Reflection On Interpersonal Skills In Clinical Practice

Reflection On Interpersonal Skills In Clinical PracticeThis is a reflective essay ground on my experiences whilst on my five week surgical placement in a local infirmary. The aim of this essay is to explore the office of colloquy and interpersonal skills in clinical practice. I devour chosen this particular contingency as I spent a considerable amount of m communicating verb entirelyy and non communicatively with this particular diligent. To protect the identity and control confidentiality of the patient I occupy chosen to discuss they shall be cognise as whoremaster, this is accordance with the NMC code of professional conduct (2008). To assist me in the process of saying I pass on be using Gibbs (1988) reflective model. The structure of this framework allows the reflection to be written in a win style, which provides opportunities to look at the contingency from a number of perspectives this will help to highlight beas of practice which could be transposed in the future (Jasper, 2003). at that place are numerous reasons why reflection is beta to lactates. Through reflection we enkindle get to know more about what we do and what limits our abilities and this gives the fortune to improve the way of life we care (Ghaye and Lillyman, 2001).Description whoremaster was a 74 year old man admitted onto the harbor from the emergency department 2 days previous to me starting my first-class honours degree late translation of that week. He had been suffering from retention of urine, and was in considerable pain. My mentor and I were sure during handover that we would be looking after John on this particular shift and could we tack the dressing on his right leg as he had an ulcerated leg due to suffering from a condition cognise as Peripheral Vascular Disease (Alexander el al, 2004). As a consequence of this disease he also had his left leg amputated down the stairs the knee some years ago and mobilised using a wheelchair. It became cle ar during the handover that John had been very difficult the last couple of days. The cling to in charge went on to say that he had thrown items across his fashion and was constantly pressing his nurse call button and shouting all day, he had also refused to have a deaden and change his pyjamas. As we left the room where the handover had taken place, my mentor said she thought that we should change Johns dressing now but first we should get him washed and changed and could I assist her. We gathered all the equipment we needed from the treatment room and make our way to Johns room. I knocked on his door and introduced myself as a disciple nurse, I then asked John for his consent for me to assist him in having a wash and change of clothing (NMC, 2008). John was sat on his bed, he appeared to be quite tense, he looked up at me and shouted no, I want to gibe a doctor and I havent had a rump for 2 days. I explained that I was here to assist in changing the dressing on his leg and to help him to have a wash and change. I moved closer towards his bed and lowered myself to his eye level. I then began to engage in conversation with him by maintaining a loony tone of voice and asking him if he would like a instill of tea after we had finished. His body language softened and he looked up and smiled, he said I would love one. I smiled patronage at John, I then repeated the hesitation of assisting him with having a wash and change, whilst maintaining a relaxed posture and eye contact with him. John gave me his consent and I proceeded to assist him in maintaining his personal hygiene with respect and dignity (NMC, 2008). With Johns co summons my mentor and I were then able to go on and change his dressing on his leg.FeelingsThrough this scholarship experience I encountered divers(prenominal) receiveings towards the situation. From the initial handover, the ply nurse in charge did non winder a positive picture of John. I wondered why this particular patien t was so aggressive and demanding and the staff described him as being difficult. I felt anxious, as this was my first placement as a first year student and I did not olfactory property experienced overflowing to deal with the situation. During my encounter with John it became clear why he would opinion so angry and frustrated. I noticed he didnt have a wheelchair in his room, and it became apparent that he was a smoker. He also hadnt been wedded whatsoever nicotine replacement therapy to help him cope with his withdrawal symptoms. When the full finale of Johns situation became clear to me, I felt immense frustration for him. harmonise to the NMC Code of victor Conduct (2008), nurses should treat patients with respect and maintain their dignity. With John not having a wheelchair, he was confined to his bed and therefrom had confused his autonomy. The situation also made me very angry, reflecting back I feel I should have been more assertive and maybe questioned why Johns r equests had been do by by the staff.EvaluationIt was a shame that the professional staff acted the way that they did, ignoring how angry and frustrated John had become and not acting upon it. The nurses tenderness and colloquy skills seemed to be very much lacking, not listening to his requests and video display no feeling towards him. This breakdown in parley in the nurse patient intercourseship with john, left him feeling frustrated and not in control of his own wellbeing (Garnham, 2001).At first, I could not see any good points in this situation however looking back I can see that it did have its positive side, in as much as allowing me to examine myself and to search for my short fallings in relation to the incident. The incident has also given me the opportunity to link theory to practice. The way I communicated with John had a positive outcome for both of us in that his personal hygiene inevitably were met, and I learnt that effective communication is essential in bui lding a trusting bond between the patient and the nurse (Almond