Nursing Assignment: Reflective Journal On The Significance Of Communication, Hygiene Maintenance, And End-Of-Life Care For Service Users

Question

Task:
Proposed plan includes: The purpose/aim of developing the ePortfolio is … (refer to text)

Identifies an ePortfolio platform that they will utilize. Ie. Weebly( use weebly as tutor asked for that), Wix, Google etc.,

Outlines what materials/artefacts will be collected/prepared- this can be in point form

I will include the following artefacts:

• Resume
• Education Certificates etc.,
• Awards
• Previous education
• Reflections – Critical thinking, decisions making, prioritising care
• Philosophy
• Person Centred Care
• Evidence Based Practice
• Goals for future nursing professional practice
• Nursing Code of Conduct/ Nursing Standards
• Hobbies/Interests
• Achievements
• Nursing specialisations
• Special project
• Languages ,

Explains the relevance to career development in a nursing specialty

Use Text, reference to support this

Provides a timeline for completion- this can be in a table or point form
Look at the artefacts that you need to complete every week to assist you with it’s completion

Answer

E-portfolio weblink/hyperlink from Weebly
http://kinjalpateleportfolio.weebly.com/

Philosophy of Nursing
A statement who I am: I am a nurse and I want to provide empathetic, competent, optimal, and compassionate holistic care to the best extent of my capability.

My philosophy of nursing mentioned in the context of this nursing assignment: My nursing philosophy is completely oriented with the patients’ wellbeing, based on which I follow the principles of patient-centred and evidence-based care. This is one of the most basic theories of nursing practices. I try to provide a complete package of holistic care to the sufferers for making their life quality better in the upcoming days. Additional to this, the values I mentioned above are associated with respect, compassion, trustworthiness, which is the main reason behind my involvement in this profession. However, I also try to incorporate my educational knowledge and obtain information from the recent research procedures, through which I enhance my skills and perform more efficiently in providing optimal care.

I have understood that cultural norms, sexual orientations, and ethnic background of the patients are required to be respected, and I am not allowed to show any kind of discrimination to others, as per the Transcultural Theory by Madeleine Leininger. I believe in the philosophies proposed by nursing theorists Marthe Rogers and Dorothea E. Orem, in their Unitary Human Beings Theory and Self-care Theory, respectively. I think nursing is an art, and we nurses need to fill the artistic process through symphonic interactions, coherence, and integrity.

My strengths: As per my understanding, I am hardworking and able to work in any types of pressurised conditions, along with skilfully tackling the environment. My motivation and commitment to this profession help me in maintaining dignity as well as integrity for providing quality care to the patients. I remain calm and take instant decisions in harder situations, based on my experience and knowledge, along with managing time and incorporating prioritisation skills.

Work experience: I have worked as care assistants in different health and social care service providers. My first experience I would like to discuss in the segment of this nursing assignment was as a healthcare assistant, worked in Harrow and Wealdstone, UK, from 2010 January and 2012 June. The next experience I have gained from Shri Sat Kaival Hospital, Anand, Gujrat, India, as a general nurse, from 2012 August to 2014 July. I have also worked as a staff nurse in Om Hospital, Vadodara, Gujrat, India, from the year 2015 August to 2016 March. After that, I have shifted to Perth, worked in Sunflower Care Services as a disability support worker, from 2016 May to September 2017. Now I am working in Baptist Care Communities for Life as a care partner, situated in William Carey Court, Busselton from the year 2017 September.

Education: I have completed my diploma study in Nursing and Midwifery from BMJ School of Nursing, Bangalore, India, in the year 2008. In 2016 November, I have obtained my certificate III in Individual Support from the Institute of Health and Nursing, Perth. At present, I am pursuing the course of a graduate diploma in Nursing from the same institute, from 201 February.

Skills: I am very flexible and can handle any kind of environment or situation. I always try to build a positive relationship with my co-workers, superiors, and service users. Being an efficient and reliable team player makes me trustworthy for all of my colleagues and hierarchies. Apart from this, I would like to mention in this section of nursing assignment that I have different interpersonal skills which are essential in the nursing field, such as communication, time management, and management of pressurised conditions. Along with this, I also have effective skills in administration and record keeping. Enough knowledge I have obtained regarding the process of providing quality care to the patients, along with tubule feedings and medication familiarity. My compassion and adaptable nature support me in gaining success in each of the cases I have worked.

Career goals and ambitions: Since I am working in the nursing profession from 2010, therefore, I have obtained different types of working experiences throughout this time. After completing my graduate diploma course in Nursing, I want to study further in postgraduate in Nursing for improving my informational knowledge. My ambition and career goal both is related to this field as mentioned in this reflective report of nursing assignment, as I want to be the Head RN of NHS Australia. However, I know that this is a too big dream for me, but I want to chase this dream or ambition for gaining the opportunity at least once in my life.

