Interim reflection

Table of Contents

Interim reflectionThe main purpose of this reflective essay is to reflect on a challenging situation that I have experienced during my clinical placement as a student nurse. In this reflection, I will be following the Gibbs reflective cycle (1988).DescriptionIn the clinical practice, nurses may face various ethical issues and challenges; but a nurse can avoid ethical dilemma by making correct decision underpinned by ethical principles and theories (Johnstone, 2016). My first year (NUR125) clinical placement was allocated at Southern Cross Care (SCC) Pearl supported care in DINAH (dementia) ward. I still remember the incident that happened during my second week of clinical placement. I was assigned to look after 72 years old Mrs. June (name changed for patient privacy and confidentiality) with diagnosis of vascular dementia and diabetes mellitus under the supervision of my preceptor. According to her care plan, wound dressing should be attended by doctor on her left lower leg (diabetic foot ulcer) once daily. After completing doctor round, under the supervision of my preceptor, I cleaned the trolley and made everything ready for dressing. Whilst, my preceptor had to attend a staff meeting so she suggested me to observe the dressing procedure and assist the doctor. The doctor had already maintained hand hygiene and opened the dressing set for wound cleaning. But suddenly, he got a phone call from his private hospital to attend the emergency surgery. He hangs up the phone and start performing procedure without maintaining hand hygiene or alcohol rub. In that situation, I thought to speak up but it was too late because he had already started the procedure.FeelingDuring that situation, I felt very bad because as being a student nurse, I could not advocate on behalf of the patient and could not maintain the patient’s safety. However, nursing code of ethics (value statement 1) states that nurses’ value quality nursing care for all people to ensure patient’s safety and wellbeing (NMBA, 2018). While in that situation, I was afraid to talk with the doctor about the hand hygiene and aseptic techniques because he was the senior doctor and also I thought that he is more experienced than me. But, this incident bothers me a lot during my whole shift, so I develop the courage to discuss the incident with my preceptor. She suggested me that as being a nurse we should make quick ethical decision based on evidence-based practice if we are in an ethical dilemma because our ultimate goal is to safeguard wellbeing of the patient. She also told me that we must talk with doctor about the incident when he comes to visit the patient. Finally, my preceptor got chance to discuss about the incident with the doctor and he accepted his mistake and told that he was in rush so he did not realized about the hand hygiene.EvaluationThe situation was very challenging for me and I also feel guilty that I could not make quick decision to maintain patient’s safety and security. But I have also learned many things from this incident such as advocating on behalf of client if someone follow the unethical behaviour as well as I learned about the importance of code of ethics in nursing practice. Furthermore, I am also pleased that the doctor takes the feedback in a positive way and it seems that he is now more alert about hand hygiene and aseptic techniques.AnalysisFrom the given scenario, it can be analyzed that nurse should make quick ethical judgment when they are in ethical dilemma (Johnstone, 2016). It is also very important to advocate on behalf of patient if some other health professionals follow the unethical practice to promote the health and wellbeing of patient. Thus, I develop the courage to discuss the issues with the preceptor and doctor which could be beneficial in future to avoid the same error. Therefore, I also get to learn from this incident that hand hygiene is the very important in health profession because it helps to prevent the cross infection and promote the patient’s safety and wellbeing (Mclaws, 2015).ConclusionIn conclusion, ethics is very important in nursing practice because it provides proper guidance to conduct right practices. Every nurse faced different ethical issues and challenges but nurse should think critically and applied ethical principles and guidelines to provide effective nursing care to the patient. Therefore, from this incident, I learned that being a nurse, I should develop ability to make quick decision to maintain patient’s safety. My preceptor also suggested me that I need to develop the courage to challenge the practice of other co-workers realizing the wellbeing of patients at the forefront of my mind.Action planIn my next placement, I will aim to develop assertive skills when working with other team members and make ensure that the patient wellbeing is maintained. This experience made me promise to myself that I would never hesitate to advocate on behalf of patient if someone is following the unethical behaviors.ReferencesJohnstone, M. (2016). Key milestones in the operationalisation of professional nursing ethics in Australia: A brief historical overview. Australian Journal of Advanced Nursing, 33(4), 35-45. Retrieved from, M. (2015). The relationship between hand hygiene and health care-associated infection: It’s complicated. Infection and Drug Resistance, 8(12), 7-18. doi: 10.2147/IDR.S62704Nursing and Midwifery Board of Australia. (2018). Code of Ethics for Nurses in Australia. Retrieved from