Development of Competent Nursing Skills

Development of Competent Nursing Skills Introduction This essay focuses on a reflection on the development from novice, to competent beginner, to skilled practitioner in the light of my own development in clinical nursing practice. It is based on the signposts identified within my clinical learning portfolio and focuses on the notion of the helping role and caring skills within nursing practice. It utilises a reflective framework to better identify and reflect upon the journey from novice to practitioner. The model for reflection I have chosen is Gibbs Reflective Cycle (see Appendix). Reflection has been described as as a process of internally examining and exploring an issue of concern, triggered by an experience which creates and clarifies meaning in terms of self, and which results in a changed conceptual perspective (Boyd and Fales, 1983). Therefore, the experiences of my three placements are explored under three rotations of Gibbs Cycle. Meretoja et al (2004) state that nurses self-recognition of own level of competence is essential in maintaining high standards of care. I have chosen the caring role based on my own recognition of the level of competence achieved in this area. Cycle One Novice to Advanced beginner What Happened. I had to assist a patient in with personal care; make them comfortable in bed and collaborate in pressure area management; assist with toileting, washing, mouthcare, and application of emollient cream. I also had to document care and any deviations from the norm. Feelings I was very aware of my inexperience and of the trust this patient placed in my and the nursing team. I was also aware of the intimate nature of the care I was providing, and the fact that it was basic care also highlighted the fundamental role such care has in supporting health promotion and patient wellbeing. Evaluation I was uncomfortable at first, and clumsy in the provision of the various aspects of care. However, my mentor was informative, supportive and helpful, which assisted me in doing the various tasks. However, I found it difficult to complete these as quickly as I should have. I did learn to communicate with the patient and provide a sensitive approach. Analysis This situation required fundamental aspects of the caring role. It also demonstrates the link between basic nursing care an every other aspect of nursing. The NMC (2004) requires nurses to provide individualised care for their patients. The care for this person was based on their own needs and adapted as those needs changed. I was able to identify those needs and develop competency in providing care at this level. The caring role was very rewarding but physically and emotionally taxing However, I was still in the process of identifying particular needs and responding to them, such as toileting, which required me working with others in a collaborative manner, which I did not find easy. I also realised how much I did not know about nursing. Conclusion In this situation, I could have developed more collaborative working skills and modelled myself on those around me more actively ie., copied the ways in which other nurses and healthcare assistants provided care. When I did do this, it was effective. But I found that despite my enthusiastic approach, my knowledge base meant that I did not always understand the rationale for what I was doing. Action Plan The action plan from this was to take the confidence and competence I had developed in the practical skills and incorporate them into all aspects of the caring role. It was also to identify areas where my knowledge base was lacking, and seek out this knowledge. Keeping knowledge up to date is a requirement of the NMC code of condut (NMC, 2004). Working collaboratively is another NMC requirement (NMC, 2004). Taking this knowledge forward into practice made this process of reflection a learning activity. Cycle Two Advanced Beginner What Happened As part of my role assisting with patient care, I had to monitor pain levels and assist with providing analgesia as prescribed, along with monitoring its effectiveness. This was a surgical placement, and I also discussed with elderly patient their coping and wellbeing after hospital discharge. I engaged in health education and support to enable clients to be self-caring. I was also responsible for monitoring wellbeing through performing and recording clinical observations, recording fluid balance and reporting any abnormalities. I was also involved in providing personal care to patients in a safe manner, especially in the disposal of waste products. Feelings To begin with, I felt glad to be working at a more advanced level of competency, and felt confident in my basic nursing skills including performing clinical observations. However, the increased demand also meant increased pressure and I was aware of this. Again, I felt that I had developed a degree of competency but was very aware of my need to develop further knowledge and skills. The caring role involved supporting people and I had to access other professionals