A Focus on NMC Value

Introduction

In nursing, reflective practice is important because it allows the nurses to assess their professional experience and make sense of the care situation regarding the way it has impacted the patient as well as them. It is essential in making nurses have better understanding of the strength and weakness of personal skills and care situation they are involved which in turn enhances their professional and personal skills along with assists in delivering enhanced care in future in similar situations (Reljić et al., 2019). Josephine’s Reflective Practice & Clinical Supervision session mentioned that professionalism is one of the key values to be showcased in the care environment. Thus, the reflection would be regarding the NMC value of “Promote Professionalism and trust” in the current context. In nursing, reflection is presented by using key reflective models like Gibb’s Reflective Cycle, Rolfe’s Reflective Cycle and Driscoll’s Reflective Model.

In presenting the current reflective piece, Gibb’s reflective cycle is to be used instead of the Rolfe’s reflective cycle and Driscoll’s reflective model. This is because Rolfe’s reflective cycle does not allow full articulation of the position from which the reflection is executed due to its simplicity. Since reflection in nursing is not only summarisation of practice, but is to the proactive evaluation of care engagement, therefore the model is not to be used (Sharples and Levett, 2020). Driscoll’s model is not to be used because it provides little scope for effective reflection in case the three of the stemmed questions are not engaged beyond the superficial level of the assignment (Brohi, 2021). However, Gibb’s reflective cycle is to be used because it is easier to be implemented, allows evaluation of experience over time and provide ability to make accurate and balanced judgement regarding the care quality from patient’s and professional’s end (Li et al., 2020).

The steps of the Gibb’s reflective cycle are as follows:

Description

In the current nursing placement, as a student nurse, I was allocated to care for a early-stage acute myeloid leukaemia (AML) patient named Morris (the pseudonym used to maintain the confidentiality of the patient as per NMC Code of conduct (NMC, 2018)) who as 70-years old. He was admitted to the hospital due to feeling of intense bone pain in the ribs, hips and breastbone along with pale skin, feeling of fatigue and fever. On hospitalisation, based on the initial diagnosis, the patient was referred for chemotherapy and bone marrow biopsy to determine his health condition. The reports are collected by me and I made detailed record of the patient information to be evaluated by the clinical professional for prescribing required care and medication to the patient.

During development of the patient’s records, my mentor would often interfere and ask me to provide additional support and care to a patient by the side of Morris’s bed who was later identified to be her distant relative. However, I would politely mention her I would equally care for both the patient as they are equally responsible for my assistance which though upset her, but she avoids to speak with me any further. Few days after, Morris was feeling better under my care when he made a demand by giving me few dollars to buy a chocolate so that he could give it to his nephew who regularly comes to visit him. My mentor thought that I was accepting the dollars as a trivial gift of favour and reported against me to the authorities. The authorities charged me to be unfair in providing care to which I requested to have thorough examination of the incident to which I cooperated by mentioning all the actions I performed with proof of the receipt that was provided to Morris for the chocolate. I asked the authorities to ask Morris regarding the incidence to which they mentioned they would evaluate and on further investigation they identified the truth. I was resolved of the charges and I apologised to the mentor for not mentioning beforehand regarding the incident to which she replied to have accepted my apology and warned me for further such actions.

Feelings

During the care situation of Morris, while I was developing care records for him, the continuous interruption from my mentor to look after another patient with additional care made me feel lack focus in care which led me to feel frustrated and angry. However, I controlled my emotions and acted politely with the mentor to mention her that I am equally caring for both the patient. This was mentioned by me as I feel preferring one patient over the other would show discrimination in care. During the care, when the mentor misinterpreted my act of helping Morris as part of accepting gifts made me feel stressed and led me to acted in a nervous way by trying to interact with mentor to explain the situation. However, when the mentor avoided to listened to me and reported my behaviour, I felt depressed that wrong allegations has been made. However, I improve my emotion and developed a strong attitude to prove my innocence by supporting the review to be performed against me by the authorities. During the situation, I felt others thought I was really guilty as I never mentioned about the favour asked by the mentor for caring her relative at the ward which I repeatedly refused to which she may have executed the act to take revenge. However, during the investigation and after the action, I found that my colleagues were cooperative and already knew my innocence as they affirm my innocence my mentioning what they heard about the conversation and money being accepted.

