CRITICAL INCIDENT AND REFLECTION
Critical incident means activity, situation or circumstances which give very good or bad result on end results. These incidents can be positive or negative, so there are possibilities of good or works result on outcome.
Reflection means similar image as present in opposite side. In context of projection, reflection means performing task by putting oneself in particular situation and then sharing view, thoughts, experience etc. related to it (Butterworth and Faugier, 2013).
With the help of reflective report, reader can understand situations in effective manner. This gives idea about various activities such as what actions that have been undertaken in order to improve it and they are able to explain pints in more depth. This helps to give clear description about portrayed situation.
There are some disadvantages of reflection such as over thinking, difference in perception, critical evaluation, time consuming, etc.
There are three different models of reflection which are Graham Gibbs, Donald Schon, David Kolb. In this report, Graham Gibbs reflective cycle is used.
(Source: Graham Gibbs reflective cycle, 2017)
This model is used because this provides systematic learning and knowledge of particular event. This helps to provide appropriate conclusion after considering all aspects. In this model there are following steps- initial experience, description, feeling, evaluation, analysis, general conclusion, specific conclusion, personal action plans.
INTRODUCTION TO INCIDENT
As I am working as nurse in Broomfield Hospital – Chelmsford, East England, there are several patient with which I have to deal. I am associated with emergency ward of Broomfield Hospital – Chelmsford, East England. I face various accidents cases such as fire broke out, road accident etc. every day (De Groote and Raszewski, 2012). I dealt with an road accident case which was very pathetic and the condition of patient was very serve when he was admitted to hospital. This individual got hit with mini truck because driver of truck was driving wrong side at night. Truck got tilted because it was overloaded. The person was an adult who was severely injured. He got severe brain injury, blood was clotting from his head, hands, legs. He was fractured because of crack in 16 bones. Some of onlookers admitted him to hospital and no one of them was aware of any of his acquaintances or family member. It was tough to contact his family members and relatives because of lack of sources. Afterwards on the basis of his vehicle number, respected parties were informed.
The situation of the patient was miserable as there were no individual who was ready to take responsibility of person. Due to lack of treatment, patient paralysed and ultimately died. Because adult was under truck, so his body was severely injured from various places. In hospital, treatment of such person was refused because as there were no identification of family member with him as per legal norms and onlookers refused to sign medical papers, hence his treatment got late as his family member did not arrive by that time. Because of night, there was no doctor to operate him. When I was dressing with him as nurse my hands were shrivelling. At that time, I feel very bad because that patient urgently needed the treatment and administration of hospitals first need his family member in order to complete paper work (DiCenso, Guyatt and Ciliska, 2014). As per my opinion, this was not right in that consequence and according to me, these legal norms should be manageable and amendable. Hence, due to lack of proper treatment and care, the person died in the hospital. As per the nursing ethics, this is not ethical for a hospital if a person die cause of late treatment and dearth of proper care. In such cases, ethics are main prior. When patient need treatment administration department was waiting to complete paper work and then treatment will start. Because of overloaded truck he was late admitted to hospital and severely injured. This act of admin department of hospital is unethical.
There is requirement of different aspects which are important for performing operations in effective and efficient way. Being nurse, I was not so associated with administration department of hospital, hence in this case, I wasn't able to make administrative decision while incident was incurring (Fawcett and Desanto-Madeya, 2012). There are few people who waited for his parents to hand over safely and provide help to them. This could be better if people signed documents at hospital. So timely treatment of patient can start. Being nurse, my actions to this situation was effective because with doctors I was also dressing patient though admin department refused to admit without legal formalities. I have done this because my conscious does not allow to wait for patient's parents. I acted best as per moral and ethics. I felt that being professional does not mean that one only need to follow rules and regulations but fulfil one's duties and comply ethics while performing acts.
THEME 1 ETHICAL DILEMMA
THEME 2 TRAINING EDUCATION TO PROFESSIONALS
THEME 3 ARRANGEMENT FOR CONTINGENCIES
THEME 1 ETHICAL DILEMMA
Ethical dilemma means decision making ability of person whether to select professional practices and ethical behaviours. This situation arise when there are two ways and candidate has to choice one. As in my case where I am working as nurse, there is ethical dilemma whether to treat patient or to follow official policies of hospital. In this case, I had to breached my confidentiality and there were possibilities of violation of ethical policies. There are some situations arise where person can not speak against its workplace policies. In the above undertaken case, I am working in organisation as a nurse (Hayman and et. al., 2012). As per my mentioned case, my ethics did not allow me to wait for patient's family but as per my workplace ethics and policies, I was not able to aid him before paper work. So this was the biggest ethical dilemma that standard my work. From this event, my ethics and principles got affects as I am not able to perform work according to my moral.