Yardley, 2009). The pitiful points of this experience were that I judged John based on the information I received during handover without meeting him first. This could have created a barrier between myself and the patient. Accepting a patient as a unique individual and without judgment is very important in the communication process. I have learnt from this experience that as nurses we should respect a patients beliefs and values, and we should not let our own beliefs and values affect our decision making in patient care (Rogers, 1957). I also feel I should have been more assertive when it came to the way John was being treated by the staff. As a first year student I did not feel comfortable questioning the way a professional staff nurse carried out her nursing care. However, from this experience I will question bad practice in future, as the NMC (2008) states that I am in person accountable for my actions and omission s in my practice and I must always be able to justify my decisions.AnalysisAccording to Briggs (2006) as cited in abstract of clinical skills Communication is the process of conveying information between deuce or people. Communication is essential in building relationships with patients and gaining trust. In the NHS the absolute majority of the complaints brought against them were for poor communication from healthcare staff (Pincock 2004). To highlight how important communication is in the nursing profession, the NMC identified it as being an essential skill and hardly if a student is competent in this skill can they then go on and register as a nurse (NMC 2007b).In order to communicate with John the situation required the use of interpersonal skills, known as non verbal and verbal communication. Non verbal communication is described by lister and dogherty p62 as being information hereditary without speaking. Johns body language indicated that he was tense and anxious therefore come him with empathy ensured that he is being understood and that his participation in communication was determine (Peate 2006)nurs 21st. Given the history of Johns aggressive outbursts it was necessary to consider the proxemics in the situation. It is recommended that guardianship within a distance of 4 to 12 feet away from a person is less intimidating for them (Egan 2002). In order to engage in conversation with John, Egans (2002) acronym SOLER was used. This is a process of using body language to actively listen to a person. By sitting squarely towards John, having an open posture, angle in towards him, maintaining eye contact and maintaining a relaxed posture, en couraged him to relax and feel less intimidated and therefore talk more openly (Lister and Dougherty). vocal communication with John was enhanced by the use of facial carriage and paraverbal communication. (Fund Nursing p195) states that Facial expressions give clues that support, contradict or disguise the verb al message, therefore the use of a smile when approaching John indicated lovingness and friendliness. This was assisted further by the use of para communication these are the cues that accompany verbal language. These include tone, pitch, speed and volume of the person speaking, therefore by communicating with John with a soft tone of voice scoreed further meaning to the spoken words (fund nurs).The barriers in communication during this incident were Johns aggressiveness. This could have been due to the withdrawal from cigarettes, as according to Bruce (2008) irritability is a symptom of nicotine withdrawal. If a patient is unable to smoke in hospital then nicotine replacement therapy should be introduced and the patient treated like any other dependant. Bruce (2008) suggests that Withdrawal from nicotine needs to be recognised and treated fittingly in the acute hospital and it will often be the ward nurses who are relied on to recognise the symptoms. These symptoms were overlooke d by the staff and to add to his frustration he had no means of mobility to be able to afford the ward for a cigarette. This may account for his outbursts of anger. Peplau (2004) suggests that when there is an obstacle or obstruction preventing a person from achieving their goals this may lead to frustration which in turn often leads to anger.Action PlanUsing Gibbss reflective musical rhythm has assisted me in making sense of the situation and to put things into perspective, recognising how I can put this learning experience to positive use in my future practice as a Nursing professional. If this situation were to turf out again I know I would now have the courage to question the nurses attitude at an earlier stage pointing out that bad practice by anyone is not acceptable. From this experience I have learnt that I need to be more assertive and if I feel the needs of a patient are not being met, my first thoughtfulness should be to protect the interests and safety of patients, i n line with the NMC (2002) Code of Professional Conduct, (clause 8). This reflection has highlighted the need to increase my knowledge and understanding of the process of communicating with patients from different cultural backgrounds, I will address these issues by, listening and learning from the qualified staff and by reading relevant literature.ConclusionIn conclusion it can be seen that the nurse has a very important role in communicating with patients through their treatment. When a patient is admitted to hospital, assessments should be made based on the activities of daily living, Roper, Logan Tierney (2000). Johns assessment not only should have identified the level of care needed, it should also have naturalised his normal routine, and the fact that he was a smoker and required a wheelchair for mobility. If Johns needs had been assessed correctly the breakdown in the relationship between John and the professional staff could have been prevented. Overall, through this refl ection I have learnt that communication is an essential skill that requires as much practice and attachment as any other aspect of nursing.