Critical Incident – Preconceived Ideas

No names atomic number 18 apply in this writing to maintain long-suffering confidentiality and conform to the data shield act 1998 captious incidents originated in the United States, Colonel John C Flannagan was a psychologist who worked most with the Air Force and their procedures for reporting evidence concerning consummationive or otiose behaviour within different situations (Ghaye 200664-65). Tripp (1993 24-25) claims that minute incidents appear to be usual rather than diminutive at root sight, but are rendered searing through analysis.Critical incidents burn be either positive or negative They are usually stimulates that answer you consider the events that brace happened to undertake to generate them some sort of meaning (Hannigan, 2001). Using a critical incident as a guidance of reflecting helps individuals identify make that has been right-hand or unhelpful in a situation. The value of a critical incident coffin nail differ from person to person it is u sually a personal experience with meaning to an individual, heretofore critical incidents can be useful for a range of people for object lesson, school-age childs, lecturers, service users and the general public.They give an insight into the feelings of the person writing and are often relat suitable to others. In attachment 1 I fork out depict my critical incident. Following this I impart inform the importance of a critical incident and the effect on practice, in particular how it has influenced my practice as a student check. This experience has greatly influenced my training in a number of ways. As a student nurse I believe it is hard to stay off having a preconceived judgement of a enduring.After receiving a brief translation of the diligents diagnosing from my mentor, I believed this affected role would possibly be frail and sedentary, laid in bed with a poor tonus of life. However what I was greeted with was the total opposite. This is affected by the patient s own judgement of her illness, often receiving a prognosis such(prenominal) as this prompts a dramatic change in the patients lifestyle. It can be argued that this is the hardest part in accepting a diagnosis is the get to change. In accessing readiness to change, we need to look at the individuals state (Broome 199831).If a particular patient is non ready to hold their lifestyle it can become unenviable for them to come to terms with their diagnosis. Patients futile to come to terms with their diagnosis or patients finding their illness difficult after a period of time are apparent to run across from depression or anxiety (Reid, et al 2011). However upon visiting this patient it was clear to me that this patient was able to accept her diagnosis and had readily original the challenge to adapt her lifestyle. To me this seemed like a phenomenal act for her to light upon in such a short space of time interest the diagnosis.Communication is a key aspect of any type of bursti ng charge, in particular terminal solicitude as the patient in question is likely to feel s lotd and anxious some their prognosis. There are a number of different reasons for thisIncluding diagnosis and intercession of their disease, long-term physiological alterations, fears of slip by and death, dependence on grapplegivers, survivor guilt and negative effects on families. (Groenwald et al 1992 580)Communication should be an equal conversation that supplys both the nurse and patient to include what they need to say.For a nurse it is important to listen to a patient as developing a therapeutic relationship will often make the patient feel much open to banter about their feelings and concerns. The therapeutic relationship facilitates the ability for a patient to fulfill their desired state of maximum wellness (Brooker, and Waugh, 2007236 Kozier, et al 201295-97) Patients should be able to freely express their beliefs, values and concerns in a non-judgemental and supportive w ay (Barker 201031).A therapeutic relationship is essential in developing trust betwixt a patient and nurse and is fundamental for care with service users such as my patient. A therapeutic relationship can be described as one that allows for the meeting of nursing needs to the mutual propitiation of a nurse and patient (McQueen 20009). This should reduce anxiety and whitethorn allow the patient to feel more comfortable in addressing any concerns touch the prognosis. This incident has made me think about the barriers to communication and the effects they can have on other staff members, patients and their families. Understanding the potential problems allows us to better understand how something might be able to work more efficiently (Ellis 201188). There are a number of barriers to communication for example physical barriers such as a door being closed, perceptual barriers for example going into a conversation thinking that the person isnt going to understand or be