Reflective Essay using Driscore Model

REFLECTION USING DRISCOLL MODELNameInstitutionA REFLECTION USING DRISCOLL MODEL Introduction Reflection is a major component of transformation, used to promote personal growth and improve one’s skills and competence in the nursing field. The reflection practice helps nursing practitioners to explore their experiences and understand their clinical roles in their dairy nursing practices. Additionally reflection critically assesses our efforts and content to help in our career progression in providing relevant skills and technics to use as health care practitioners (Koshy et al., 2017). The essay reflects on a situation where i had an encounter with a mentally ill person in my line of duty, and expected to provide good care to him together with a team of other nurses.. The essay is based on driscoll’s model of reflection which will help us reflect on individual clinical performance. The reflection will be later used to make necessary adjustments for future nursing practice. The driscoll’s model helps us focus on the experiences we had by asking ourselves on what we did in a particular situation, how it was done, and lessons leant from the situation using what, so what and now that. Therefore these skills helps develop competence and in development of our career,Application of the modelWhat? During my placement, I worked in a team of four members where my main role was to attend to patients with mental disorders. Mental illness is a condition that is associated with change of ones thinking, behaviour and emotions caused by psychological factors. Mental illness needs a lot of attention, comprehensive and integrated mental health in order to improve the situation (Lake, 2017). Our team was called Psychiatric Union and we worked together in counseling the mentally challenged either by drug and substance abuse or psychosis disorders. It was during this time a patient by the name Mary was brought to emergency department complaining of chest pains, headache, haziness, feeling dizzy, nausea and dry mouth. After a close examination by the medical team, the said symptoms had no physical cause. It was then realized that Mary was prescribed anxiety disorder medication. Therefore Mary had to be referred to our team for mental assessment. My team leader advised me to go and introduce myself to the patient and inform her that we would attend to her in few hours’ time after she rests since having a good sleep is good for mental health and reduce anxiety (Scott, Webb & Rowse, 2017). As I approached the bed Mary was, I noticed that all the curtains were all pulled around the bed and she had started putting all the beddings on the floor and covering herself with the curtains. I greeted her and started introducing myself to her, explaining my role and the importance of health assessment to her. Before I could even finish my explanation, she quickly woke up from the bed and took a bottle of water besides her and attacked me. Fortunately I was quick and snatched it from her before she could hit me. She turned violent and started shouting go! Go! Go away. I don’t need your help. At this moment I did not know what to do as I was completely frozen by the situation. Mary situation became uncontrollable as she started shouting even more, and running around the room. I was totally confused and did not know what to do. According to Anthony, Oluyemi and Radiance (2018), there is high prevalence of fatal attacks from mentally ill patients to health care givers. This is because health care givers are not able to predict patients that cause harm or assault immediately or in which form the harm may occur. Hence it important nurses take precautions and keep a distance when handling mentally sick patients unless assured of the safety. By this I quickly walked away from Mary’s bed area and returned to the team leader to inform him of the happenings. My team leader advised that we should wait for Mary to calm down as medical practitioners were to work on her .Furthermore we had to request for Mary psychiatric records. After calming down my team leader who was also my mentor went back to see Mary. After an hour of a through talk with Mary, he came back and informed me that Mary was under a panic attack that’s why she had reacted that way. She shouted me to go as was very agitated and worried that she could not face a stranger. Agitation is a common problem to people experiencing Schizophrenia, dementia and bipolar disorders which is accompanied by tension aggressiveness, a feeling of an ease leading to violence (Roberts 2018). It is a mental disorder as a result of poor organization of psychomotor activity. Everybody is prone to agitation especially when experiencing strong emotions even in sober situations. Patient at risk of agitation needs urgent attention and care. I thanked my mentor for being skillful enough and managed to calm and talk to the patient, as it was very important in prevent further deterioration of patient condition.So What? I was so preoccupied and confused for what happened, wondering whether there was any kind of grudge between me and Mary, reason why she reacted that way. I continuously judged myself whether I had a bad approach to Mary or my appearance and dressing was not wanting or either Mary did not want students to be involved in her caring. My thoughts towards this Mary’s incidence were full of fear as I had never experienced or dealt with such incidence before. I felt very much pressure as I was worried that my mentor had so much expectation from me and did not want to appear in competent or unable to handle such patient cases. I was aware that patient safety depended on me; therefore it was my obligation to ensure Mary’s was received quality care and she was safe no matter her condition (Jang & Lee, 2017). However I had to stay calm though I was under pressure in order to make good judgment of the patient. Keeping calm when under pressure gives one time for problem solving and stay focused in unpleasant