Professionalism and public protection in nursing simulation reflection
This essay aims to critically reflect on my simulation exercise with a made-up character ‘Joyce’. The simulation exercise was an interaction was between me and ‘Joyce’ who was having a chest infection and thus help her understand her respiratory system.
Reflection is a very important component of learning (Arbel, 2009). This reflection will enable me to learn from my experience and to also understand the areas I didn’t do well during the simulation, ultimately help in stimulating both my personal and professional growth (Jasper, 2013).
Reflection practice is viewed as an important approach for professionals who embrace lifelong learning (Jasper, 2013). John and Freshwater (2005) defined reflection as assessing previous experience to develop tacit and intuitive knowledge to gain new understandings. Botten (2012) stresses the importance of reflection for nursing students, as it enriches their clinical learning, enabling them to learn more about themselves and the way they practice. Therefore, student nurses must reflect regularly to advance their training, knowledge, skills and behaviour to care for their patients to the best of their ability.
During the simulation exercise, I observed appropriate nursing principles including checking consent before the start of the exercise. Kozier et al. (2008) expressed nurses are obligated to respect patient’s privacy and confidentiality needs. As a nurse, you owe a duty of confidentiality to all those who are receiving care. This includes making sure that they are informed about their care and that information about them is shared appropriately. To achieve this, you must respect a person’s right to privacy in all aspects of their care (NMC 2020). When preparing for this simulation exercise I read and understood that consent represents the moral and legal expression of a person’s right to have their independence and self-determination respected and without it, any treatment or even touching may well be interpreted as a crime.
Similarly, during my interaction with the patient I demonstrated an understanding of my limitation as a first-year student nurse, I acknowledged when to refer her to other health care professionals and senior colleagues for assistance e.g. the patient asked about hemoglobin which I was not very sure on how to respond. This is in line with the NMC code (2020) which states that one must respect the skills, expertise and contributions of your colleagues, referring matters to them when appropriate. Also considering the specific needs of the patient, it is necessary to refer her to the following members of multi-disciplinary for further assessment and to be able to advise her appropriately. These members of the multi-disciplinary team include; social services, physiotherapists, occupational therapists and social workers. ‘Joyce’ as a patient living with a respiratory infection, referring her to rehabilitation services was considered to help in improving her health and endurance (NICE, 2006).
I was very cautious about the information I provided to the patient comparing to her level of understanding. I practised in line with the best available evidence and to achieve this, I made sure that any information or advice given is evidence-based (NMC 2020). I thoroughly explained the anatomy of the respiratory system to fit her understanding by explaining to her that the main function of the human respiratory system is to transport air into the lungs and to facilitate the diffusion of oxygen into the bloodstream. It also receives waste Carbon Dioxide from the blood and exhales it. I also made special emphasis on the relationship between socioeconomic factors and respiratory health. Respiratory illness can be debilitating and cause emotional, social, psychological and physical distress due to the impact on daily living. I believe through the multi-disciplinary approach we will be able to help with all these needs and enable her to live her daily life independently (department of health, 2010).
I understand the important role communication play in building a therapeutic relationship by involving patients in their treatment, allowing them to always ask questions, permitting them to express their feelings (McHugh-Schuster 2000). Allowing patients to express their opinion will also help in effective patient care and patients‘ well-being, as it is important to actively listen to what patients are saying both verbally and non-verbally. I was very empathetic about the patient`s condition; empathy has been stated to be an important feature in the therapeutic relationship and provides the ability to recognize and understand the patient’s feelings and point of view objectively (Chambers et al 2008). Hughes (2012) expressed that professionalism is about attaining the highest quality of care by maintaining standards and demonstrating good judgement and competence at all times are key factors of a therapeutic relationship.
Through the feedback, I am made to understand that I should have used appropriate terminologies during my interaction with the patient. I must acknowledge the fact that as a first-year nursing student, I am not experienced in clinical and treatment communication and as a result, my choice of words while communicating to the patient was not very appropriate.
In hindsight, another preventive factor was my inability to translate some anatomical terminologies into a simple term for her understanding. During my preparation for this simulation exercise, I was made to understand that some nursing and medical terminologies ought to be appropriately explained to the patient and their families to ensure effective communication thus help in positive treatment outcome. This is in line with the code set by the NMC (2020) It stated that in other to communicate clearly with the patient we should use terms that people in our care, colleagues and the public can understand. I was very cognizant of this fact and I intended to make use of diagrams/pictures to better demonstrate and explained the respiratory system to her which I failed to do because I was in a haste. We should always take reasonable steps to meet people’s language and communication needs, providing, whenever possible, assistance to those who need help to communicate their own or other people’s needs. Using a range of verbal and non-verbal communication methods, and consider cultural sensitivities, to better understand and respond to people’s personal and health needs (NMC 2020).
Therefore, it is imperative for nursing students who take care of patients in hospitals to learn how to communicate appropriately with the patient they interact with ( Xie et al., 2013). A study conducted in 2014 at Fatemeh School of Nursing and Midwifery in Shiraz, Iran by Joint Commission on Accreditation of Healthcare Organizations (JCAHO) demonstrated that most nursing students required improvement in their communication skills in both clinical communication behaviour and treatment communication ability. Lambrini kourkouta et al. (2014) stated that if nurses wanted to be successful in their work, they had to study communication and interpersonal relations through special courses and internships. They also needed to learn various aspects and applications of communication in various fields of nursing (kourkouta & papathanasiou, 2014). It should be understood that communication skills are indispensable in therapeutic relationships and as a result, every nurse must demonstrate effective communication skills and should always strive to communicate to their patients in precise and clear language thus help to improve the standard of care given to their patients.
I also noticed that during my interaction with the patient and she requested for a connection via social media. I must confess that I did not do well in this, and as recommended I should have applied more depth when she made her request. As a first-year student, I was a bit confused about her request. I failed to adequately explain to her that ethical issues that may arise from her request. NMC (2020) instructs that nurses must keep appropriate professional boundaries in the relationships they have with patients and they must also ensure that all aspects of the relationship focus exclusively upon the needs of the patient or client.
Nevertheless, social media can support health care providers in a variety of ways, including fostering professional networks, promoting timely communication with patients, friends and family members, and educating and informing clients and other health care professionals. It also helps provides nurses with a way to express their feelings, and seek support from colleagues, peers or anybody using those social media platforms. Despite numerous professional opportunities these social networking sites presented, it also has some ethical challenges especially if you are not thoughtful and cautious about its usage. These coherent needs and possible benefits may result in the nurse divulging too much information, and violating patients right to privacy and confidentiality. Dr. Younggren (2010) clarifies that communication between care providers and clients through electronic means, like Twitter and Facebook, are “arguably not confidential.” He also contends that these types of communication are likely to be completely discoverable and in no way protected by privilege. Consequently, Nurses must maintain professional boundaries with their clients at all times to advance the care being offered to them while in the hospital or their homes by respecting patients’ dignity and independence at all time. Nurses need to provide a high quality of care by adhering to the ethical principles and policies enshrined in NMC Professional standards of practice and behaviour and other relevant nursing literature. This will help to prepare them to deliver good work ethics so that patients are cared for appropriately and enhancing their experience positively.
In conclusion, I believe this reflective exercise will increase my knowledge and improve my practice thus help enhance effective delivery of care. I am now more mindful about my responsibility and limitation as a student nurse and be able to exert professionalism in my practice.