16 Reflection and future learning Julie McGarry, Phillip Clisset, Wendy L. Walker, Davina Porock Introduction In this chapter we give some examples of the challenges students commonly experience when working with older people during their clinical placements. The scenarios contain clinical challenges, professional issues and learning opportunities. You will be able to use the knowledge you have gained from this book, the recommended reading and your placement experiences to reflect upon how you might respond to each of these situations. You may want to discuss the scenarios with your peers, mentor or personal tutor to gain their perspectives and advice. Each of the scenarios presented is followed by a short response. As you will see, the situations that are described are quite complex in terms of the issues that they raise. After reading our responses, consider how you might respond if faced with a similar situation. We provide headings for each of the scenarios, for example ‘professional issues’ or ‘communication and decision making’ – however, in reality, each scenario traverses all of the domains of learning. At the end of this chapter is a list of some recommended reading around reflection, reflective practice, decision making and critical thinking. There are many tools available to help you to reflect on your practice and the challenges that you will encounter. We include Gibbs Reflective Cycle in this chapter but there are many different tools and models that you might wish to consider. You will find a particular framework that suits your personal style of reflection and your university programme will also include possible frameworks to use. Reflection on practice a student nurse experience Professional values and caring for older people I was on a placement yesterday and while I was working with a care assistant she asked me to help her ‘quickly lift’ an older patient up the bed. This isn’t how we have been taught in school and she didn’t use any equipment although there was a hoist in the room. Although I refused, I felt under pressure to help her. The care assistant’s practice in this scenario is questionable and may be putting the patient at significant risk, for example potential to cause pain, discomfort or harm and issues of skin integrity (as well as injury to the member of staff). As a student nurse you have a duty of care to report practice that could be unsafe or at risk of harming the patient. This can be challenging and students may be concerned about the consequences of reporting and how they will be treated in practice. You may wish to report your concerns to your mentor in the first instance and your personal tutor at the university will also be able to support you and offer guidance and support regarding the complaints procedure. While this can be challenging, many students describe a sense of pride in protecting and acting as an advocate for patients and ensuring that poor practice and abuse does not go unchallenged. Reflection on practice a student nurse experience Communication and interpersonal skills I was so scared about looking after Mrs Singh because she was dying and she comes from a different religious and cultural background to me. I was worried about saying the wrong thing and of getting upset in front of the family and being of no help to anyone. But I found it so rewarding just to be available to the family as they sat with Mrs Singh next to her bed. With my mentor’s support I was able to help keep her comfortable and her family too. I found that just being there was enough and I didn’t have to be talking all the time. Being quiet and just being there for the family was what they needed. I learned a lot about what nursing means from this experience. It is quite normal and usual to feel anxious about caring for someone who is dying. Sometimes it feels like the opposite of why we chose nursing – we should be ‘saving lives’! But, in reality, it is one of the great privileges of our profession. It is good to voice these concerns with your mentor during placement and you should debrief with your personal tutor when you are back at university. Take the time to watch a trusted mentor in the way he/she deals with the patient and family and also with his/her own emotions. Talk about the experience with your classmates and take the time to write a reflective journal on the experience. All these things will help you learn and use the experience. Don’t fall into the trap of thinking you should be doing something or being busy. It takes some courage to be simply present and available to comfort and help both the patient and family. With this kind of attention, families will make a healthier transition to bereavement. The additional learning in this scenario could also involve learning about different cultures and religion. Consideration of Singh as a surname would tell this student that the patient has a Sikh background and that although she has been identified by the student as Mrs Singh, the name Singh is usually used by her husband as his surname or family name. Reflection on practice a student nurse experience Nursing practice and decision making Today I went out with my mentor, a district nurse, to see a gentleman who had fallen at home and sustained a skin tear to his leg. His son was there and he was anxious that his father kept falling when no one was with him. The son complained that his father would not stay in his chair when unattended and he insisted on doing little jobs in the house. The son asked about long-term nursing home care and, on hearing this conversation, his father became very distressed, stating that there was nothing wrong with his mind and he would make that decision when it was time. There was a lot of tension between them and it upset me to witness the family conflict. I also felt my mentor did not have the opportunity to explore their concerns and advise them due to her full list of calls. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: The concept of independence in old age Dignity in care for older people Caregiving in later life Communication, assessment and planning care Stay updated, free articles. 