Critical Reflection on current clinical knowledge and development

Critical Reflection on current clinical companionship and growthWithin this assignment I lead critically reflect on my clinical knowledge to examine and consider my future development needs with a focus on my final management organization and future plower as a registered nurse. I learn chosen two areas which I line up are relevant to my future development needs namely Quality Assurance and Multidisciplinary/Agency aggroup working and employ the Gibbs model (fig. 1)as a framework will reflect upon my give teaching delivers and achievements to learn and write an an nonated reflection highlighting my development needs from which I will formulate a own(prenominal) Development Plan. This beneathtaking demonstrates my commitment to the need for continuing professional development in order to call forth my knowledge, skills values and attitude needed for effective nursing employ ( growth 4.1) and will address deficits in my knowledge and skills and identify any shortcomi ngs indoors my own or others example and help me cope with rehearse tie in issues experienced within my previous placements. I yield chosen Gibbs reflective model as a basis for reflection as I ascertain it is easily understood and encourages a clear rendering of the situation, analysis of feelings, evaluation of the experience, conclusion and reflection upon the experience to consider a solution if the situation arose once more (Brooker Nicol 2003). It has been advocated that reflective practices are a method of bridging the gap between nursing theory and practice, and as a tool to develop knowledge embedded in practice (Chong 2009). Furthermore in reflecting on the centering we deliver parcel out we can identify weaknesses, build on strengths and develop best practice (Myser et al 1995, Johns 1996). However, there are those who are sceptical of the practice and the idea of reflection in nursing is enigmatic and confused and not base on discipline related evidence based research (Gustafsson et al (2007). Some studies however, confirm shown a positive response from practiti one and only(a)rs who have attributed reflective practice to changes in their practice (Paget 2000, Cooke Matarasso (2005). In consideration of these views my approach to reflection as a means of recognizing strengths and weaknesses in my learning and practice to modify me to make positive changes to my future practice will be unbiased. Therefore my reflective enumerate will include an open and honest description of what I have gained from the experienceIn conclusion, my briny aim is to enhance my professional development by reflecting upon past education and clinical experience using the Nursing and Midwifery proficiencies as a benchmark. Furthermore by utilizing the reflective model I will not only identify my strengths and weaknesses but also recognize potential opportunities or threats which will enable me to prepare for my future development and alert me to any threats allowing me to overcome any difficulties I may encounter. Teekman (2000), states that passim the literature it is well emphasized that reflective practice is an effective tool to reduce or snuff come in the perceived theory-practice gap. I will therefore endeavour to utilize this exercise to transform my theoretical learning into evidence based practice. By doing this I can substantiate my claim to having knowledge of evidence based care to ensure safe practice ( progress 2.5)Gibbs Reflective CycleDescriptionWhat happened?Action planIf it arose once again whatwould you do?FeelingsWhat were youthinking and feeling?ConclusionWhat else could youhave done?EvaluationWhat was good andbad astir(predicate) theexperience?AnalysisWhat sense canyou make of thesituation?Fig. 1REFLECTIVE SELF-ASSESSMENT world-class DRAFTGibbs (1988) model let downs with entreating the question What happened? and asks What were you feeling. This allows me to give an greenback of the events that occurred , and in order to add significance to the narrative I will relay my feelings more or less the event directly after explanation about the incident.During the course of my placement whilst working in an acute psychiatric in- patient role I was delegated some duty for circumstance patients by senior members of round. In addition I was often allowed to urge on both group and matched sessions supervised by a trained member of staff. However, due to other demands within the hold surround staff were often unable to run the groups and one-to-one sessions with the patients could often be time limited.However, on one particular day I was approached by a patient for whose care I was given responsibility He appeared very agitated and complained that over the previous few days he had become foiled by the lack of attention he was been receiving from nursing care staff the lack of information he was being given in respect of his care. He also complained that he had been informed that he wo uld have regular access to therapeutic groups and this was not happening. This patient had show a keenness to participate in full in his care to facilitate a quick recovery and discharge from the harborI was sure that staff had been busy but matte up uneasy at his distress and afraid to tell him that staff had been too busy therefore unable to run the groups. In addition I did not feel confident enough to explain his treatment plan. I was quite annoyed though that he had not been consulted or involved in this previously, therefore I consulted with his named nurse voicing my concerns and asked if she could alleviate his concerns. (NMC Proficiency 2.6) was achieved by my articulating my own emotional and psychological responses to situations with colleagues in a professional manner. By also being conscious of my own limitations at the time I achieved (NMC proficiency 1.1). The nurse took him into a quiet room and in my presence explained the situation to him apologising for the a pparent lack of attention he had received. She assured him that the therapeutic group would be commencing later that day and allowed him to vent his feelings and concerns about his care and anxieties about his illness. She reviewed his plan of care with him taking account of his wishes and desired outcomes. On listening to how she handled the session, I felt quite inadequate afterwards thinking I should have been able to deal with the situation as I was competent at formulating care plans. interest the session I decided to approach my mentor to ask to discuss the situation and we agreed that I would take the time to read through the interconnected Care Pathway of each patient under my care and become familiar with their use by suggested I