Discuss about a Article on Placement Reflection of and Adult Nursing Student Nurse 3rd Year?
Gibbs’ reflective cycle (1988) is a model popularly used for the reflection of nursing practice. It has six stages, which includes description, feelings, evaluation, analysis, conclusion and action plan. This is a reflective study on a patient that we received in our rehab unit from the hospital (Bulman and Schutz 2013).
The first stage of Gibbs’ reflective cycle is description, so the first phase of this work will be the description of the event. When I arrived on the day shift, my mentor allocated me to look after a patient who was admitted from the hospital at our rehab unit and I was supposed to look after him at the intermediate care unit.
The patient was admitted with the complains of liver disease, ascites, swollen abdomen and alcohol withdrawal symptoms. I performed the primary diagnostic examinations like blood pressure monitoring, observed the fluid balance, weight check, etc. Respiratory status was monitored and degree of peripheral edema was assessed. Sodium and fluids were restricted to minimize fluid retention and correct dilutional hyponatremia (Keogh 2014, p. 11). Serum albumin and electrolytes were also monitored. From the provided descriptions, I had a clinical feeling that the patient might be suffering from alcoholic liver disease or liver cirrhosis depending upon the complaints he had during admission. Therefore, I will have to focus on the interventions related to such diseases and handle the associated symptoms. I did all I had to do to the patient throughout the shift with the help of my mentor who was helping me with patient care and monitoring whenever needed.
The second stage of Gibbs’ reflective cycle is the feelings developed during the experience. I felt like I managed to look after the patient well as I had to do all the required nursing interventions my entire shift. I took the guidance and support of my mentor regarding something, which I was uncertain. I gained immense confidence and knowledge while looking after the patient and assessing his diseased condition (Mikkelsen et al. 2015, p. 3632). Any abnormal condition was immediately reported to the mentor and the nursing care taken thereafter was extremely helpful. This exposure levered my practical experience for the disease care conditions. Prior to the experience, I had doubtful feelings as this was the first time I was facing with alcoholic liver disease. During the experience, I learnt the nursing intervention procedures and the associated treatment to be provided. My reaction during the experience was very much attentive as this was a learning phase. After the experience, I had gathered sufficient experience to face similar situations for such patients.
The third stage of Gibbs’ reflective cycle is evaluation of the positive and negative experiences I encountered during the process. The positive factor was that I gained a lot of confidence. It was me alone who was designated to take care of the patient. Therefore, every other thing associated with the concept of nursing was practically applied by me with full confidence. Like the different medications that the patient was administered and the rational reasoning behind it (Vardy et al. 2013, p. 261). Diuretics like spironolactone and frusemide were given to the patient for controlling edema and ascites and block the aldosterone effect. Potassium was administered to make up the loss of Potassium due to urinary loss and liver disease. Arterial vasodilators were administered improve the cardiac output. There were no such negative experiences as such excepting the fact that since this disease required long-term treatment and care, I was not assigned this patient for more than a day and so I could not learn from the entire regimen of treatment. The experience was good and informative and I had the opportunity to learn a lot. Everything went well throughout the experience without any bad event. The experience ended well but I could not remain throughout the complete intervention process for the treatment.
The fourth stage of Gibbs' reflective cycle is analysis. From this reflective study, I learned that nursing is all about decision-making and clinical judgment. The job of a nurse is to provide patient care and a competent decision maker who is accountable for his actions through continuous learning. The nursing practice is essentially based on research, evidence and critical thinking that is entirely dependent on the diverse population of patients as well as their individual needs. I had to record all the nursing interventions accurately for the care I provided and made complete entries of the findings, assessment and treatment in the patient’s notes. The nursing interventions provided by me during the experience were the primary care during his admission. These interventions collectively lead to the treatment of the patient. My mentor appreciated the interventions provided by me.
The fifth stage of Gibbs’ reflective cycle is conclusion. This includes the further steps, which should be taken to improve the patient condition and improve my skills. As I assessed my patient with the help of my mentor, I had to chalk out mitigation guidelines to prevent further health degradation of the patient. The patient was advised to have a balanced nutrition and develop good food habits. He should immediately stop any intake of alcohol by any means. His family members should be intimated of the problem and urge to provide social support for the gradual recovery process. I also need to keep my knowledge updated and learn more about patients with liver disease (Jaurigue and Cappell 2014, p. 2154). I could have given the patient intervention throughout the treatment process. However, I could not do that as my shift timings got over and I was not assigned this patient again. My learning goal was met by this experience regarding the nursing interventions. I got an opportunity to implement my knowledge during the experience.
The sixth stage of Gibbs’ reflective cycle is action plan. It states the importance of setting up the experience to face similar future problems. It is important in the profession of nursing to have a teamwork and mutual co-operation. Since I got a limited chance to work on a single patient, I will make it a point to follow the complete treatment regimen for a single patient next time. This will enrich my nursing skills and, therefore, my confidence will be boosted to become a better nursing professional. Although I had a very good experience, still I would require learning more face such situations with confidence. For this, I need to learn more about emergency patients and their intervention through theory and practice. The priority area of improvement will include patient intervention and care without the supervision of my mentor.
Bulman, C. and Schutz, S. eds., 2013. Reflective practice in nursing. John Wiley & Sons.
Jaurigue, M.M. and Cappell, M.S., 2014. Therapy for alcoholic liver disease.World J Gastroenterol, 20(9), pp.2143-2158.
Keogh, K., 2014. Nurses’ role in reducing deaths from liver disease is crucial. Nursing Standard, 29(11).
Mikkelsen, M.R., Hendriksen, C., Schi?dt, F.V. & Rydahl?€ђHansen, S. 2015, "Coping and rehabilitation in alcoholic liver disease patients after hepatic encephalopathy – in interaction with professionals and relatives", Journal of Clinical Nursing, vol. 24, no. 23-24, pp. 3627-3637.
Vardy, M., Day, E., Webb, K., Russell, C., Sudhakaran, P., Ahmad, I., Cobain, K. and Aldulaimi, D., 2013. PTH-122 a retrospective study to compare the effectiveness of referral methods to alcohol services for specialist treatment from an acute hospital following brief intervention. Gut,62(Suppl 1), pp.A261-A261.