Long term and Short term goals
Like in every other profession, the nursing profession is also dependent on the setting of different goals and objectives, which are required to be fulfilled by the individuals involved in this profession. The nursing assignment examines the statement of Takahashi et al. (2019) that setting specific goals can support a person in seeing their future through a clear vision. It gives some urge for looking forward, some ideas for improving self, and some areas requiring change. In a nursing career, one can formulate the elements in their goals on which they need to work on.

Apart from this, since nurses need to collaborate with their co-workers and service users, therefore, it is necessary to create SMART goals. SMART goals are more effective and efficient than the normal goals, as they represent the goals in a specific way. The acronym SMART stands for Specific, Measurable, Attainable or Achievable, Realistic, and Time-Bound. As per the statement of Kolesov et al. (2018), SMART goals help in providing more insights into the patients' daily goals, along with increasing the confidence level of the healthcare providers. In this , I am including my 2 short terms and 2 long term goals within this nursing assignment as per my ambitions and career aspects in the nursing profession.

What are the short term goals mentioned in the case scenario of nursing assignment?
Goal 1: To learn the different process of medication administration, counselling, and health promotion

Goal 2: To improve knowledge about the technical application in the field of nursing and healthcare

What are the long term goals mentioned by the researcher in the case scenario of nursing assignment?
Goal 1: To understand the ways of providing excellent and quality patient-centred care

Goal 2: To develop various interpersonal skills essential for this profession

Reflective journals
Introduction
The present nursing assignment is a reflection that can be considered as one of the most valuable tools for the nursing students and professional practitioners also, as it helps them in learning from their routine or scheduled practices. Nursing students often use the practice of 'reflection' for analysing their day-to-day experiences, along with obtaining the summarised learning point from them (Jootun and McGarry, 2014). The main purpose of writing a reflective journal is to provide details about an event to the readers, along with its associated feelings as well as consequences. In this paper of nursing assignment, I am going to discuss different types of experiences I have obtained from my placements, through using the reflective framework of Gibbs. Therefore, in this reflective journal on nursing assignment, I will be discussing the significance of communication, hygiene maintenance, and end-of-life care for service users.

Discussion
During my first placement as discussed in this nursing assignment, my supervisor allocated lots of tasks including both documentation as well as practical monitoring of the patients. At that time, one patient suffering from dementia was staying under my supervision. The workload was excessively higher and I got confused while doing the paper works. Since I have to monitor and observe the patient also, therefore I was doing my works sitting inside the patient's room. During my working hours, the patient was asking different questions, due to which I became frustrated and shouted one time over him. After that, he stopped talking to me and looked more depressed. Since he was suffering from dementia, the duty of providing medicines and therapy was allocated to me. However, after that incident, he did not interact with me, neither taken medicines nor doing the other exercises, which was essential for improving his health.

After the time passed, I felt that I have done very wrong to the old person. As he had trust in me and liked my company, he just wanted to talk with me. I became afraid of my activity and discussed this matter with my supervisor. He taught me that maintaining our behaviour and attitude, even at a high level of work pressure, is essential for the nurses, as they need to tackle different conditions in their lives. Besides this, since he was a mentally challenged person, he required more empathy and support from the care providers for getting back in his normal life. Fragkos (2016) mentioned that effective communication is the way of showing respect to service users and their norms. Apart from this, I also have learnt from the NMBA nursing codes of conduct that effective communication can help in building a trustworthy relationship with service users (Nursing and Midwifery Board of Australia - Professional standards, 2019). Therefore, I need to maintain my anger or frustration level while working as a nurse. At present, I am more managed and organised and do not get confused or frustrated in any situation. I follow the principles of effective communication while talking to my patients and other co-workers.

During my second experience as discussed in this nursing assignment, I was working as a general nurse, my supervisor gave the duty of observing and managing the physical wounds of the patients admitted in the general ward. As per the statement of Tsukuda et al. (2019), it is necessary to follow the principles of hygiene maintenance while observing or handling the wounds of patients, as it would decrease the risk of pathological contamination. Along with this, wearing personal protective equipment is also essential while handling the wounds for eliminating the risk of self-harm. However, I forgot to wear apron, gloves or masks and observed the wounds of different patients without washing my hands or changing my dresses. My supervisor noticed that matter and told me the consequences of such negligence on patients' and my health.

