Reflective Analysis AssignmentEdgar Ian Jaime300949599Centennial CollegeNoureen JiwaniMarch 9th, 2019Look BackIn week 5, I was assigned to provide care for a client who was admitted to unit for renal failure. Whenever I am in clinical, I would always start off my shift by assessing vital signs, doing a full head to toe assessment on the client, and document all of findings into the client’s chart. However, during the shift I was approached by two of my peers to assist them with their clients for procedures such as morning care. As a result of my actions, I failed to provide client-centred care for my assigned client, as well as I failed to make this client my number one priority, thus affecting the nurse-client relationship. Because of this, I faced extreme criticism from my clinical instructor concerning my actions on that day. This is an event that I want to reflect on in this reflective analysis.ElaborateIn week 5, I was assigned to provide care for a client who was admitted for renal failure. Although this was my fourth shift in clinical, I was still in the process of transitioning from a long-term environment to an actual clinical setting. As always, when starting to provide care I would assess my client’s vital signs, perform a full head to toe assessment, and document my findings in the client’s chart. While I was performing my head to toe assessment, my client had a BM. Because of this I had to reach out to a peer to assist me in cleaning the client. After cleaning the client, I had resumed my head to toe assessment. Unfortunately, this would be the last time that I would check on my client. Throughout the entire duration of the shift, I was approached by two of my peers. They proceeded to ask me if I could provide assistance for task such as morning care. I agreed to help out my peers. However, because I was extremely busy with helping out my peers, I failed to check on my client, as well as perform the necessary task that I needed to do with my client. These tasks include morning care, reposition the client every two hours since they had a stage 2 pressure ulcer on their sacral area, and provide proper wound care for the client. Towards the end of my shift, I was approached by my instructor in regards to my client. My clinical instructor approached me saying that the client’s family member brought up concerns saying that the client hasn’t been provided any care since the morning, nor has the client been repositioned lately. When my clinical instructor asked me if care was provided for this client, I replied yes, however when both my instructor and I checked on the client, we came to find that the clients diaper was full of feces. As a result of my failure to make my client my number one priority, I received extreme criticism from my clinical instructor and was immediately put on a performance improvement plan at the end of the shift. The feedback that I received from my instructor made me feel very disappointed and ashamed in myself because I had failed to provide client-centred care. In addition, I failed to perform such simple task with my client which at the end affected the nurse-client relationship. In addition, this situation made me feel very incompetent as a practical nursing student.AnalysisThe primary issue here is that I failed to make this client my number one priority. I failed to provide client-centred care for my client, and as a result this affected the nurse-client relationship. Throughout the entire duration of the shift, I didn’t give myself any opportunities or time to perform the necessary task that I needed to do with my client. Instead, I was focussed on helping others with their client’s and getting their task done instead of primarily focussing on the client that was under my care and completing the task that I needed to do. Truthfully, I was not very particular nor close with the people in my clinical group and I had the mindset that if I would say no then they would do that same if I would ask for their assistance. According to Epstein (2011), “Patient-centred care is a quality of personal, professional, and organizational relationships. Thus, efforts to promote patient-centred care should consider patient-centredness of patients, clinicians, and health systems”. Therefore, promoting this type of care will help to achieve the optimal health outcomes, and strengthening the relationship between the nurse and the client, as well as the client’s family members. As a nursing student, it is extremely important that I not only promote, but provide client-centred care for the clients that I will be taking care of since this is part of my practice both as a student and a future nurse. According to the CNO Professional Standard: Therapeutic Nurse-Client Relationship, the nurse must be “committed to being available to the client during the entire duration of care” (p. 6). In relation to not providing proper client-centred care, this greatly affected the relationship between myself, the client, and the client’s family member. According to the CNO Professional Standard: Relationships, “The client’s needs are the focus of the relationship which is based on trust, respect, intimacy, and the appropriate use of power. Nurses demonstrate empathy and caring in all relationships with client’s, families, and significant others” (p. 11). In addition to this, having a positive nurse-client relationship “develops trust and acceptance between the nurse and the client and an underlying belief that the nurse cares about and wants to help the client” (Kozier et al, 2014, p. 438). Because I was caught up with helping out my peers with their clients instead of being there for my own, this negatively affected the relationship between the client and I. And as a result of my negligence, the client’s family member no longer trusts nursing students to take care of that client, and as a result of that breach of trust I take full accountability. I need to thoroughly review these standards not only to refresh my knowledge and understanding, but to also improve my practice as a nursing student and provide the best amount of care for the clients that are under my care and supervision. RevisionAs a nursing student, it is important that I am aware of the task that I am responsible for in the clinical setting. In addition, whenever I am assigned to a client, I need to make sure that I am providing the best amount of care for that client in order to maintain that sense of trust between the nurse and the client. It is unacceptable and unethical for a nurse to neglect the needs of their client’s and primarily focus on the needs of other client’s who are not under their care. Lacking these values and the knowledge relating to client-centred care can truly affect the nurse-client relationship. That is why I will take certain measures to improve my practice. In the future, I will develop an agenda that outlines what I plan to do throughout the shift along with certain timelines that includes the activities that I want to complete with that timeline. These activities include documentation, head to toe assessment, medication administration, wound care, etc. I will take full accountability of my actions during my shift, assure that I will not commit the same error of being neglectful towards my client, and assure that my assigned client will always be my number one priority. In addition, I will create a routine to reassess my client every 30 to 45 minutes. Reassessing my client will help to promote optimal health outcomes, promote client-centred care, and strengthen the nurse-client relationship. Lastly, I will go through the CNO Professional Standards which will serve as a guide in my nursing practice. I will thoroughly go through each standard in order to refresh my knowledge concerning what the nurse must demonstrate through those standards. Refreshing my knowledge on the professional standards can furthermore improve my practice as a nursing student, but as a future nurse as well. New Perspective Through this reflective analysis I have concluded that providing client-centred care is extremely one of the most important factors of being a nurse. The biggest mistake that I can do as a nurse can is be neglectful towards my clients and no excuse that I can offer will explain the reason why that client was ignored during the entire duration of care. Through this experience and intense reflection, I had come to realise how extremely important priority is in the health care setting. It is important that as a nursing student, I continue to provide and promote client-centred care during the duration of the client’s time in the clinical setting. This experience serves as a wake-up call for me, not only as a nursing student but most importantly as a future nurse, most especially since I will soon be placed into the field on my own, and will be providing care for more than one client. In addition, I will continue to use whatever resources are available to furthermore refresh my knowledge and understanding concerning the importance of providing and promoting client-centred care in the clinical setting. References CNO Practice Standard: Therapeutic Nurse-Client Relationship, Revised 2006. (2018). Retrieved March 09, 2019, from http://www.cno.org/globalassets/docs/prac/41033_therapeutic.pdfCNO Professional Standards, Revised 2002. (2018). Retrieved March 09, 2019, from http://www.cno.org/globalassets/docs/prac/41006_profstds.pdfEpstein, R. M., & Street, R. L. (2011). The values and value of patient-centered care. Annals of family medicine, 9(2), 100-3.Kozier, B., Erb, G., Berman, A., Snyder, S.J., Buck, M., Yiu, L., & Stamier, L.L. (2014). Fundamentals of Canadian nursing: Concepts, process, and practice (3rd ed.). Upper Saddle River, N.J.: Pearson Education, Inc.
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