As in society, being a nurse, I have to deal with various situations where ethics does not allow me to perform such work. Hence, in order to deal with such situation, I have to work according to official policies (Hockenberry, Wilson and Rodgers, 2016). About in above discussed case, patient was severely injured that doctors should have not waited for paper work formality. Later, the manager and staff determined to treat patients breaching hospital ethics. In this situation, more improvement can be done if administration department also support this patient. Due to lack of timely treatment, patient got affected with paralysis. This situation would have not raised if admin department would have admitted the individual. In this situation, I faced dilemma that whether I should to go with my ethics and first aid patient or follow official policies or I should comply my organisation ethics. As per situation of sufferer, doctors also make policies which are effective and significant for maintaining good situation of workers. There is requirement of alteration in official policies of hospital, so patient can be treated properly.
There is difference in perception of every individual to deal with certain situation. In this case, there were some staff members which feels that policies of hospitals are correct. Because in case of any miss-happening, there are possibilities that family member may file case. Police must also performed their operations frequently, so they could identify family member's of sufferer. In this case of accident, there was requirement of practitioner educational need (PEN) to comply in regard of performing business practices to handle this case in more appropriate manner curing patient more appropriately and finely (Holloway and Galvin, 2016). Doctors and nurses are stuck with case because of ethical dilemma between work place policies or their morale. There were two situations in front of everyone whether to go with hospital policies because they are working their as staff or to provide first aid to him. Hence, in such case, this is hard to determine which ethics should be complied and nurse has to make decision as per the consequences so as the staff did.
THEME 2 TRAINING EDUCATION TO PROFESSIONALS
Training is one of the effective way through which performance of employees can be improved at work place. As per the requirements of employee and demands of organisation, this is fundamental for company to coordinate proper training to introduce worker with new skills and knowledge and deal with their imperfection shaping their views. This helps to perform commercial activities in more effective manner. There are different methods through which training can be provided to workers at hospital such as classroom training, transfer, job rotation, conferences, seminars, etc. that can be employed as per the consequences and different requirements of company (Keating, 2014).
As per accident case, while I was dressing sufferer as nurse, my hands were shriving. The present my personal nursing skills which lack proper training. In order to overcome this, hospital administration need to focus on training program which can help to perform commercial operations at hospital. If hospital had provided appropriate knowledge to their employees and nurses, I would be able to provide that patient first aid in more effective and suitable manner. As per improvement in technical aspects of hospital, the training method which was most suitable had to be adopted. There were possibilities that some staff were not ready to learn new techniques, then in this case administrations has to strict their performance appraisal policies. As per case, I analysed that if appropriate training is provided then this is effective and significant for treating patient in well manner. Above discussed case shows that patient was admitted to hospital at night, at that time there were no doctors so in this case, if worker or nurses would have provided proper training along with the subordinate level staff, then treatment of patient could have be done in appropriate way. In order to operate him, there were no such efficient doctors and compounder did not have sufficient knowledge. With the help of training, it could have been easier to provide emergency treatment to individual.
Research is appropriate and effective because there is situation at the time due to critical situation of patient my hands shrivel (Kennedy, Barnsteiner and Daly, 2014). But if training would have performed then I would have able to work confident and with use of latest equipments. In medical line, confidence is one of the most component which helps to perform critical operations, several treatments of patient. Not only training but practical implementation is also important. This helps to deal with contingencies emerged at workplace.
This similar case was happened in Cromer Hospital – Cromer, UK when there was no doctor to deal with situation. In this situation, nurse operate that patient and able to save his life. This is because they provide training to their staff. They have time to time training program and under doctor's presence they perform their training to practical knowledge such as operations of patients. This provides confidence to nurses and they are able to work in contingency. This makes brand of image of Cromer Hospital – Cromer, UK in industry.
