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Moral ethical dilemmas in the medical field
Moral ethical dilemmas in the medical field
Moral ethical dilemmas in the medical field
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Introduction
The objective of this paper is to contribute a critical reflection of an event that happened in a nursing background. The Gibbs Cycle is the most famous reflective cycles developed in 1988 (Howatson-Jones, 2016), which it will benefit on me to learn on the events, to support it further, empower a set of action plan and determined objectives relating to the events. Gibbs cycle will be used as the skeleton for this critical reflective assignment. The framework of the paper provides a description of the problem, feeling on the problem, an evaluation, analysis, conclusion and an action plan.
Description
The event was taken place during my nursing experience. I was a new fresh graduated nurse and was assigned to Medical and Surgical
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Many studied have reported that there is high recurrent of self extubation happened in the care of nurses with less working experience compared with nurses with more than 4 years nursing experience (King & Elliott, 2012). After seeking help from a mentor, there was a lot of valuable information that I need to learn.
Evaluation
Nevertheless, nurses must always be prepared for surprises and departures from the norm. In this experience, there was both a negative and positive experience. The negative experience arises is I faced moral distress and nervous in nursing intubated patients. There was some suggestion stated that one of the contributing factors of nurses to have moral distress when they have had a lack of experience (Burston & Tuckett, 2013).
However, the positive experience that I will able to learn from a new experience and meet new challenges in my nursing reality. Nevertheless, the mentor had explained that there were some of intervention that could have been taken before the incident happen. I could have a proper communication skill when interacting with an intubated patient and getting a preceptor, nurse manager or clinician support and supervision in the clinical
I was then introduced to a patient who was in isolation. Her legs were immovable and were crossed in a very uncomfortable position. I wish I could’ve done something so that her legs could be in a more comfortable position, but all I could do was observe and get her a cup of ice cold water to drink. During this clinical observation, I didn’t get to see much but overall, it was a good experience. It made me realize what it was like to be in a hospital setting and what it meant to be a nurse. Seeing how the patients were still able to smile through all the pain they went through, it made me want to become a nurse even more because I would also like to make my patients happy. If I could do one thing differently during this clinical observation, I wish I didn’t ask my senior nurse about what externships she took and instead, I wished I asked her more questions about the patients in order to gain more information about
Newly graduated nurses lack clinical skills necessary to evolve professionally and carefully from academics to bedside practice (Kim, Lee, Eudey, Lounsbury & Wede, 2015). How scary is that not only for the patient but also for the new nurse himself or herself? While being faced with new challenges, an increasing amount of newly graduated RNs felt overcome and unqualified. Twibell and Pierre explain how new nurses express “disillusionment” about practice, scheduling, and being rewarded. Frustration and anger between employees play a huge part in NGNs resigning because of the lack of experience and knowledge of what to do in high stress situations (2012). Nursing residency programs have proven to directly improve patient care, develop critical
In less stressful environment, nurses able to incorporate caring relationship, improve interactions between patient and a nurse, and develop understanding of the other person’s perspective (Nicely, K, Sloane, D., Aiden, L., 2012).
The purpose of this essay is to reflect and critically study an incident from a clinical setting whilst using a model of reflection. This will allow me to analyse and make sense of the incident and draw conclusions relating to personal learning outcomes. The significance of critical analysis and critical incidents will briefly be discussed followed by the process of reflection using the chosen model. The incident will then be described and analysed and the people involved introduced. (The names of the people involved have been changed to protect their privacy) and then I will examine issues raised in light of the recent literature relating to the incident. My essay will include a discussion of communication, interpersonal skills used in the incident, and finally evidence based practice. I will conclude with explaining what I have learned from the experience and how it will change my future actions.
The nursing theories that are currently in place in the emergency room to promote professional growth and development are vital; however, there are other nursing theories that could be implemented to help improve professional growth and development. A theory that should be implemented to more effectively promote professional growth and development is Orem’s theory of self-care deficit. Orem’s theory is considered a “realistic reflection on nursing practice” (McEwen & Wills, 2014, p. 146). If the nurse is not taking care of him or herself, “stress [can] accumulate [and the] nurse can … become angry, exhausted, depressed, and sleepless” (Ruff & Hoffman, 2016, p. 8). By the nurse having these feelings he or she is not able to take care of him
"Philosophy is an attitude towards life that evolves from each nurses’ beliefs" (Parker, 2001). It is the philosophy that underlies our practice what brings to life our desire to be nurses. Philosophy is essential because it is the natural extension of our interest in knowing the truth (Parker, 2001). A metaparadigm is the widest perspective of the discipline and a way to describe the concepts that concern the profession of nursing (McEwen & Wills, 2014). In this paper, my philosophy of nursing will be discussed through reflection on the four nursing metaparadigm concepts to determine if anything should be added or taken out.
