Reflection On Interpersonal Skills In Clinical Practice

Reflection On Interpersonal Skills In Clinical Practice This is a reflective essay based on my experiences whilst on my five week surgical placement in a local hospital. The aim of this essay is to explore the use of communication and interpersonal skills in clinical practice. I have chosen this particular incident as I spent a considerable amount of time communicating verbally and non verbally with this particular patient. To protect the identity and maintain confidentiality of the patient I have chosen to discuss they shall be known as John, this is accordance with the NMC code of professional conduct (2008). To assist me in the process of reflection I will be using Gibbs (1988) reflective model. The structure of this framework allows the reflection to be written in a clear way, which provides opportunities to look at the incident from a number of perspectives; this will help to highlight areas of practice which could be changed in the future (Jasper, 2003). There are numerous reasons why reflection is important to nurses. Through refle ction we can get to know more about what we do and what limits our abilities and this gives the opportunity to improve the way we care (Ghaye and Lillyman, 2001). Description John was a 74 year old man admitted onto the ward from the emergency department 2 days previous to me starting my first late shift of that week. He had been suffering from retention of urine, and was in considerable pain. My mentor and I were informed during handover that we would be looking after John on this particular shift and could we change the dressing on his right leg as he had an ulcerated leg due to suffering from a condition known as Peripheral Vascular Disease (Alexander el al, 2004). As a consequence of this disease he also had his left leg amputated below the knee some years ago and mobilised using a wheelchair. It became clear during the handover that John had been very difficult the last couple of days. The nurse in charge went on to say that he had thrown items across his room and was constantly pressing his nurse call button and shouting all day, he had also refused to have a wash and change his pyjamas. As we left the room where the handover had taken place, my men tor 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 made our way to Johns room. I knocked on his door and introduced myself as a student 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 see a doctor and I havent had a cigarette 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 soft tone of voice and asking him if he would like a cup of tea after we had finished. His body language softened and he looked up and smiled, he said I would love one. I smiled back at John, I then repeated the question 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 operation my mentor and I were then able to go on and change his dressing on his leg. Feelings Through this learning experience I encountered different feelings towards the situation. From the initial handover, the staff nurse in charge did not paint a positive picture of John. I wondered why this particular patient 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 feel experienced enough to deal with the situation. During my encounter with John it became clear why he would feel 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 given any nicotine replacement therapy to help him cope with his withdrawal symptoms. When the full extent of Johns situation became clear to me, I felt immense frustration for him. According to the NMC Code of Professional Conduct (2008), nurses should treat patients with respect and maintain their dignity. With John not having a wheelchair, he was con fined to his bed and therefore had lost his autonomy. The situation also made me very angry, reflecting back I feel I should have been more assertive and maybe questioned why Johns requests had been ignored by the staff. Evaluation It 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 compassion and communication skills seemed to be very much lacking, not listening to his requests and showing no feeling towards him. This breakdown in communication in the nurse patient relationship 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 needs were met, and I learnt that effective communication is essential in building a trusting bond between the patient and the nurse (Almond Yardley, 2009). The bad 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 personally accountable for my actions and omissions in my practice and I must always be able to justify my decisions. Analysis According to Briggs (2006) as cited in compendium of clinical skills Communication is the process of conveying information between two or people. Communication is essential in building relationships with patients and gaining trust. In the NHS the 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 only 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 transmitted without speaking. Johns body language indicated that he was tense and anxious therefore approaching him with empathy ensured that he is being understood and that his participation in communication was valued (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 keeping 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, leaning in towards him, maintaining eye contact and maintaining a relaxed posture, encouraged him to relax and feel less intimidated and therefore talk more openly (Lister and Dougherty). Verbal communication with John was enhanced by the use of facial expression and paraverbal communication. (Fund Nursing p195) states that Facial expressions give clues that support, contradict or disguise the verbal message, therefore the use of a smile when approaching John indicated warmth 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 added 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 appropriately in the acute hospital and it will often be the ward nurses who are relied on to recognise the symptoms. These symptoms were overlooked by the staff and to add to his frustration he had no means of mobility to be able to leave 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 Plan Using Gibbss reflective cycle 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 arise 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 consideration should be to protect the interests and safety of patients, in 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. Conclusion In 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 established 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 reflection I have learnt that communication is an essential skill that requires as much practice and consideration as any other aspect of nursing.

