I contacted the consultant expressing my concerns, the consultant agreed to see Sydney the following week. The day following the appointment the consultant contacted me to say that she was concerned that Sydney was in respiratory failure and needed to be admitted but had refused.
Sydney explained that he did not want to go to hospital as if he was dying he would rather die at home. He had some loose ends to tie up. I explained to Sydney and his wife what was happening to his body and what in-patient treatment he would receive.
Sydney was reassured he was not in the terminal phase of his disease. I allowed him time to ask questions. I took his oxygen saturations and explained why they were low and what was needed to increase them.
I offered Sydney alternative places of treatment such as the local rehabilitation hospital that I knew he liked but he continued to refuse. I asked the wife if she felt she needed any support but she refused. I suggested that the district nurses call over the weekend to check he was okay but his wife refused saying she could cope.
I talked through with his wife what to do in an emergency and that I would call again first thing Monday morning. I contacted the district nursing team leader who was working that weekend so she was aware of the situation should his wife call.
I sent a fax to the consultant to let her know of the outcome of my visit. I documented the consultation in his notes. As a nurse I did not feel comfortable with Sydney refusing treatment when not in the terminal phase of his life limiting condition. As a nurse, I feel I have a responsibility to improve my patients health and well being. As a health care professional, I have to take these areas in to consideration when deciding what is in the best interests of my patients and making a clinical decision.
I have always been taught as a nurse that I need to be able to justify my decision with confidence should I ever be asked to. However, what is important is to assess risk whilst providing the patient with all the information without prejudice and agree with them on an outcome that is in their best interests whilst respecting their autonomy and acting where necessary as their advocate.
I felt that the consultation went well. I felt able to communicate effectively with Sydney as we had a good relationship prior to this incident. A part of developing a relationship with patients and their families, nurses develop a greater respect for their autonomy and choice over their own care. As a district nurse I had experience with similar situations, and had previously reflected on these and therefore felt more comfortable dealing with this incident.
I felt confident that Sydney had capacity as I was familiar with the mental capacity act. However, I have since attended a training update on the mental capacity act so that I can make evidence based decisions. I felt that Sydney had been given all the information he required to make an informed decision. He was given the potential outcome of not going to hospital and he was prepared for that. Sydney and his wife were offered all available community services but refused.
I did, however, feel that I would have benefited from some counseling skills. However, the review also found that acne treatment may lead to improvement of the psychological disorder that are so often co-morbid.
This made me feel re-assured that prescribing oxytetracycline had been the right thing to do. My own experiences of acne also meant that I was able to relate well to the patient. I also felt some anger during the consultation. I also felt regret and guilt. I regretted not referring the patient onwards for emotional support and for not exploring the psychological impact of the acne in more detail.
I also felt a sense of pride that this young man had the courage to come to the clinic by himself to seek help for his acne. I remembered how upsetting acne was as a teenager and I remembered that I would have been too embarrassed to have ever gone to a clinic or to have sought help from an adult. In turn, I also felt happiness.
I felt happy that this young man had come to the clinic and I felt happy that I was able to help him. On evaluation, the event was good in a number of ways. Firstly it added to my experience of dealing with young people and in dealing with the problems that are unique to this population of patients. I have not had many young patients during my nursing career and I welcome the opportunity to gain experience with this group.
Furthermore, it re-affirmed my career choice as a nurse. During your career you always have doubts as to whether you have chosen the correct path. However, there are points in your career when you feel sure that you have made the right choice.
However, there were also some negative elements. Firstly, the appointment was quite short and I am worried that this may have made the patient feel rushed and uncomfortable. After the consultation I did some research into the effects of acne in young people.
In particular, the authors found that directly asking about suicidal thoughts should be encouraged during consultations with young people. This information only served to make me feel more anxious and I wished that I had bought this up with the patient. On reflection, being able to relate to the patient increased my ability to deal more effectively with the situation. I feel that the patient was able to open up more to me because he sensed my sympathy for him and his situation.
It was found that the ability to connect to them was extremely important and so I think this is why the patient felt comfortable opening up to me. On reflection, I am also now convinced that the patient coming to see me was a very positive event.
The patient could have chosen to go on suffering and could have chosen not to open up and talk about the problems his acne was causing. In a review of the literature, Gulliver, Griffiths and Christensen found that young people perceived embarrassment and stigma as barriers to accessing healthcare. Therefore, it could have been very easy for the patient to have avoided coming and seeking help.
I felt a range of both positive and negative emotions during the consultation, and I think this re-affirmed for me that I enjoy nursing and enjoy helping others. It is important to genuinely care about patients and to provide them with the best care possible. This would be hard to do if you did not feel empathy for patients. The experience also helped me realise that I need to actively search out training and learning opportunities regarding working with young people with mental health issues.
If the same situation was to arise again I think that I would approach it in a slightly different way. In particular, I would have offered to refer the patient to further support services. During the consultation the patient mentioned that he felt that the spots on his face made him unattractive to the opposite sex.
In addition to providing medication to get to the biological and physiological roots of the problem, on reflection I think it would have been beneficial to the patient to have provided information about charities that offer self-esteem and confidence building. Such charities that offer these services include Young Minds http: In retrospect, I also believe that I should have given the patient a longer consultation time in order for us to have explored the psychological impact of his acne in more detail.
Coyne has found that young people are rarely involved in the decision-making process when it comes to their consultations. Therefore, giving the patient more time to discuss his problems may have improved his sense of wellbeing as he felt more involved in his care process. There are a number of elements to my action plan. Firstly, I will make sure that in the future the consultation room has leaflets and information pertaining to mental health problems in young people.
This way, young people can access the information if they perhaps feel too embarrassed to talk about it. Hayter has found that young people accessing health clinics put a high value on a non-judgemental approach by health staff.
Therefore, in future I would be sure to be aware of my attitude and make sure that either subconsciously or consciously; I am not making any judgements about the patient. Hayter also found that young people had serious concerns regarding confidentiality, especially during busy times at the clinic. Therefore, in the future I would be certain to reassure young people that their details and consultations are kept completely confidential.
To re-assure young patients, I may ask them to sign a confidentiality form, which I will also sign in front of them. Furthermore, my action plan will include improving my knowledge and awareness of working with young people as a nursing professional.
Student Nurse Reflective Essay In order to help me with my reflection I have chosen Gibbs (), as the model to help guide my reflective process. This model comprises of a process that helps the individual look at a situation and think about their thoughts and feelings at the time of the incident.
Reflection Of Clinical Practice Nursing Essay. Print Disclaimer: This essay has been submitted by a student. This is not an example of the work written by our professional essay writers. You can view samples M., Gerrish, K., and Ermami, A. Student nurse's experiences of communication in cross cultural care encounters.
Nursing Reflection as a Student Nurse Words 3 Pages The following essay is a reflective account on an event that I, a student nurse encountered whilst . Reflective: Patient and Student Nurse. Topics: Nursing, This is a reflective essay which will address a recent experience gained from the Intensive Treatment Unit (ITU) that occurred during my placement and while under the Overseas Nurses Programme. This will utilize John’s Model for Structured Reflection (MSR).
Student nurse tips: Learning and moving on, ending your reflective essay neatly Ok, so you’ve talked about the ethics of care, and the importance of the 6Cs. You’ve applied these to your experience, and you know why you felt like you did. Database of FREE nursing essays - We have thousands of free essays across a wide range of subject areas. Sample nursing essays!