Example Reflective Essay using Rolfe Reflective Model

Example Reflective Essay using Rolfe Reflective dumbfoundThis reflective essay allow for adopt Rolfes model of reflection, (Rolfe, G et al. 2001) which was derived from Bortons developmental model. (Boyd E et al. 1983)The scenario is presented as Appendix 1 and the forbearing has been anonymised as lee in accordance with the NMC guidelines (NMC 2008)What?When analysed in overview, unrivalled mint none that the of import issues contained in this scenario are that a schizophrenic patient, who may therefore be psychotic, who is for sure mixed-up cod to his metabolic disturbances (hyponatraemia) and possibly idiopathic confusion, has do an allegation of physical assault once against another staff member. The patient is likewise forgetful and the event happened three days ago. Clearly the incident cannot be confidently verified at this stage and there is a skepticism as to whether the patient is reliable in making this allegation. Analysis revolves virtually my reflection on the actions that I took and whether they could be considered appropriate or un headstrong of improvement.My role in the event was that I was the recipient of the allegation. Having heard the allegation, I tried to make sense of it. On the one hand I was mindful of the seriousness of the allegation if it were true, and therefore I was likewise aware of the potential harm that an untrue allegation could cause to the headmaster rectitude of the finicky who was involved. I was obviously aware of leewards potential for confusion and psychosis, only when I was excessively impressed by the apparent veracity of his medical record and also by the fact that he started to cry when he was spread abroad it. (Nicol M N et al. 2004)On balance, I did believe his account of the situation. I therefore felt that I had a moral and headmaster vocation to escalate the complaint to the Senior shelter Sister. After a catamenia of discussion with the hospital ward Sister, I filled in an I ncident subject Form (IR1), which was then forwarded to the hospital management.After the event, I experienced a period of prolonged self-examination. I was concerned in case I had inadvertently been party to a false allegation and considered notwithstanding the consequences for the particular involved. After a period of intense reflection, I concluded that I was right to take the action that I did, both because of my nonrecreational profession to do my best for the patient besides also because I was playing as the patients advocate in these circumstances, which havemed entirely appropriate. (Brooke C et al. 2007)The response of the Ward Sister seemed entirely appropriate. I believe that she went and spoke to Lee herself and determined that there was sufficient evidence to make the reporting of the incident (IR1) appropriate. This quiet me greatly. The Ward Sister also discussed the ethics and implications of the situation with me, which was both professionally helpful and considerate, as she could see that I was unclear about what I should do in these circumstances.In any reflective process, one also has to consider the feelings of the patient. In this case Lee did appear to be blissful that he was being taken badly, but his fluctuating lucidity meant that further questioning did not clarify the situation any further. He certainly appeared to be pleased when he was told that the special would not be depute to him again.So what?The theoretical elements of the depth psychology of this situation are straightforward. Jasper, in his erudite series of analyses (Jasper M 2007), acknowledges that part of the responsibility of being a professional practitioner is to ensure that you give the best care practicable to your patients or clients. In an analysis of a similar situation, the author is unequivocal in his assessment that the professional duty of the nurse is to share such reports of affirmable patient abuse with their immediate superior. Even if t he patient is of reduced readiness or of questionable relipower (Jasper M 2007 Pg 36), they should therefore considered vulnerable in the professional sense, and offered greater, not less, protection.An ethical analysis would suggest that the nurse should shake up the Principle of Non-Malificence, which was derived from the often quoted dictum of Hippocrates, which stated that one should first do no harm. (Carrick P 2000). This Principle stated that healthcare professionals mustiness ensure that their patients are not harmed, nor will come to harm. (van Uffelen J G Z et al. 2008).I did consider the possibility of speaking to the Special in an unofficial capacity, but came to the conclusion, that there was nothing that they could say which would change the victorian course of action. This concurs with the opinion of Tschudin who analyses a number of similar situations. (Tschudin, V 2003).This take of analysis gave me a deeper insight into the situation and reinforced my initial conclusions relating to the straight-laced and appropriate course of action.Now what?Given the fact that