THEME 3 ARRANGEMENT FOR CONTINGENCIES
There are different contingencies emerge at workplace while working an organisation that need to cope up as per distinct consequences. Hospital is other name of contingency. There are possibilities that patient may come at any time and in any situation. Here, different situations can arise at hospital and a doctor and nurse is liable to perform their duties at any cost. When I saw this case, I felt that there must be some flexibility in plans and policies of hospital. This helps to deal with situations in more ethical manner (Kimberly and Manchikanti, 2012). As per case, if organisational policies of hospital were flexible then there were good policies that person may able to live life. This helps admin department of hospital to deal with changes and actions are taken to provide treatment. There are some rigid policies of hospital which affects working style of hospital. But at the same time, there must be some contingencies in which administration department can keep morale and ethics first.
Doctors were not allowed to take care patient if paper work was not complete, in this situation administration must had provided treatment under class of contingency. This helps to save life of sufferer. As medical line was the industry where contingencies arise frequently and if alternate was not using then case may occur to death.
Essex County Hospital, UK is the hospital which has some policies in which they can cure patient and this helps to save life. In this case, they did not ask for paper work and good treatment can be provided. There was one case of road accident then in this case administration department of Essex County Hospital, UK does not wait for patient's family member and police verification case in order to treat patient. This contingency policy helps to maintain balance between official policies and ethics and morale at work place.
Apart from this, there must be 24*7 doctor at hospital which works in order to deal with such situation. Patient must not deprived of treatment because of absence of doctors. There is much scope in medical sector, so practitioners must be part of hospital which enhance their practical knowledge and hospital does not deprived of doctors (Kitson and et. al., 2013). There must be arrangement of ambulance which are important for transporting patient from spot to hospital. This service must be fast and frequent and drivers must have knowledge how to drive safely.
Why are you here? What are you aiming for?
- I selected nursing as my educational field because my father is a surgeon doctor and his medical practices inspires me to opt for the same field. I am attracted toward this stream since childhood and I tried to gain knowledge about the diseases and their treatment as well as precaution from my father (LeMone and et. al., 2015). These conversations has developed my interest toward becoming a nurse. I want to become a nurse because it is my passion and I want to serve the society.
- I have some knowledge regarding the medicine and symptoms which is required while having conversation with patient. This will be very beneficial during my study or while practising. Apart from this my communicational skills are good which is very essential for a nurse while communicating with patients. As bag communication skill may creates misunderstanding that may be riskier for a patients health as well as career of a nurse.
Time management and learning style
- Since, I am working in a clinic along with my studies so I find it difficult to provide proper time to my studies at home. Therefore major barrier to my studies is lack of time which distract me while studying. On the other hand, I also resides in another city and because of which I also have to mange each and every thing by own. So these are the major barriers which affect my study at home. In order to overcome this, I decide to make a schedule which help me in studying at home effectively (LoBiondo-Wood and et. al., 2013). No, I am not agree to plan study at home with anyone as I don't get time from my job and this plan may hamper their work.
- SWOT analysis
I am hard working and have good communicational skills that help me in building therapeutic relationship at work place. I have caring nature and also feel empathy toward others which are required within a nurse.
I some time find difficulties in managing a balance between work and life. I am sensitive kind of person and loose confidence in front of patient who is more injured.
There are lots of job opportunities for me after the completion of education of registered nurse. This degree will give a meaning to my job or career as well as I get an opportunity to serve others.
Major threat is that higher staff level will reduce the chances of getting opportunity at work. Another major threat is that when number of patient increases work become more stressful and shift time may also get extended.
Recommendations :- To overcome these issues, I decided to assign time for my each task so that I can develop a balance between my job and life as well as I can also manage my work when patients are more. This help me in operating my work without any stress (Munhall, 2012). Apart from this I can also ask my seniors for guidance which help me in improving my skills and competencies that automatically build up my confidence.
VARK is a model which describes various learning styles such as visual, auditory, reading & writing and kinaesthetic learning. From these learning styles I prefer auditory as well as reading and writing learning style for studying. As both the styles are very beneficial for me because in auditory learning style I attend seminars and lectures which involves two way communication and I can solve my queries by asking questions. Another learning style is reading and writing for which I use to visit libraries for collecting study material related to my course. I use to read books and journals for gaining knowledge and to write down my notes to use it for further preparation.