Around the 1960s, nursing educational leaders wanted to formulate a nursing theory that contained knowledge and basic principles to guide future nurses’ in their practice (Thorne, 2010, p.64). Thus, Jacqueline Fawcett introduced the metaparadigm of nursing. Metaparadigm “identifies the concepts central to the discipline without relating them to the assumptions of a particular world view” (MacIntyre & Mcdonald, 2014). Fawcett’s metaparadigm of nursing included concepts of person, environment, health, and nursing that were interrelated. The metaparadigm ultimately contributed to conceptual framework to guide nurses to perform critical thinking and the nursing process in everyday experiences in clinical settings.
Clinical confidence, and independence are two components of nursing practice such that cannot be perfected through classroom education, self-study or by reading the evidence based literature. Throughout my nursing education, I have struggled with as many of clinical instructors have put it “being too hard on myself”. Morrell & Ridgway (2014) highlight how students’ perception of a lack of knowledge often contributes to ongoing anxiety. My tendency of being highly critical of my abilities, and having a consistent sense of anxiety associated with practicing independently has been an ongoing challenge for me. Reflecting upon how I have coped with the challenges of developing, and maintaining clinical confidence is
One of the theories of nursing is Dorothea Orem’s self-care theory, also called the self-care deficit theory. Nursing theories are important for several reasons. The profession is strengthened when knowledge is built on sound theory (Black, 2014). Theory is important for reasoning, thinking, decision-making, and supporting excellence in practice (Black, 2014). Dorothea Orem’s theory is a conceptual model that provides a structure for critical thinking in the nursing process (Black, 2014). A conceptual model provides a comprehensive and holistic perspective of nursing (Black, 2014). Orem published her theory in 1959 and continued to develop her model, eventually formalizing three interrelated theories: theory of self-care, theory of self-care deficit, and theory of nursing system (Black, 2014). The focus of Orem’s model is the patient’s self-care capacity. The process helps to design a nursing process specific to each patient that will provide for the self-care deficit of the patient (Black, 2014). Self-care deficits exist when the patient has limitations and the self-care requirement is greater than he patient’s capacity (Manzini & Simonetti, 2009).
Nursing is a medical profession that involves the care and management of patients majorly in the hospital setting. This paper seeks to illustrate the fact that nursing is both a science and an art. Nursing is a science because it involves evidence based practice, education of the public, lifelong learning for the nurse and administrative roles that are allocated to the nurses. Nursing is also an art because nurses depend on intuition, have the capacity to promote positive change, are understanding and culturally sensitive.
The ongoing education and training which supports the nursing as a profession must be maintained. The self-concept of nurses is enormously important in maintaining a professional identity.
Before my shift started, I did my research about my new client for week three clinical. I thought I was well prepared for the clinical, I knew the client’s mental and medical conditions but I was more focused on the client’s mental health issues and not the medical illnesses. When the nurse informed me that client W was experiencing shortness of breath due to his COPD, I was a bit shock because I was not expecting that to happen.
My first patient that I started as student nurse on one of the long Rehab Center was a seventy two year old man who had Clostridium difficile (C.diff), Dementia, Hip replacement, and Obesity. Due to the above sickness he had many complications. I can still remember his face suffering from pain. Because of his lack of ambulation and incontinence, he had developed a very serious pressure ulcer under his sacral area. I went through to the room with my instructor and the instructor introduces me for the patient as his student nurse from Towson University and will taking care of him. However the patient was not happy and he becomes a challenging patient in my first experience day. But I may learned more from that challenging patient for my future experience.
After the handover, I was asked by my mentor to attend to a patient who is bed ridden to have her personal care done with the assistance of one of the health care assistant staff. The patient was recently admitted to the ward and she looks sc...
This reflective essay will discuss three skills that I have leant and developed during my placement. The three skills that I will be discussing in this essay are bed-bath, observing a corpse being prepared for mortuary and putting canulla and taking it out. These skills will be discussed in this essay using (Gibb’s, 1988) model. I have chosen to use Gibb’s model because I find this model easier to use and understand to guide me through my reflection process. Moreover, this model will be useful in breaking the new skills that I have developed into a way that I can understand. This model will also enable me to turn my experiences into knowledge that I can refer to in the future when facing same or similar situations. Gibbs model seems to be straightforward compared to the other model which is why I have also chosen it. To abide by the code of conduct of Nursing and Midwifery Council (NMC) names of the real patients in this essay have been changed to respect the confidentiality.