attend and participate in multi-disciplinary meetings. By recognising this I was adhering to the code of professional conduct (NMC) 2008, to consult with a colleague when appropriate and work within the limits of my competence. Moreover, I achieve d (NMC Proficiency 4.1) by demonstrating a commitment to the need for continuing professional development and ain supervision activities.In addition a multi-disciplinary meeting was arranged for the patient and his father and my mentor allowed me to align this and suffer feedback on his progress in order that I gain experience in multidisciplinary working. previous to the meeting I scrutinized his ICP to familiarise myself with his situation and plan of care to enable me to identify his needs and achieved (NMC Proficiency 2.2) by providing relevant and current health information to the patient during the meeting. Rees et al, (2004) informs us that ICPs are tools which map out the pathway of clinical events and activities for all professionals involved in a specific patient group. The ICP helped clarify my roles and responsibilities as well as improve team working and communication. This enabled me to become more informed and also provide the patient with information on his plan o f care which would be carried out throughout his journey from inlet to dischargeIn attendance at the meeting were the consultant Psychiatrist, Named Nurse, Pharmacist, Community Psychiatric Nurse, Occupational therapist and myself. I provided feedback on the patients progress to the Consultant Psychiatrist and other team members, and highlighted the patients concerns about his treatment demonstrating (NMC proficiency 3.2)by working collaboratively with multi-disciplinary team members to enable the delivery of effective patient care, prior to the patient and his father attending. This provided the Consultant Psychiatrist with an overview of the patients mental health and progress to date. The patient and his father were then invited to attend the meeting the patient was given the opportunity to tell the Consultant Psychiatrist how he was feeling and discuss any issues he may have. He was also given the opportunity to talk about his order medication and ask questions which were ans wered both by the doctor and pharmacist. The pharmacist also gave some advice about his indicate dose of prescribed medication making suggestions to the doctor about possible changes due to a complaint by the patient that he was experiencing stiffness in his legs. The patient was allowed to discuss his involvement in therapeutic groups he had accompanied and their benefits. The patients father was also given the opportunity to ask any questions and voice any concerns he may have. Discussion between me, the consultant and patient provided clearer picture of the situation I and felt more at ease having further clarified the process of his care would be while on the ward. I felt more confident and satisfied that the patient was now more at ease and satisfied with his present care and was able to meet (NMC proficiency 2.4) by updating the patients plan of care following the meeting.The close stage Evaluation Gibbs model making sense of the situation and asks What was good or bad. I w as prosperous to see a positive outcome which was due to inclusion of the patient in his plan of care and collaboration within the multidisciplinary team meeting which alleviate the patients concerns. I was not happy at my own lack of confidence to initially deal with the clients concerns and the fact that the patient had to complain before being richly involved in his care. Having this awareness of my own emotions and of weaknesses in my practice and consulting with the patients named nurse assures me that I am managing myself, my practice and that recognizing my own abilities and limitations (NMC Proficiency 1.1) and resolving this by taking action to improve in this area of practice.In conclusion, stage five of the Gibbs (1988) model, I feel the more experience I gain in the ward environment and more I learn about ICPs I can improve patients quality of care and collaborating with other members of the multidisciplinary team I will gain knowledge and confidence to enable me to ta ke that misuse from being a student to becoming a confident registered nurse and deal complex situations such as described above.In the final stage of Gibbs reflective model the question is asked If the situation arose what would I do? I will continue to utilize reflective practice to improve on my knowledge and skills and develop my Personal Development Plan to highlight gaps in my knowledge. I will use my private development plan within my final placement to address my weakness and build on my strengths whilst pursuance opportunities for further development taking account of any threats.EVIDENCE BASED RATIONALEI have used the two main areas within my recent practice where I have identified both strengths and weaknesses. Although multidisciplinary working and the quality assurance tool Integrated Care Pathways are interlinked they will be discussed on an individual basis to maintain coherence and facilitate separate Personal Development Plans.I will therefore begin by discussi ng Integrated Care Pathways as a quality assurance measure, what I have wise(p) to date, highlighting my development need, and why this is important to my practice.Integrated Care PathwaysEvidence Based RationaleMy experience of Integrated Care Pathways during my training has been limited, therefore I require to improve my knowledge and participation in undertaking and documenting a comprehensive, systematic and accurate nursing assessment of physical, psychological, social and spiritual needs of patients. It is indispensable therefore require to further enhance my knowledge and the requirements of (NMC proficiency 2.3) as part of my development needs. ICPs have not been implemented within any of my placements in the community or long term ward settings. However, an Integrated Pathway for admission and discharge has been implemented within an acute ward setting where I was placed. This has been implemented to standardize practice across every psychiatric admission ward within Lana rkshire (Kent Chalmers 2006), and to facilitate better co-ordination of discharge planning and facilitate continuity of treatment in the community (NHS Lanarkshire 2007). The purpose of Integrated Care Pathways has been defined in different ways within the literature. Quality Standards Scotland (2007) highlights the quality assurance conniption indicating that ICP standards will support service improvements in relation to the process or care and outcomes for individuals.PLANNED natural actionMETHODS OF EVALUATION FOR PDP