Pros:- By attending seminars for auditory learning will help me in updating my knowledge as these presentations are given by experienced persons which provide us practical example to clear our concepts. Another benefit is that we can memorise the concepts through reading books which we learned through lectures.
Cons:- Major drawback of reading & writing learning style is that books may not be of current edition which leads to explosion of information that is not valid currently (Oermann and et. al, 2016). Auditor explanations is not clear till we go through the visual example of it.
In order to move away from comfort zone, I required to develop the skill of critical thinking as for becoming a nurse it is very essential to be prepare for each situation and take correct decisions. So critical thinking will help in being adoptable to changes and also help them in judging the situation and take appropriate decision.
Library and searching database
While searching the database regarding my study I came to learn about various sources through which I can collect information to enhance my knowledge. These sources are books, journals, internet etc. Apart from this I also get to know that what methods should be opt for sorting the data according to our requirement (Parahoo, 2014). While searching and collecting this database I came up through various difficulties such as proper informations are not available in journals content present is just the abstract of whole topic. Another difficulty faced by me is that books that are available in library are not of latest edition. So in order to overcome these difficulties I decided to search the latest information and recent editions over internet. This help me up to a great extent in enhancing my knowledge and I have learnt various changes that are bring within the nursing practices by government. Apart from this I also get to learn about various other things which are not available in books and very essential for performing nurse practices.
Evidence based practice and different types of literature
Research refers to process of systematically investigating about a particular topic or problem in order to establish facts and bring out a conclusion. Resaerches are of two types which are as given below:
Qualitative research :- This research is generally conducted to gain knowledge about underlying reasons, motivations and opinion. It help in developing an idea or hypothesis for potential quantitative research
Quantitative research:- It refers to the structured way of gathering and analysing the data obtained from different sources (Polit, 2013). This data is collected by using statistical, computational and mathematical tool for deriving the result.
In order to conduct this research and collect information, there are two sources available that are explained below:
Primary data :- It refers to the information collected by a researcher which is fresh and is never collected by any other person before. It includes sources like survey, interview or experiment.
Secondary data :- It refers to the data which is previously being researched by some person and is now access to fulfil the information need of current research. Common source of collecting secondary data is libraries, internet search, journals, government public services etc.
From this research and literature review I find out about various growth opportunities for me in this field and various methods through which I can improve my skills as well as knowledge. I also learnt about various benefits which I will get while pursuing my course in the university (Ricci, 2013). Apart from this I also came to known about the practical lectures provided by universities that help me in clearing my concepts by visualizing them practically. In addition to this I also find out about various concepts that I must go through and learned about in order to bring efficiency in my work.
By using this literature I also came to know about the methods through which I can set my goals and objectives that further guide me to perform actions. It also help in deciding my action plan through which I can improve my skills and abilities for becoming a effective nurse.
Progress in developing referencing skills
The study material and other sources provided are prove to be very beneficial for me as it help in enhancing knowledge regarding my course and career. It help me identifying the various growth opportunities in nursing filed which I can opt for my further progress in this field. By using these sources I came to known about the changes that have taken place in this field. Further it also helps me to know about various course in this sector that I can opt for developing my career.
No as such there was no such major issue which arise in performing research. But at few points I feel that due to lack of resources I am not able to perform work in appropriate way (Yoder-Wise, 2014). There is less of time, so I am not able to collect proper and effective information. As I was working in team. My team was very effective and hard working, so positive outcomes can be gained. There is use of newspapers, books which is little tough task. Because there are some books which are not readily available. I am able to attain goals in appropriate manner.
As per above discussion, it is clear that in medical sector, ethics are most important component. I have learnt that being professional in medical line, humanity is one of the basis component. I have learnt that apart from, professional educational, morale of doctors has to be build. With this I am able to deal with client in more ethical manner. This helps me to deal with situation by balancing my professional and morale equally. In future I am able to perform operations my profession work with more deliberately and this helps me to enhance my knowledge in enhancing case. After this case whenever any similar incident happen, then primary treatment is given to patient before paper work. This helps a lot to save life of sufferer and this provides blessing from society. After from morale ethics, this is beneficial for brand image of hospital also. Reflection is important because it provides knowledge about current situation and it provides knowledge about personal experience of candidate also. This also provides good image in industry and I am able to pursue my clinical sector in efficient manner.
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