Loss of Opportunity for Higher Education

A profession that most of us choose to follow will vary in many ways. Most people would follow a path that would entail penetrating the business world, while some would focus on other undertakings that include government related duties, medical professions and legal professions.   In my case, initially pursuing a career by defending and serving the country through using service for the flag by offering labor and passion for the country were my initial steps. Many people view joining the military as a waste of time, but in my case, serving the flag above anything else was main prerogative. This is perhaps one reason that what many would call as a deprivation of gaining higher education and exploring other opportunities that can eventually help out my tenure of service towards my country. Military occupations are known to end somewhere along the line and once this happens, a secure future may not be clear when it comes to depending on pensions as the main source of living later on. The basic business knowledge, strategies and management styles are definitely something that is not present or available at this time. While I am serving my country, participating in the on-going crisis that needs my attention, the desire and need to gain the necessary business knowledge needs more time to focus on. Being said, such events prevent me from attending to the needs of my family and dependents. Education is a very important investment, a choice that I had foregone, but given the opportunity to grab a decent education at any point will surely be something that I will not allow to pass. Such has become a hindrance in allowing my wife to gain better ground as far as opportunities. Understanding my current profession is not so easy to do. While I would have avoided the matter had I been chosen to pursue a degree of relative education, then perhaps this matter of attaining the proper educational level instead of serving my country was the purpose I had undoubtedly chosen. While there are no regrets on my part for being where I am now, the opportunity lost is quite devastating as  people would consider it. Providing a better future for my family was evidently set aside, and this is something that was a gamble on my part as far as life’s decisions are concerned. Taking the initiative of placing my country in lieu of my personal security for me and my family is clearly something that will deprive me of planning and preparing for the future once I have ended my years of service. However, hope still floats and even though time is a key element in investing in education has been lost, pardon or assistance to my dependents is something that I am really praying for. Due consideration in exchange for placing practically my life for a country I love dearly in exchange for the security and future of my wife and dependents is the only recourse I see to offset the loss from the educational benefits I have given up. But once time permits, pursuing education to whichever level suitable and to my abilities will remain to be my battle cry. There is no turning back to where I am now, but only time to adjust and look forward to being given the chance to undertake new and different challenges and seek education upon the remaining educational opportunity once given and allowed.