I became extremely scared and anxious, after doing such negligence while treating with the service users. I thought that it might affect the health of the patients, as well as its negative consequence, might affect my health also. I felt ashamed after doing such a silly mistake and showing a high level of negligence, and I thought it might affect my nursing career also. However, my supervisor showed me enough kindness and told me not to repeat this behaviour. Maintain hygiene and wearing personal protective equipment is one of the basic professional boundaries of the nurses noted in the case of nursing assignment, which is also mentioned in the NMBA nursing codes of conduct (Nursing and Midwifery Board of Australia - Professional standards, 2019). However, I have now understood the significance of hygiene maintenance and learnt lots of new techniques from the NMBA nursing codes of conducts. Therefore, during my present practices, I carry all of my PPEs with myself and follow different other hygiene maintenance techniques, such as washing hands by disinfectants, sanitising surfaces, washing PPEs daily and so on (Dubé and Ducharme, 2015).

The third experience happened in my current working place and the same has been discussed in this section of nursing assignment. I am working here as a care partner, and therefore, I often have to deal with the patients requiring end-of-life care or palliative care treatment. During my initial period, I have taken responsibility for a patient suffered from lung cancer for more than 5 years, and at that time, he was at the end stage of his life. Therefore, it is to be noted in this nursing assignment that his family members also want our organisation to arrange some special treatment protocols for making his last days better. At that time, I was not familiar with the end-of-life care treatment process, and therefore, I forgot to provide informed consents to the family members. Apart from this, since my knowledge regarding this matter was not so filled, therefore, I could not understand that it is essential to involve all family members and the patient also in the end-of-life care process (Goulet, Larue and Alderson, 2016). Therefore, some phases of confusion have risen during the patient’s treatment, such as confusion regarding the therapy incorporation, medicine administration, and making plans according to the cultural beliefs of the patient.

I would like to mention in the context of this nursing assignment that the head nurse of this organisation has noticed my practices and asked me about the matter. I confessed that I do not have any prior experience regarding the end-of-life care treatment, therefore, I felt confused sometimes while dealing with the patient. The head nurse stated that it is one of the most significant codes of conduct included in the NMBA nursing codes. The code states that it is required to accept the refusal of treatment based on the opinion of the patient. Additionally, it is also essential to incorporate the cultural practices, norms, values, and beliefs during end-of-life care (Nursing and Midwifery Board of Australia - Professional standards, 2019). After that, I have read about the end-of-life treatment and its significance in the lives of those people, who are dying. At present, I am actively involved as a care assistant and provide holistic palliative care to the patients to come to our organisation.

Conclusion
Therefore, based on the entire reflective discussion provided within this nursing assignment, I have demonstrated different types of experiences I have faced during my professional placement as a nurse. Many others are also there, all of which could not be discussed. However, one fact is that although I felt fearful, anxious, or ashamed sometimes, I have learnt lots of things while undergoing these experiences. I have learnt that proper communication is extremely essential in this profession, as service users often remain dependent on our supportive behaviour and respects we show to them. I have understood the importance of using personal protective equipment; especially while actively participate in the care process, for avoiding contamination of diseases. Lastly, I have learnt about the end-of-life treatment process, which is an integrated part of the care protocols. This process is essential for dying people to improve their quality of life. However, since learning is a continuous process, therefore, I can conclude in the context of this nursing assignment that I would carry my learning process throughout my professional career, as this would help me in gaining more empowerment and more knowledge regarding this noble field.

Reference List
Dubé, V. & Ducharme, F., (2015). Nursing assignment Nursing reflective practise: An empirical literature. Journal of Nursing Education and Practice, 5(7).

Fragkos, K.C., (2016). Reflective practice in healthcare education: an umbrella review. Education Sciences, 6(3), 27.

Goulet, M.H., Larue, C. & Alderson, M., (2016), April. Reflective practice: A comparative dimensional analysis of the concept in nursing and education studies. In Nursing forum (Vol. 51, No. 2, pp. 139-150).

Jootun, D. & McGarry, W. (2014). Reflection in Nurse Education. Journal Of Nursing & Care, 03(02). doi:10.4172/2167-1168.1000148

Kolesov, V. I., Danilov, O. F., Hmara, G. A., & Portnyagin, A. L. (2018, August). On goal setting in the sphere of Smart Grid. In IOP Conference Series: Earth and Environmental Science (Vol. 181, No. 1, p. 012013). IOP Publishing.

Nursing and Midwifery Board of Australia - Professional standards . (2019). Nursingmidwiferyboard.gov.au. Retrieved 17 November 2019, from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx

Takahashi, P.Y., Quigg, S.M., Croghan, I.T., Schroeder, D.R. & Ebbert, J.O., (2019). SMART goals setting and biometric changes in obese adults with multimorbidity: Secondary analysis of a randomized controlled trial. SAGE Open Medicine, 7, p.2050312119858042.

Tsukuda, M., Fukuda, A., Taru, C. & Miyawaki, I., (2019). Development of a Questionnaire for the Reflective Practice of Nursing Involving Invasive Mechanical Ventilation: Assessment of validity and reliability. Nursing assignment Nursing open, 6(2), 330-347.