Lee had describe a possible episode of abuse, it seems entirely appropriate that it would be the right way investigated. The action of the Sister in removing the Special from caring for Lee also seemed appropriate and proportionate. It may have been considered more appropriate to suspend the Special from work, but in circumstances when one is dealing with a confused and psychotic patient and there is a significant element of uncertainty about the veracity of the allegations, this might be considered inappropriate and unduly damaging to the Special. (McMillan J 2005)At the time of the reporting of the incident, I apologised to Lee myself and quieten him that such a situation would not be allowed to occur again. I feel that this was also a professionally appropriate course of action, as it not only communicated a professional sense of responsibility to Lee, but also it demons trated the fact that I was taking his complaint seriously and was sorry that it had happened. (Kozier, B et al. 2008)When analysed in overview, I effectively had two possible potential outcomes of the situation. Either I believed that Lees story was believably true, or I didnt. This gives rise to a deeper analysis and, in the address of Cruess Cruess, the evolution of a student into an expert practitioner is judged by the ability to operate from a deep and holistic get winding of the total situation, a concept that is often referred to as professional intuition. (Baillie L 2005). Cruess et al. suggest that this professional intuition is better considered as professional expertise, which is generally built up and gained over years of experience and which, when tested in the clinical environment, can become an altogether more robust concept. (Cruess S R et al. 2007). chiding on this situation, together with the guidance received from the Ward Sister, has helped me to fully unders tand the main elements of this situation. If I were to encounter such a situation again I would feel more confident in dealing with the situation rather than having to reflect at length after the event. Such analysis has helped me to realise that, to cite Schon, it is one of the ways professionals evolve and move beyond rule-bound behaviour and which enables them to function in a world of uncertainty and see problems in a holistic way and act appropriately. (Schn, D A (1987)AppendixScenarioA 78 year old gentleman called Lee was admitted to my Ward with schizophrenia and other medical conditions, one of which includes confusion and hyponatremia. It has been explained to the patient and his next of kin that due to the dangerously low sodium level Lee is on a fluid restriction of 750 mls per day, however due to the patients mental statue, he constantly demands fluids and if not given he will start screaming and disturb other patient and can be very aggressive a time. For this reason th e Senior Sister quest a special in order to provide a one to one care for Lee.I supported the patient with personal hygienics care one morning, Lee began to cry, when I asked what is the matter Lee? he said, three days ago a special slapped my arm and emaciated me. And he said I was waiting for her to finish her shift to avow a staff nurse, by then I had forgotten. I trust when my son will visit me, I will remember to tell him what has happened.I reassured him that this will not happen again and I also apologised on her behalf and told Lee that particular specialist will not be caring for him any more.I reported the incident to the Ward Senior Sister and together we filled in an Incident piece of music Form (IR1).ReferencesBoyd E Fales A (1983) reflective tuition the key to learning from experience. Journal of Humanistic Psychology, 23 (2) 99-117Brooke C Waugh A Eds (2007) Foundations of nurse Practice, Fundamentals of Holistic Care. Lond Mosby Elsevier.Carrick P (2000) Medi cal Ethics in the antediluvian World. Georgetown University press PhiladelphiaJasper M. (2007) Professional Development, Reflection and Decision Making. Blackwell Publishing, Singapore.Kozier, B, et al. (2008) Fundamentals of Nursing Concepts, exhibit and Practice. Harlow Pearson Education.Nicol M N, Bavin B C, Bedford-Turner S B, Cronin P C Rawlings-Anderson K R (2004) Essential Nursing Skills 2nd ed. Churchill Livingstone, MosbyNMC (2008) Nurse Midwifery Council Code of professional conduct Standards for conduct, performance and Ethics (2008) London Chatto Windus 2008Rolfe, G., Freshwater, D., Jasper, M. (2001). Critical Reflection in Nursing and the Helping Professions a Users Guide. Basingstoke Palgrave Macmillan.Schn, D A (1987), Educating the Reflective practitioner Toward a New Design for Teaching and Learning in the Professions, Jossey-Bass Publishers, San Francisco.Tschudin, V (2003). Ethics in Nursing the caring relationship (3rd ed.). Edinburgh Butterworth-Heineman n.van Uffelen J G Z, Chinapaw M J M, van Mechelen W, Hopman-Rock M (2008) Walking or vitamin B for cognition in older adults with mild cognitive injury? A randomised controlled trial. British Journal of Sports Medicine 2008 42 344 351