Many students expand their view of the world during

There was a time when the world we live in was in a somewhat peaceful mode. There was existing discord among countries and there were political and social misunderstandings being resolved but overall, there was a semblance of a fragile peace and tolerant understanding of each others problems, race, and gender. That all changed overnight after the events of September 11.Overnight, the tolerance and fragile peace existing between our country and those of the Middle East, Europe, and Asia was thrown into a dizzying tailspin. Everything that we thought we knew about our middle-eastern neighbors was thrown out the window and they suddenly became an almost persecuted race worldwide. This loss of tolerance and understand towards the Middle Eastern nationals saddens me no end. Perhaps it is because, even though I was born and raised as an American, my family's roots are deeply entrenched in the Middle East.I lived eleven years of my life as a citizen of the Middle East. Â  I am one of them. Therefore, I understand the culture and religion even though I am now more influenced by my westernized upbringing. Even though my parents tried hard to instill some of our Old World value into me, it was a struggle for me to identify with the traditions and ways they wanted me to follow.No one else in my social circle had to follow the same norms as set by their family that I did. Eventually, the western ways won out and I forgot what it was like to be a Mid Easterner. This is why I believe that the person or classmate who will have a tremendous impact on my life while in college will be someone who is an exchange student or foreign national enrollee from any part of the Middle East.The reason I believe this is because; I have slowly come to realize that the people from the Middle East have been suffering from prejudice since the events of 9/11. The race has been judged collectively and branded by the world as terrorists. All member countries of that eastern block have been judged by the decisions and acts of a few misguided people from their area of the world. It is time for us to stop the prejudice. It is time to stop the war. It is time for us, as the free leader of the world, to stop, analyze and think about what we are doing to those people. It could be an act of veiled of revenge already on our part. That understanding can start small and trickle down. It can start with me.I would expect that this potential classmate of mine to help me understand where the prejudice comes from. Why do we see them in such bad light? How do they view us as a nation? I believe that a fellow Middle Easterner student and I will be able to relate and have many things in common. Â  He may not be from the country my parents come from. But, he will at least share the same beliefs and traditions as my parents and maybe, just maybe, I can learn even more from him about my roots and traditional heritage. Those things and lessons will be fun for me to encounter because I missed ou t on those things when my family moved to the United States.Since he will be like a mentor to me, I also expect to learn other things from him. I expect to learn more about tolerance for others who may not understand from him. He can show me how to deal with the situations he faces everyday. I have been known to have a short attention span so dedication and effort are not really very strong points in me as a student and person. I am hoping that he will be able to teach me that since Middle Easterners are known for their tolerance and patience in the face of adversity.Aside from those specific things, I know that I will learn a lot in terms of life lessons from him or her simply by observing the person as his or her daily life unfolds. Everyday is a learning experience for everyone, he or she can be my out of class mentor, friend, and ally if need be.