interested in what you are going to say. Emotions can also be barriers to communication as salubrious as cultural, gender, interpersonal and intellectual (Kozier et al 201246).I believe my patient may have had emotional barriers to communication with the nurse and myself. She had already accepted her diagnosis and her decision not to converse with us about her condition may indicate that it was difficult for her to discuss it with others, despite being comfortable with it herself. The occurrence that the patient was comfortable with her illness made me think about the description of health. My patient had said she mat healthy and therefore to her, despite having an illness, she didnt consider herself as unhealthy.The World wellness Organisation (WHO) describes the definition of health as a state of complete physical, mental and genial well-being and not merely the absence of disease or infirmity (WHO 1948 Kozier et al 20126) although this is the most comm whole used definition for health, s eeing this patient led me to review its significance. The patient I saw clearly didnt view this definition to be the same as her meaning of health. health differs for every individual, my patient felt well and therefore in her credence she was healthy.It is understandable that she didnt want to be continually reminded of her pubic louse, it was enough that her license had been reduced due to the fact the nurses were coming into her home in the first place. My mentor and I decided to respect the patients wishes and allow her to come to us when she felt she would like to talk rather than forcing her to speak to us, we arranged to detect nurse interaction with this patient to a minimum so she could refrain some normality in her life. Patients are made aware that they have the right to choose, accept or decline treatment and these decisions are respect and supported. (NICE Guidelines 2012) It was at this point I began to understand the value of concordance. McKinnon (201169) stat es a compact of equals on which care plan is negotiated, concordance enables patients to not only make decisions about their care, but to work in parallel with the health care professionals towards a mutually agreed outcome. It could have been easy for my mentor to do by the patients wishes and focus solely on her wound care and expect her to simply comply as the nurses are considered to be the experts, until now her feelings were recognised and her autonomy wishes were responded to.My mentor displayed an excellent example of holistic care according to Linsley (2011273), who states that nurses have to be aware of the social, environmental and psychological aspects of health and not just physical signs and symptoms of an illness. Before meeting this patient, I didnt realise how daunting the experience of health care professionals can be, I had always wrongly presumed people would be euphoric to receive care to make them feel better, however in this instance it has proved to me th at not everyone has this view.It has enabled me to think about my role as a student nurse and it has made me reflect on so many different aspects of penny-pinching nursing care, from communication and concordance to holistic care. Before my interaction with this patient, I didnt understand just how important it was for patients to have their say. I couldnt help but wonder if I had been the registered nurse in that situation, would I have been task orientated and wanted to get the job make rather than taking into consideration the patients wishes? As a first course of study student I am aware of my limitations and understand that I have a lot to learn.I thought about how I would feel if I was in the patients situation and of course Id want to be involved in the decisions made concerning my care. The experience with this patient has enabled me to develop as a student nurse, and will inform my practice throughout the whole of my career. Seeing first hand such a good example of conco rdance and holistic care from my mentor has give me a great platform to base my learning experiences on. References Barker, J (2010) Evidence-Based exercising for Nurses. London Sage Publications Ltd. Berman, A. Erb, G. Harvey, S. Kozier, B.Morgan-Samuel, H. and Snyder, S (2012) Fundamentals of treat Concepts, process and practice. Harlow Pearson. Broome, A. (1998) Managing Change. Hampshire Macmillan kettle of fish Ltd. Ellis, P. (2010) Evidence-based practice In nurse. Exeter Learning Matters Ltd. Ghaye, T. and Lillyman, S. (2006). Learning journals and Critical Incidents. 2nd ed. Hampshire Palgrave Macmillan. Groenwald, S. Goodman, M. Hansen Frogge, M. and Henke Yarbro, C (eds. ) (1992) Comprehensive Cancer Nursing Review. Sudbury Jones and Bartlet publishers Inc. Linsley, P. Kane, R. and Owen, S. eds) Nursing for Public Health Promotion, Principles, and Practice, Oxford University Press. McKinnon, J. (2011) The nurse-patient relationship in Linsley, P. Kane, R. and Owen, S. (eds) Nursing for Public Health Promotion, Principles, and Practice, Oxford University Press, pp. 64-74. McQueen A. (2000). Nurse-patient relationship and alliance in infirmary care. Journal of Clinical Nursing. 