity for practice, Standard 4: comprehensively conducting assessment, Standard 5: developing nursing plan, Standard 6: Providing safe, appropriate the responsive quality nursing practice and Standard 7: Evaluating outcomes to inform nursing practice (nursingmidwiferyboard.gov.au, 2018).
Given below is the Analysis of the video based on the GIBBS reflective cycle:
The events in the video can be best described using the 5 W’s of the event:
What happened: The event depicted a regular nursing visit in a hospital ward. The nurse came to check the vital signs of the patient, and they both engaged in communication.
Where did the Event occur: The event occurred inside a hospital ward.
Who was there: The incident involved a patient and his nurse.
What were the people doing: The patient and nurse were engaged in a therapeutic and professional conversation, as the nurse was checking the vital signs of the patient.
What was the result: At the end of the video, the patient seemed to be friendly with the nurse, and he was looking forward for the next visit from the nurse.
(youtube.com, 2018)
I was able to understand from the given video, that the incident was in a clinical set up, possibly a hospital ward, where the patient was staying. He seemed to be recovering from a recent episode of ill health and seemed to be getting better in his health. The patient expressed that he was feeling a lot better than before, even if it was not at a 100%, and did not express any sort of dissatisfaction of qualms regarding the care being given to him. The patient also expressed a sense of humor, and was responding to the nurse properly. He seemed to have been comfortable around the nurse, and showed interest in engaging in a friendly communication. The nurse also was very friendly in his nature and approach towards the patient, and showed concerns towards the well being of the patient. The nurse courteously introduced himself when he entered the patient’s room, and explain the nature of the visit. He tried to develop a therapeutic and professional relation with the patient, and was honest in his response to the patient’s queries, which he attentively listened to. This showed that the nurse strongly followed the standard 2 of the NMBA and NCAS guideline on the development of therapeutic and professional relation (nursingmidwiferyboard.gov.au, 2018).
The nurse showed adherence to the standard code of practice recommended by the NMBA and NCAS. The nurse tried to develop a therapeutic and professional relation with the nurse (Standard 2), and was able to make the patient feel comfortable in engaging in a conversation with the nurse. Both the patient and the nurse seemed to be very friendly in the communication, which showed a positive relation being developed among them. The nurse also was able to make himself familiar with the patient, how long he was staying in the hospital, how he felt and gave him confidence that his vital signs were good, and was indicative of recovery. The nurse provided courage to the patient, by informing him that he can soon expect to be discharged, and the patient seemed to be happy about it. It was evident that the nurse was able to instill confidence in the patient, and made the patient feel better. The comfort level of the patient could be understood by the subtle joke shared and responded between the two, and of patient expressing that he looked forward for the next visit. The nurse also exhibited professional qualities, in keeping the patient informed about the condition, and in addressing the patient’s queries with honesty. The nurse also maintained eye contact with the patient, and was respectful to him at all times. His information was also very clear and easy to understand, and he avoided using complicated jargons which could have confused the patient.
The nurse showed different skills that helped to develop communication with the patient. His usage of language was appropriate, and his body language proper, the communication strategies utilized were also very effective, and the attitude as well as demeanor of the nurse was professional, courteous and respectful. The autonomy and privacy of the patient was also identified and respected by the nurse. The nurse also paid attention to the thought processes and opinions of the patient, and thus followed the competencies and skills needed to develop a therapeutic and professional relation in accordance to standard 2 of NMBA (nursingmidwiferyboard.gov.au, 2018).
What went well: The nurse was able to develop unfriendly, therapeutic and professional relation with the patient.
What did the others do well: Both the nurse and the patient seemed to be engaged in friendly conversation.
What went wrong: AT one point the nurse got too stuck up checking the vital signs, and he failed to respond to the patient, which he quickly rectified, and promptly resumed conversation after doing the necessary checks.
What didn’t turn up the way it was supposed to: The conversation seemed to be successful, and things seemed to have fallen into its place pretty well.
Who and what contributed to how things turned up: The efforts of the nurse and the friendly nature of the patient enabled the development of the therapeutic and professional relation.