Critique Person Centred Counselling - 3169 Words

I want to be genuine and spontaneous and me; but youve got to help me. Youve got to hold out your hand, even when thats the last thing I seem to want. Only you can wipe away from my eyes the blank stare of the breathing dead. Only you can call me into aliveness. Each time youre kind, and gentle, and encouraging, each time you try to understand because you really care, my heart begins to grow wings, very small wings, very feeble wings, but wings! Extract from Poem Please Hear What I am not Saying. Charles C. Finn This Critique of Person Centred Counselling offers an insight into The Person Centred Approach developed by Carl Rogers. I will firstly introduce Rogers and his influences. An exploration of Person Centred Counselling†¦show more content†¦When we do so, self actualisation will occur. Rogers likened this actualisation process to the growth of plants, having an innate tendency to grow from a seed to full potential when exposed to favourable conditions. Rogers believed that for a person to achieve self-actualisation they must be in a state of congruence, thus, self-actualisation occurs when a person’s ideal self is congruent with their actual behaviour and self-image. For the client to self actualise; key principals must be employed during the counselling process. Outlined as follows: Key Concepts of Person Centred Counselling * Humans develop in a positive and constructive manner if a climate of respect and trust is established. Once proper conditions for growth are present, the client will be facilitated to gain personal insight and take positive steps toward solving difficulties. * The characteristics of people included trustworthiness, reliability and constructiveness. The core of every human being is positive. Unfavourable characteristics arise out of defensiveness due to internal imbalances, low self esteem and fear. * People are resourceful and capable of self direction, possessing the capacity to regulate and control their own behaviour. Counselling is a means of tapping into the client’s personal resources with the ultimate goal to empower the client to realise their potential. * In the initial phases of counselling, clientsShow MoreRelatedUnconditional Positive Respect1569 Words   |  7 Pagesin counselling, unconditional positive regard, congruence and empathy is crucial. Find. Conditional positive regard is based on whether if the client meets specific expectations, desire or requirements unlike unconditional positive regard. On the other hand unconditional positive regard can in some cases be difficult for the counsellor. Sometimes the counsellor may strong disagree with racist or prejudice views but in the counselling sessionRead More Communication and Interpersonal Skills1495 Words   |  6 PagesThe aim of this assignment is to critique a role play, and look at the positive and negative, that relates theory and knowledge regarding the use of communication and interpersonal skills, and how and when to use verbal, non-verbal and Para-verbal communication within the role play scenario that was chosen. The author will also discuss the different models of Communication, and how they use a person centred approach to counsel and interact, and how best to handle and approach a situationRead MoreA Long Term Care Home2736 Words   |  11 Pagesof living with a loss, the primary emotion that follows that is grief. â€Å"Grief is a natural response to loss. It’s the emotional suffering you feel when something or someone you love is taken away.† (Melinda, 2014) The more attached you are to the person the more devastating the loss will be. Greif is most commonly associated with the death of a loved one and this usually is the most intense form of grief. In Arthur’s case it is clear he is grieving the death of his wife Lily, as he still speaks asRead MoreThe Importance of Diversity in Counselling Contexts Essay3376 Words   |  14 PagesC0602- Counselling contexts Tutor: Kevin Hogan Submission date: 31st May 2013 ‘The importance of diversity in counselling contexts’ The importance of diversity in counselling has been the subject of much research over the last 50 years Patterson (1996) and is aimed at preventing inequalities among different population groups regardless of ethnicity, gender, sexual orientation, social class, age, physical abilities and religious beliefs/beliefs. (Patterson, 1996) When considering the differentRead MorePerson centred therapy2630 Words   |  11 Pagesï » ¿ 5th November 2013 Essay 1: ‘Evaluate the claim that Person–Centred Therapy offers the therapist all that he/she will need to treat clients’. In this essay I will look at the benefits and the disadvantages of person-centred therapy and consider whether it provides sufficient tools for the therapist to be effective in the treatment of the client. Looking at the underlying theory (self-actualisation, organismicRead MoreReflective Essay On Counselling1690 Words   |  7 Pagesapplied to a counselling roleplay and applied content over the duration of the module. Furthermore, identifying what has been covered and what has not been covered in the roleplay, its strengths, weaknesses, what needs developing and how it can help as counsellors within the field. The first topic will reflect on the skills and attributes that have been applied to the roleplay and how it has been beneficial. The second topic will be a critical analysis on the roleplay conducted during counselling focusingRead More‘’Evaluate the Claim That Person-Centred Therapy Offers the Therapist All That He/She Will Need to Treat Clients‘’.2560 Words   |  11 Pagesmultitude of reasons relating to personal growth, marital or family conflict and work dissatisfaction to name a few. One of the recognized theories of counselling today was develo ped by the humanistic psychologist Carl Rogers in the 1940s and although this new approach to psychotherapy ran contrary to the theories dominant at the time, person-centred therapy is considered one of the major therapeutic approaches nowadays, whose concepts and methods have influenced and inspired the practice of many therapistsRead MoreReflective Essay1814 Words   |  8 PagesReflective Essay – 6th June 2012 My journey to become a Counselling Psychologist began in 2008 when as a Life Coach; I had a self referral who suffered from anxiety over his forthcoming exams in his second year at university. I started collaboratively setting goals to manage his workload and set timetable into manageable chunks through asking him challenging questions so that e can start to think for himself. He had plenty of resources namely his family, time, books but he just would not settleRead MoreMy Core Philosophy And It s Ongoing Development2547 Words   |  11 PagesIn formulating this essay I will give a descriptive account of my core philosophy and it s ongoing development. I will evidence my way of working in context to counselling theory, relating this to the course s guidelines. Giving reflections on personal, intrinsic values and beliefs, their application in practice within a placement setting. There are many emerging influences that shape both my professional and personal development as a practitioner. Accessing a vast array of life experiences, contributesRead MoreClient Centered Therapy Or Client Based Approach Essay2461 Words   |  10 Pagestheories which can be used to assess, analyze and find a solution a client’s problem. In my client’s case, I would love to use the client- centred therapy to figure out a way to assist her and her family. It is the duty of a Social worker to listen and understand the problem his or her client is going through and find a way to fix it together. Using client-centred therapy would be a good way of working together with the client to get to the root of the problem and to solve it. Client-centered therapy