to ensure I gave the right information and that my care had been effective. Evaluation It was good to find that I had the clinical competence to effectively monitor clinical status. However, the complex nature of patient needs meant that I still didn’t always know the answers to their questions. Being involved in discharge planning was an enabling activity for myself and the patients. I developed competence in the administration of medications, under supervision, including controlled drugs, but felt I still needed more practice and skill in this area. Colleagues noted my competence and qualified staff were happy to delegate a range of appropriate tasks to me. Analysis It would appear that the caring role means the provision of patient centred, holistic care. This was achievable in this situation but required a lot of knowledge and the ability to provide focused attention and empathic care whilst carrying out complex clinical nursing tasks. This was harder to achieve, and I was made aware of my continued learning needs around medication and surgical care, for example. However, I must have developed some competence as qualified staff were happy to delegate to me and to act on my feedback. Conclusion It is hard to see what else I could have done, except perhaps done more reading around surgical care, discharge planning and the nurse-patient relationship. Action Plan It was possible to identify future learning needs, and so my action plan included building on my current competence by engaging in more advanced practice, under supervision. Having the confidence to engage in more complex nursing tasks will help me to achieve more competence in advanced practice in the future. Recognising the demands of the caring role means that I will view future practice as based upon this role. Cycle Three Competent Level What Happened. I monitored patients with chronic pain and helped with analgesia. I also supported patients with freedom of choice for their own care (NMC, 2004) and provided personal and palliative care in sensitive manner. I mastered more advanced practical nursing skills including aseptic technique and safe disposal of sharps. I fully documented all care given, and recorded medication given, and communicated to staff at shift change during the nursing handover. Feelings During this experience, I felt that my knowledge and experience in the caring role was finally coming together. I was confident and happy in engaging with patients and providing empathy and a supportive manner, whilst also carrying out more complex clinical tasks appropriately and effectively. It was very nerve-wracking giving handover, but I became more confident as I had more practice. Evaluation I was able to provide care of a high standard, and recognise my sphere of competence and seek help when needed. I was able to engage in effective caring relationships with clients, meet their individual needs, but also value my own input into their wellbeing. Analysis It was obvious that I had moved on to a level of nursing competence which allowed me some autonomy. I was able to act with less direct supervision, but still access the support of the whole care team. The caring role extended to the provision of all care, including end of life care, and I was able to utilise my knowledge and experience and also identify my learning in action, and my future learning needs, which have changed since the first reflection. Conclusion The change from novice to competent practitioner in the caring role has demonstrated not only the acquisition of skill but the incorporation of clinical abilities into what is really a way of being with patients. Action Plan Signposting future learning needs is important following this reflection. I was able to identify the need to still learn advanced clinical skills and perhaps know more about the range of other professionals who could enhance care in individual situations. Conclusion This reflection has signposted my development towards competent nursing practice. The caring role encompasses provision of basic care, advanced techniques, medication and pain relief, health promotion, end of life care and collaborative care. It seems to be the fundamental and most important part of nursing practice. Collaboration and coordination, as well as the holistic management of the situation, are highly recognized as meaningful characteristics of competent nursing practice (Meretoja et al, 2002). References Boyd E, Fales A. (1983) Reflecting learning: key to learning from experience. Humanist Psychol 23 (2) 99–117. Gibbs, G. (1988) Learning by Doing. A Guide to Teaching and Learning Methods Further Education Unit, Oxford Polytechnic, Oxford Meretoja, R., Leino-Kilpi, H. Kair, A. (2004) Comparison of nurse competence in different hospital work environments Journal of NursingManagement.12(5) 329–336 Meretoja, R., Eriksson, E. Leino-Kilpi, H. (2002) Indicators for competent nursing practice Journal of Nursing Management 10(2) 95-102 Nursing and Midwifery Council (2004) Code of Conduct Available from www.nmc-uk.org Accessed 30-4-07.

