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NSG1204 Nursing Skills II Question: Aim: The aim of this assignment is for the student to demonstrate an ability to critically reflect on caring for an older person with impaired cognitive function for the purpose of evaluating personal performance and improving practice. Task: Reflective self-review of an experience, situation or performance allows for deeper learning and insight to improve professional practice (Dubé & Ducharme , 2014; Pearson, 2012) For this assessment item, you are required to write a reflective essay on an experience in caring for an older person with impaired cognitive function. You are to use the Gibbs (1988) model for reflection to address the following criteria: Address each of the following sections: Provide a succinct description of the situation, and in the context of nursing Identify and briefly discuss your thoughts and feelings Discuss what was positive and not so positive for you in the situation Present a succinct analysis of the situation – the deeper meaning or learning about yourself (values, ideals, beliefs about the situation) Discuss what could have done differently Identify actions you need to take to improve your performance Answer: Introduction  The nursing or healthcare services need proper education and training of the caregivers so that the caregivers can be able to provide effective care services to the patients. In this matter, various learning techniques are used and one of the most useful learning techniques is reflective learning technique. The reflection associated with the learning from own previous experience. It is very effective in learning as at the initial point we recall our previous experiences in a purposeful way and applying reflective procedures we can understand the incidences of our prior experiences more effectively. This helps us in taking proper action. The reflective writing is a part of reflective learning that helps in recording the learning experience from the previous experiences. This particular essay is on my own reflection of caring an older person with impaired cognitive function. For this reflection writing, I have used the Gibbs model of reflective writing (Carmen M, 2017).      Gibbs Reflective Model: Description  We face various types of situations throughout our nursing career, which provide us with effective knowledge and experiences. Furthermore, these experiences aid us in the similar types of situations in the future nursing career. Once, I had faced significant issues with one of my patient who was suffering from impaired cognitive functions.  The patient was a 72 years old male and had dementia and for this reason, he forgot the things frequently. In dementia, the patients are usually suffering from declining memory, along with their reasoning and communication power are also decreasing eventually.   The name of the patient was John Mathew. He was a 72 years old man and a retired teacher. He came to our healthcare unit for treatment of his injuries because he slipped at his bathroom and that cause injury in his hand and toes. I had taken care of him and washed his wounds and put a dressing on them. Afterward, I administrated some medications prescribed by the physician of the healthcare setting.  Mr. John was suffering from dementia and his mental and physical health had been worsening day by day. I noticed that he had communication difficulties and he even did not memorize his own name and he frequently ask me about myself and why he was brought to the healthcare unit (ENEH, VEHVILÄINEN-JULKUNEN & KVIST, 2012).        Feelings  For the first time, when he enquired about me and asked me why he was taken to the healthcare setting, it was my first experience with the dementia patient and I could not understand what was happening.  The patient did not remind the reason for his visit to the healthcare unit and asked what happened to him and how he got those injuries. He even did not recognize his daughter Emma Brown who took him to the healthcare setting (Trigg & Mohammed, 2014).  It was the very awkward situation for me as I could not understand what to do.  According to the nursing concept, it is normal that in the situation where the patient himself does not understand his problems and for the situation in which he has to admit in the healthcare setting, the nursing staffs initially feel embarrassed and uncomfortable.  Because that was my first encounter with the dementia patient I was also in a very uncomfortable situation (Fortinash & Holoday-Worret, 2012). Evaluation  It is common for the dementia patient that they frequently forget things and cannot perform effective reasoning or cannot communicate properly. Hence, the behavior of Mr. John was very normal for a dementia patient. Mr. John was unable to remember the incidents, which took places and involved him. He did not remember his name and did not recognize his own daughter (Ganzer, 2007). He was suffering from dementia and it was the critical phase of a dementia patient. Moreover, for me as a new nursing staff and new experience with the dementia patient was significantly different. I was very upset for myself as I could not perform my assignment properly or provide required care services to the patient. However, that was also normal as I was new in this type of situation. Before this particular incidence, I did not see any incident of this type. However, I was a little bit nervous initially but after some time I could be able to manage the situation. It was the positive side and a good indication of my bright future as a healthcare staff. However, I was very upset about my interaction with Mr. John as I was a little bit annoyed when I was conversing with him. Afterward, I felt that my behavior with a critical patient like him was not proper and I should have patience at the time of handling this type of situation in my nursing practice (Hallett & Brooks, 2017).        