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16 Reflection and future learning Julie McGarry, Phillip Clisset, Wendy L. Walker, Davina Porock Introduction In this chapter we give some examples of the challenges students commonly experience when working with older people during their clinical placements. The scenarios contain clinical challenges, professional issues and learning opportunities. You will be able to use the knowledge you have gained from this book, the recommended reading and your placement experiences to reflect upon how you might respond to each of these situations. You may want to discuss the scenarios with your peers, mentor or personal tutor to gain their perspectives and advice. Each of the scenarios presented is followed by a short response. As you will see, the situations that are described are quite complex in terms of the issues that they raise. After reading our responses, consider how you might respond if faced with a similar situation. We provide headings for each of the scenarios, for example ‘professional issues’ or ‘communication and decision making’ – however, in reality, each scenario traverses all of the domains of learning. At the end of this chapter is a list of some recommended reading around reflection, reflective practice, decision making and critical thinking. There are many tools available to help you to reflect on your practice and the challenges that you will encounter. We include Gibbs Reflective Cycle in this chapter but there are many different tools and models that you might wish to consider. You will find a particular framework that suits your personal style of reflection and your university programme will also include possible frameworks to use. Reflection on practice a student nurse experience Professional values and caring for older people I was on a placement yesterday and while I was working with a care assistant she asked me to help her ‘quickly lift’ an older patient up the bed. This isn’t how we have been taught in school and she didn’t use any equipment although there was a hoist in the room. Although I refused, I felt under pressure to help her. The care assistant’s practice in this scenario is questionable and may be putting the patient at significant risk, for example potential to cause pain, discomfort or harm and issues of skin integrity (as well as injury to the member of staff). As a student nurse you have a duty of care to report practice that could be unsafe or at risk of harming the patient. This can be challenging and students may be concerned about the consequences of reporting and how they will be treated in practice. You may wish to report your concerns to your mentor in the first instance and your personal tutor at the university will also be able to support you and offer guidance and support regarding the complaints procedure. While this can be challenging, many students describe a sense of pride in protecting and acting as an advocate for patients and ensuring that poor practice and abuse does not go unchallenged. Reflection on practice a student nurse experience Communication and interpersonal skills I was so scared about looking after Mrs Singh because she was dying and she comes from a different religious and cultural background to me. I was worried about saying the wrong thing and of getting upset in front of the family and being of no help to anyone. But I found it so rewarding just to be available to the family as they sat with Mrs Singh next to her bed. With my mentor’s support I was able to help keep her comfortable and her family too. I found that just being there was enough and I didn’t have to be talking all the time. Being quiet and just being there for the family was what they needed. I learned a lot about what nursing means from this experience. It is quite normal and usual to feel anxious about caring for someone who is dying. Sometimes it feels like the opposite of why we chose nursing – we should be ‘saving lives’! But, in reality, it is one of the great privileges of our profession. It is good to voice these concerns with your mentor during placement and you should debrief with your personal tutor when you are back at university. Take the time to watch a trusted mentor in the way he/she deals with the patient and family and also with his/her own emotions. Talk about the experience with your classmates and take the time to write a reflective journal on the experience. All these things will help you learn and use the experience. Don’t fall into the trap of thinking you should be doing something or being busy. It takes some courage to be simply present and available to comfort and help both the patient and family. With this kind of attention, families will make a healthier transition to bereavement. The additional learning in this scenario could also involve learning about different cultures and religion. Consideration of Singh as a surname would tell this student that the patient has a Sikh background and that although she has been identified by the student as Mrs Singh, the name Singh is usually used by her husband as his surname or family name. Reflection on practice a student nurse experience Nursing practice and decision making Today I went out with my mentor, a district nurse, to see a gentleman who had fallen at home and sustained a skin tear to his leg. His son was there and he was anxious that his father kept falling when no one was with him. The son complained that his father would not stay in his chair when unattended and he insisted on doing little jobs in the house. The son asked about long-term nursing home care and, on hearing this conversation, his father became very distressed, stating that there was nothing wrong with his mind and he would make that decision when it was time. There was a lot of tension between them and it upset me to witness the family conflict. I also felt my mentor did not have the opportunity to explore their concerns and advise them due to her full list of calls. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: The concept of independence in old age Dignity in care for older people Caregiving in later life Communication, assessment and planning care Stay updated, free articles. Join our Telegram channel Join Tags: Placement Learning in Older People Nursing A guide for students Mar 1, 2017 | Posted by admin in NURSING | Comments Off on Reflection and future learning Full access? Get Clinical Tree