and stressful situations. When one is at peace, the mind becomes active hence enabling one to think clearly to coup with the situation. Likewise, I had to forget what had previously happened and be focused on helpful strategies to help Mary (Kharadze and Gulua 2018).Additionally, my mentor noticed my situation and advised me to calm down and told me those were just normal cases for people with mental disorders. From my mentors advice i felt some kind of relive and reduced anxiety I had. She convinced me nothing wrong I had done as she expected that would happen from the patient. After the mentor talked to Mary, now she was more than willing to take a mental assessment for her. When taking mental assessment, I realized that there were some social issues from Mary that required further discussion and needed to be explored into details for further understanding of Mary’s condition. Informing my mentor on Mary’s situation, the mentor advised me to talk to her in guidance of treatment plan we had drafted. As I continued talking to Mary, she revealed to me that her anxiety symptoms began six months ago after the death of her husband whom she depended on, in tragic road accident near their home area. Previously the symptoms were mild but as time went by the situation worsened. Furthermore as I continued to assesses her she disclosed to me that not only was she suffering from anxiety but also she felt very depressed and she often loss appetite, associated with recurrent mood swings during the morning hours. According to Carrol and Rado (2009) patients experiencing anxiety are susceptible to depression accompanied by withdraw symptoms such as restless, and loss of appetite. From previous Mary psychiatric record, Mary had been prescribed for anti-depressant two months ago, unfortunately Mary had not followed the prescription as she took the dose only when she was unwell but when the body was in normal condition she was not concerned of the medicine. Actually Mary had a problem following the dose completely saying sometime she forgot to take, and she never complied with doctor’s prescription. Though there was a carer who took care after her at home, she did not follow her advice. It seemed the carer never educated Mary on importance of medical adherence as outline by Jimmy and Jose (2011). This is rate at which a patient behaviour agrees to correspond to the recommendations of a care provider. In this context, the patient and physician work together for the wellbeing of the patient. Patient education and motivation is very crucial for the recovery of the patient. It came to my attention that Mary had developed fear of anti-depressant dependency and fear of the side effects of drugs. Patients experiencing anxiety are believed to prefer taking natural substances for managing the condition and resist antidepressant drugs. Inconsequence the patient tends to develop side effects of that antidepressant (Givens et al., 2006). Mary claimed that the drugs were very addictive and she would not want to use them. From her point I assured to educate her more on importance of anti-depressant drugs and they would treat her from anxiety and depression if proper prescription is given and followed. I was able to convince Mary that it is recommendable she takes keen in finishing the dose given as it helps in fast recovery of her illness. With anti-depressant drugs one should be consistent taking it for six weeks and even after feeling better she had to complete the dosage to reduce the emergence of anxiety symptoms. Gladly Mary agreed to take the medication without skipping a day and confirm whether it would help her. She was very happy for the information I gave her. It was clear to me that Mary was incompliant to prescription due to lack of information and importance (D Molfenter, 2014).Now What?ReferencesCarroll, V. K., & Rado, J. T. (2009). Is a medical illness causing your patient’s depression? Endocrine, neurologic, infectious, or malignant processes could cause mood symptoms. Current psychiatry, 8(8), 43-50.D Molfenter, T. (2014). Effects of Physician Communication and Family Hardiness on Patient Medication Regimen Beliefs and Adherence. General Medicine: Open Access, 02(03). Doi: 10.4172/2327-5146.1000136Givens, J., Datto, C., Ruckdeschel, K., Knott, K., Zubritsky, C., & Oslin, D. et al. (2006). Older Patients’ Aversion to Antidepressants. A Qualitative Study. Journal of General Internal Medicine, 21(2), 146-151. doi: 10.1111/j.1525-1497.2005.00296.xJang, H., & Lee, N. (2017). Patient safety competency and educational needs of nursing educators in South Korea. PLOS ONE, 12(9), e0183536. Doi: 10.1371/journal.pone.0183536Jimmy, B., & Jose, J. (2011). Patient Medication Adherence: Measures in Daily Practice. Oman Medical Journal, 26(3), 155-159. Doi: 10.5001/omj.2011.38Koshy, K., Limb, C., Gundogan, B., Whitehurst, K. and Jafree, D. (2017). Reflective practice in health care and how to reflect effectively. International Journal of Surgery Oncology, 2(6), p.e20.Kharadze, N., & Gulua, E. (2018). Organizational conflict management challenges. European Journal of Economics and Business Studies, 4(1), 30-41.Lake, J. (2017). Urgent Need for Improved Mental Health Care and a More Collaborative Model of Care. The Permanente Journal.Olashore, A., Akanni, O., & Ogundipe, R. (2018). Physical violence against health staff by mentally ill patients at a psychiatric hospital in Botswana. BMC Health Services Research, 18(1). Doi: 10.1186/s12913-018-3187-6Roberts, J., Gracia Canales, A., Blanthorn-Hazell, S., Craciun Boldeanu, A., & Judge, D. (2018). Characterizing the experience of agitation in patients with bipolar disorder and schizophrenia. BMC Psychiatry, 18(1). Doi: 10.1186/s12888-018-1673-3Scott, A., Webb, T., & Rowse, G. (2017). Does improving sleep lead to better mental health? A protocol for a meta-analytic review of randomised controlled trials. BMJ Open, 7(9), e016873. Doi: 10.1136/bmjopen-2017-016873

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