Analysis  The case of Mr. John Mathew had enriched me and given me valuable nursing experiences and afterward, that help me in my entire nursing career. Mr. John was a 72 years old male patient, who slipped and fell down at his bathroom and got several injuries. He came to the healthcare unit with his daughter Emma for the treatment of his injuries. I had given him care services like washing his wounds and then dressing the wounds properly.  Besides this, I administrated necessary medicines to the patient according to the prescription of the physician of the healthcare setting (Lachman, 2006).  According to the situation as a dementia patient, the behavior of Mr. John was justified as in dementia the patient use to forget the things easily and they even cannot perform any type of reasoning or cannot communicate with the others properly. Moreover, as that was my first nursing experience with a dementia patient, my ways of dealing with the nursing care issue related to dementia was not much improper. Moreover, afterward, I was good with the patient and did proper care for his physical and emotional health (Preedy, 2011). Conclusion The dementia is a special type of diseases in which the patient cannot remember the things and frequently forget the incidences that take place in their life. The patients are also facing problems in reasoning and communicating. In the case of Mr. John, the exact thing can be perceived. Mr. John frequently forgot the things. He even did not remember his own name and could not recognize his own daughter. It is normal for a human being that when they face these people, they have some issues. I was also in the same problem, while I provide care services to Mr. John as he could not recognize me and even could not remember the incident for which he came to the healthcare unit (Scholes, 2007). However, I had understood that the dementia patient suffers from serious memory loss and hence, they need special care. Moreover, the nursing staffs need to have patience and proper endurance in order to provide effective care services to the dementia patient.   I had to improve myself as a nursing staff and a human being to provide effective care services to the critical patient like John (Schultz & Videbeck, 2013).       Action Plan  My encounter with the dementia patient had given me adequate experiences and from this experience, I had planned my future actions on how to manage the issues of a patient with dementia. In dementia, the patient cannot remember the most recent incidences which happen to them.   Apart from this, in this disease, the patient cannot performing reasoning properly or cannot communicate with the people appropriately.  The communication difficulties and forgetfulness of the dementia patient often bring a range of behavioural issues to the caregivers like us (Shippee-Rice, Fetzer & Long, 2012). I have developed an effective action plan to short out the issues with the dementia patient and my action plan includes the development of patience and in order to provide care service to the dementia patient, I have to be patient and sympathetic to the dementia patient. It supports me in providing effective care to the dementia patient.  I have to tolerate the behavioral differences of the dementia patients and deliver proper care services to the patients who are suffering from dementia.   I have to prepare myself for the dementia patient and should prepare a plan for providing care services to the patient like John who is suffering from acute dementia.  Moreover, with proper empathy and planned care, I can be able to provide effective care services to the dementia patient (Soffer, 2014). Conclusion  The dementia patients are usually suffering from acute memory loss and the patient should care with patience and sympathy.  Besides this, from the case of John, it is come out that these patients are inefficient to perform effective reasoning and they have communication problems. The nursing or healthcare providers like me have to be prepared to provide care services to the patient with dementia. We should have adequate sympathy for these dementia patients and should handle the patients carefully with patience.  The reflection of Mr. John case helps in recalling me the situations when I have encountered a dementia patient (Tabloski, 2010). The reflective learning techniques support me in educating myself with my own previous nursing experiences. References Carmen M, S. (2017). The Person Centered Care in Dementia. Advanced Practices In Nursing, 02(01). doi: 10.4172/2573-0347.1000130 ENEH, V., VEHVILÄINEN-JULKUNEN, K., & KVIST, T. (2012). Nursing leadership practices as perceived by Finnish nursing staff: high ethics, less feedback and rewards. Journal Of Nursing Management, 20(2), 159-169. doi: 10.1111/j.1365-2834.2011.01373.x Fortinash, K., & Holoday-Worret, P. (2012). Psychiatric mental health nursing. St. Louis, MO: Elsevier Mosby. Ganzer, C. (2007). Assessing Alzheimer’s Disease and Dementia: Best Practices in Nursing Care. Geriatric Nursing, 28(6), 358-365. doi: 10.1016/j.gerinurse.2007.10.008 Hallett, C., & Brooks, J. (2017). One hundred years of wartime nursing practices, 1854-1953. Baltimore, Maryland: Project Muse. Lachman, V. (2006). Applied ethics in nursing. New York: Springer Pub. Co. Preedy, V. (2011). Diet and nutrition in palliative care. Boca Raton, FL: CRC Press. Scholes, J. (2007). Clinical Nursing Practices – Fifth EditionClinical Nursing Practices – Fifth Edition. Nursing Standard, 21(45), 31-31. doi: 10.7748/ns2007. Schultz, J., & Videbeck, S. (2013). Lippincott’s manual of psychiatric nursing care plans. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health. Shippee-Rice, R., Fetzer, S., & Long, J. (2012). Gerioperative nursing care. New York: Springer. Soffer, A. (2014). Tracing detached and attached care practices in nursing education. Nursing Philosophy, 15(3), 201-210. doi: 10.1111/nup.12052 Tabloski, P. (2010). Gerontological nursing. Upper Saddle River, N.J.: Pearson. Trigg, E., & Mohammed, T. (2014). Practices in Children’s Nursing. London: Elsevier Health Sciences UK.

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