9 (5) 723-731. Reid, A. Ercolano, E. Schwartz, P. and McCorkle, R (2011) The Management of Anxiety and fellowship of Serum CA-125 After an Ovarian Cancer Diagnosis. Clinical Journal of Oncology Nursing 15 (6), online, Available from http//web. ebscohost. com. proxy. library. lincoln. ac. uk/ehost/detail? sid=7e50352a-778c-4db4-be37-388bb618120d%40sessionmgr114&vid=1&hid=103&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3ddb=c8h&AN=2011371794 Accessed 26th February 2013. Tripp, D. (1993) Critical Incidents in Teaching, Developing Professional Judgement. Routledge London. NICE Guidelines (2012) keep patient choice online National Health Service online. Available from http//www. nice. org. k/guidance/qualitystandards/patientexperience/SupportingPatientChoice. jsp accessed 3rd February 201 3. Nursing Times (2004) Reflective thinking twist a critical incident into a topic for research online London, Nursing Times online. Available from http//www. nursingtimes. net/reflective-thinking-turning-a-critical-incident-into-a-topic-for-research/200145. article Accessed 3rd february 2013. World Health Organisation (1948) World Health Organisation Definition of Health online newfangled York, World Health Organisation Online. Available from http//www. ho. int/about/definition/en/print. html Accessed 1st March 2013. Bibliography Barker, J (2010) Evidence-Based Practice for Nurses. London. Sage Publications Ltd. Barrat, D, Wilson B, and Woollands, A (2012) Care planning A guide for nurses. Second edition. Harlow. Pearson Education Ltd. Benner, P. (1984) From tyro to Expert, Excellence and Power in Clinical Nursing Practice. Menlo Park Addison Wesley. Berman, A. Erb, G. Harvey, S. Kozier, B. Morgan-Samuel, H. and Snyder, S (2012) Fundamentals of Nursing Concepts, process and pract ice. Harlow Pearson.Brooker, C. and Waugh, A. (eds. ) (2007) Nursing Practice Fundamentals of holistic Care. Philadelphia Elsevier. Broome, A. (1998) Managing Change. Hampshire Macmillan Press Ltd. Ellis, P. (2010) Evidence-based practice In Nursing. Exeter Learning Matters Ltd. Ghaye, T and Lillyman, S. (2006). Learning journals and Critical Incidents. 2nd ed. Hampshire Palgrave Macmillan. Groenwald, S. Goodman, M. Hansen Frogge, M. and Henke Yarbro, C (eds. ) (1992) Comprehensive Cancer Nursing Review. Sudbury Jones and Bartlet publishers Inc. McQueen A. (2000).Nurse-patient relationship and partnership in hospital care. Journal of Clinical Nursing. 9 (5) 723-731. Tripp, D. (1993) Critical Incidents in Teaching, Developing Professional Judgement. Routledge London. (Appendix 1) During placement I have managed to gain experience with terminal cancer patients. When you go into a patients house, I feel you cant help but have a preconceived idea of the type of patient you are about to meet. I was awed when visiting one patient, as I was told before I entered the home that the patient had terminal epithelial ovarian cancer. This type of ovarian cancer arises from a malignant transmutation of the ovarian surface epithelium, how this transformation occurs is unknown. (Groenwald et al, 1992 466-467) When I met this patient I was unsure of what I would discover. I pass judgment a woman that was going to appear physically ill and I imagined her to be like all the other patients I had seen with terminal cancer. To my surprise we found her sitting in her conservatory reading the newspaper looking well, she was dressed appropriately and had her hair and makeup done.The patient seemed genuinely happy and didnt meet any of the previous preconceptions I had when I was earlier told about her. We were there to change a fluid bag from the patients abdomen and support the patient if she had any concerns about her illness. This is the only thing the nurses do for this patie nt, her partner, with some help from the Macmillan emergency care group complete the rest of her care. This patient had a persistent disease that couldnt be controlled. She had previously been treated with chemotherapy to try and eliminate the cancer however this had been unsuccessful.The patient had then decided along with the healthcare professionals, to withdraw treatment and only accept pain relief and support. The staging of ovarian cancer is based on surgical evaluation and forms the basis of subsequent therapy. (Groenwald et al, 1992 466-467) The regularize nurse has only just become involved in her care, shortly she is 5 months into her diagnosis. When the nurse and I tried to speak to the patient about her illness and how she was feeling, she seemed reluctant to talk about it. The patient decided she felt well in herself and didnt want to be reminded of her illness, she went on to explain that she had already