Credit Cards

PUBLIC SPEAKING Topic: The using credit card General purpose: To Persuade. Specific purpose: To persuade my audience about the using credit card Central idea : To persuade my audience about the benefits The benefits of using credit card Introduction: American Express, MasterCard and Visa Card are the more popular credit cards in Malaysia. With a credit card in hand, you can make purchases today and pay later, Body: 1) It makes shopping easy – Confidently walk into a shop and buy without having to first look into your wallet 2) Without having to carry loads of cash credit cards provide you the ease of dining at a restaurant without worrying whether you have the money in your wallet to pay for the food 3) All petrol stations nationwide accept credit cards – Making it easy for motorists to stop and fill up their tanks without worrying about having enough cash. 4) Taking a vacation out of town or even overseas can be easily and quickly. – Bookings and payments for tr avel and accommodation can be made via the phone or fax by just quoting your credit card number. Conclusion:Using credit cards also contributes toward the economy as a whole. At the same time, as long as consumer spending takes place, the government is also able to collect revenue in the form of taxes. Therefore, there is no doubt whatsoever that using credit cards has many advantages. BIBLIOGRAPHY American Express, MasterCard and Visa Card are the more popular credit cards in Malaysia. Many Malaysians today carry at least one such card especially since eligibility for such a credit card is a salary as low as RM20 000 per annum.With a credit card in hand, you can make purchases today and pay later, either in full or partially. This is only one of the many advantages and benefits of using a credit card. One of the greatest benefits of using a credit card is the fact that it makes shopping easy. Whether it is a pre-planned shopping trip or a ‘on the spur of the moment’ de cision to purchases an item that has caught your attention, you can confidently walk into a shop and buy without having to first look into your wallet to check if you have enough cash.You also do not have to walk to the automated teller machine to make a withdrawal to pay for your purchase. Besides the convenience of shopping without having to carry loads of cash, credit cards provide you the ease of dining at a restaurant without worrying whether you have the money in your wallet to pay for the food. Can you imagine, you do not even have to scrutinize the price of the dish on the menu and at the same time try to call to mind how much cash you have at hand. All you have to do is just order, eat and sign the receipt. You will be billed later.Today, almost all petrol stations nationwide accept credit cards, thus making it easy for motorists to stop and fill up their tanks without worrying about having enough cash. This not only gives motorist peace of mind when leaving home or driving long distance, but it also gives them a sense of security that they will not lose too much cash in the event of a robbery. Taking a vacation out of town or even overseas can be easily and quickly finalized as long as you have a credit card. All the necessary bookings and payments for travel and accommodation can be made via the phone or fax by just quoting your credit card number.So you can enjoy your vacation without having to worry about to carry so much cash on you. Besides that, using credit cards also contributes toward the economy as a whole. As long as people make purchases as often as they can afford it, there will be a healthy cash flow, constantly generating income for everyone in the retail, food and hospitality sectors. At the same time, as long as consumer spending takes place, the government is also able to collect revenue in the form of taxes. Therefore, there is no doubt whatsoever that using credit cards has many advantages.