(youtube.com, 2018)
Conclusion:
The importance of effective communication has been supported by many authors. Kourkouta and Papathanasiou (2014) suggested that effective communication strategies are useful to develop a therapeutic relation. Effective communication helps to achieve the positive health outcomes, and improves the perception of care (Frieden, 2014). It is therefore important that the nurse understand the patients, and is able to help them, showing courtesy, sincerely and kindles (Gausvik et al., 2015; Muhith & Nursalam, 2017). These factors further help to develop the therapeutic relation with the patient (Giger, 2016). Patient satisfaction can also be developed through therapeutic and professional relations, while such a relation can further help to improve the health outcomes of the patient (Oetzel et al., 2015). An effective framework that helps to develop a therapeutic and professional relation with the patient should involve aspects such as honesty, trust, patient centered care, and understanding patient’s needs, knowledge and evaluation of the patient’s conditions (Jukema et al., 2015).
Based on the analysis and conclusion on the video, an action plan can be developed, which can help to improve the development of the therapeutic relation between nurse and patient. The table below shows the action plan.
Objective |
Actions |
Resources |
Evaluation Strategies |
Developing therapeutic and professional relation |
1. Developing the test of the patient, Developing communication, involving empathy towards patient, foster genuineness in the nurse’s attitude, foster empowerment of the patient, ensure continui8ty of care, provide respect, ensure confidentiality and privacy of the patient, |
Panda, 2017 |
1. Patient survey forms, 2. Health outcomes of the patients, 3. Evaluating the healtrhcare professionals on how much they have understood the patient |
2. Using Peplau’s Framework, involving 1) Orientation, 2) Identification, 3) Exploitation and 4) Resolution |
Hagerty et al., 2017 |
||
3. Developing patient centric care and resp0nding to the patient’s unmet needs |
Kornhaber et al., 2016 |
References:
Emery, C., & Chang, J. (2017, July). Reflection in a new light: updating Gibbs’ reflective cycle on a foundation degree in healthcare sciences. In HEA Conference, generation TEF.
Frieden, T. R. (2014). Six components necessary for effective public health program implementation. American journal of public health, 104(1), 17-22.
Gausvik, C., Lautar, A., Miller, L., Pallerla, H., & Schlaudecker, J. (2015). Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, understanding of care plan and teamwork as well as job satisfaction. Journal of multidisciplinary healthcare, 8, 33.
Giger, J. N. (2016). Transcultural Nursing-E-Book: Assessment and Intervention. Elsevier Health Sciences. Url: https://books.google.co.in/books?hl=en&lr=&id=XCWKCwAAQBAJ&oi=fnd&pg=PP1&dq=Transcultural+Nursing-E-Book:+Assessment+and+Intervention.+Elsevier+Health+Sciences.&ots=Ub1gJkFRAB&sig=8udQ89ZMaAJfKTrBRlpuY67e3k8
Hagerty, T. A., Samuels, W., Norcini-Pala, A., & Gigliotti, E. (2017). Peplau’s Theory of Interpersonal Relations: An Alternate Factor Structure for Patient Experience Data?. Nursing science quarterly, 30(2), 160-167.
Jukema, J. S., van Veelen, N., & Vonk, R. (2015). Students experienced help from preservative care. A reflective case study of two nursing students caring from a nursing framework on good care for older people. International Practice Development Journal, 5(2), 6.
Kornhaber, R., Walsh, K., Duff, J., & Walker, K. (2016). Enhancing adult therapeutic interpersonal relationships in the acute health care setting: an integrative review. Journal of multidisciplinary healthcare, 9, 537.
Kourkouta, L., & Papathanasiou, I. V. (2014). Communication in nursing practice. Materia socio-medica, 26(1), 65.
Muhith, A., & Nursalam, N. (2017). Quality of Nursing Care Based on Analysis of Nursing Performance and Nurse and Patient Satisfaction. Jurnal Ners, 7(1), 47-55.
nursingmidwiferyboard.gov.au (2018), Registered nurse standards for practice, retrieved on 25 May, 2018, from: https://www.nursingmidwiferyboard.gov.au/documents/default.aspx?record=WD16%2F19524&dbid=AP&chksum=R5Pkrn8yVpb9bJvtpTRe8w%3D%3D
Oetzel, J., Wilcox, B., Avila, M., Hill, R., Archiopoli, A., & Ginossar, T. (2015). Patient–provider interaction, patient satisfaction, and health outcomes: testing explanatory models for people living with HIV/AIDS. AIDS care, 27(8), 972-978.
Penda, C. (2017). Establishing therapeutic nurse-client relationship with mentally ill patients in a community.
youtube.com (2018), NRSG139 Ax3 TPRVignette, retrieved on: 25 May, 2018, from: https://www.youtube.com/watch?v=550mSnqtqRA&feature=youtu.be
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