Emily Grierson a Woman Gone Mad for Love - 949 Words

Jessica Murdock January 2, 2007 Emily Grierson: A Woman Gone Mad For Love To be able to choose your own partner in life is such an important issue for all of us. How can choosing a spouse for someone be a healthy situation for the people involved? When treated like a child, with no mind to think and act for ourselves, it is inevitable that one would go completely mad. In this fantastic story A Rose for Emily written by William Faulkner, the upscale, well-to-do, Prima Donna protagonist, Miss Emily Grierson is imprisoned by her antagonist father who shields her from the world of innocent activities that young ladies and gentleman get to partake in as they journey to find their soul mates. Well into her 30 s Emily s†¦show more content†¦Emily s father was set in his old fashion and overbearing ways unwilling to let her love and be loved was the reason why, she went crazy. To feel that special emotion between a man and a woman was what Emily longed for. We have to learn that we are in charge of our lives and the option to choose who we fall in l ove with can effect us forever. Emily, after all of her formative years of being held captive by her father, was driven to the point of murder when she found out the man she loved, didn t love her back and he would eventually leave her just like her father had left her when he diedÂ…humiliated, empty, sad and alone forever. Bibliography: X.J. Kennedy, Dana Gioia, An Introduction to Fiction, Ninth Edition William Faulkner: A Rose for Emily, copyright 1930 and renewed 1958 by William Faulkner. Story reprinted from Collected Stories of William Faulkner by William Faulkner. Used by permission of Random House,Show MoreRelatedEssay about A Rose For Emily1284 Words   |  6 PagesRose for Emilyquot; tells the story of a young woman who is violated by her fathers strict mentality. After being the only man in her life Emilys father dies and she finds it hard to let go. Emily was raised in the ante-bellum period before the Civil War. This story takes place in the Reconstruction Era after the war when the North takes control of the South. Like her father, Miss Emily possesses a stubborn outlook towards life and refuses to change. This short story explains Emily, her mystifiedRead MoreA Rose for Emily - Biography William Faulkner3892 Words   |  16 PagesAmerican writers of all time.[1] PLOT SUMMARY â€Å"A Rose for Emily† is divided into five sections. The first section opens with a description of the Grierson house in Jefferson. The narrator mentions that over the past 25 years, Miss Emily Grierson’s home has fallen into disrepair and become â€Å"an eyesore among eyesores.† The first sentence of the story sets the tone of how the citizens of Jefferson felt about Emily: â€Å"When Miss Emily Grierson died, our whole town went to the funeral: the men throughRead MoreThe Yellow Wallpaper3202 Words   |  13 Pagesfrom her husband’s way of treatment. â€Å"A Rose for Emily† by William Faulkner also portrays the outsider theme statues. Emily Grierson, the main protagonist, is a woman whom is isolated and slowly gone insane after her father’s death. The community of the town knows very little of Emily but only watches her from a distance and hear rumors about her. Emily has not been paying her taxes like the rest of the community because she is supposedly a woman of aristocracy, her family held h er in high regardsRead MoreAnalysis Of The Poem The Roses By William Faulkner2072 Words   |  9 PagesSave The Roses In the short story â€Å"A Rose for Emily†, William Faulkner uses the rose as a symbol for Emily and how she lived her life. Like humans, roses live a beautiful life and then die when it s their time. While people like to save roses because they possess sentimental value, Mrs. Emily tried to save her loved ones who passed away. Some thought maybe she was just a woman you ‘would’ give a rose. Which ever reason, the way Mrs. Emily was raised gives reason for her weird and sickening actionsRead MoreA Rose For Emily And The Tell Tale Heart By Edgar Allan Poe2155 Words   |  9 Pagesâ€Å"A Rose for Emily†, and it represents the purpose of writing â€Å"A Rose for Emily†. His story, â€Å"A Rose for Emily† and â€Å"The Tell-Tale Heart† by Edgar Allan Poe both tell stories of murders, either about the murderer, or from the murderer’s point of view. â€Å"A Rose for Emily† tells the story of Miss Emily Grierson, an elderly w oman that has recently passed away. She was rarely seen, but was with a man named Homer Barron a few years before her death. The town assumed Homer would marry Emily, but he suddenly

Main Peculiarities of Patient Care Free Essay Example, 1000 words

Teaching the family the process of monitoring the vital signs of a patient is quite important. The main teaching that a family should be given is how to manage pain while at the same time making the patient comfortable (Angelos, 2007). Moreover, family patients need to be taught on the 5R s of pain management and care. These skills are necessary for relating with medical practitioners in challenging situations like the one experienced by Mrs. H. The family should also be aware of ways of taking care of a cancer patient (Pierson, 2009). Mrs. H. suffered a lot of pains that had different underlying causes which made her suffer and finally leading to her death. For instance, her lack of bowel movement is contributed by dehydration which makes it difficult for digestion to occur in the body. Furthermore, the dehydration led to lack of colour in her skin due to lack of waste excretion from the body. The kidney cannot work properly when the body is dehydrated and this leads to higher le vels of impurities in the blood. As a result, the body experiences high blood pressure that was exhibited by Mrs. We will write a custom essay sample on Main Peculiarities of Patient Care or any topic specifically for you Only $17.96 $11.86/page