Evaluation

The good thing about the experience was that I was able to abide by section 20 of the NMC Code of Conduct which mentions nursing professionals are always to uphold the standards of care and act with honesty as well as integrity (NMC, 2018). This is because honesty and integrity lead the nurses to act without discrimination and show equal value of care towards all the patients (Devine and Chin, 2018). It is evident as refusing to favour and provide additional care to the patent by the side of Morris’s bed as asked by the mentor, I ensured to have practised without discrimination or favour and provided care with equality to all patients. The other thing which went well was that I effectively controlled my emotion and acted in a professional way to respond to the complaint made against me along with cooperated with any form of investigation. This helped me to abide by sections 23 and 24 of the NMC Code of Conduct where cooperation with all nature of audit and investigation along with responding to any complaint is asked to be made by the nurses (NMC, 2018).

The thing which did not go well was that I was misinterpreted for my act which was beyond the role of my profession that is helping patients to buy things on their request. According to the NMC Code of Conduct, someone’s complaint against the person should not affect their care delivered to patient (NMC, 2018). In this aspect, the thing which did not went well was that during the complaint against my behaviour, I expressed hindered confidence and focus in delivering care to Morris and other patients under my care. This act though did not create any adverse effect on any of the patient but I thought the care of care was somewhat compromised during the event.

Analysis

The ability to perform professional care with integrity and honest as well as without discrimination for Morris and other patient went well because as a nurse I was aware of the NMC Code of Conduct and Equality Act 2010 to be followed in care. It is evident as Equality Act 2010 mentions that no care is to be provided under any discrimination towards patients and each individual are to be treated equally (legislation.gov.uk, 2010). Moreover, I was aware of the nursing ethics of justice which mentions that care is to be provided impartially and fairly to all patients regardless of their status, relationship, sexual orientation and others (Steele et al., 2019). The ability to cooperate with all investigations and response to the complaint went well because effective cooperation in the investigation against complaint helps in identifying the truth behind the action which allows authorities to decide whether the nurse is at fault or not for the action (Elbejjani et al., 2020).

The ability to avoid the influence of compliant made against me towards my ability to perform care went bad because I expressed hindered emotional intelligence on controlling my emotions to influence my care efficiency. This is evident as nurses with higher emotional intelligence are seen to be able to manage negative emotions and develop personal motivation to cope with the emotion so that adverse impact on their ability of them to deliver care is not created (White and Grason, 2019). The action of buying things for the patient did not go well because I failed to initially inform the money was provided by the patient due to which the confusion was raised that I was accessing gifts from the individual.

Conclusion

The thing I learned from the situation is that I have effective ability to act with integrity and honest along with has ability to provide care with justice. Moreover, I expressed an effective ability to maintain professionalism and trust which is evident as I tried to abide by the law set for professional conduct. The thing which did not go well was that I failed to show effective emotional intelligence due to which negative emotional influenced the deliver of hindered care.

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Action Plan

In future, to improve my current care efficiency, I intend to access training in understanding laws regarding the purchase of things on behalf of the patient when the payment is already made by them. Moreover, I intend to discuss situations of care with the supervisor or mentor before taking the decision to deliver any care to patients as a student nurse. This is because it would help me to clarify my conduct of care before actions and it would avoid to create misconduct regarding me for the mentor (Chiafery et al., 2018). I intend to develop enhanced emotional intelligence in care by developing assertive nature of communication, taking critiquing as feedback rather than punishment, practising of positive attitude, empathising with others. This is because it would help in avoiding the influence of negative emotions to control behaviour and would motivate nurses like me to practice better responding to the problematic situation (Nightingale et al., 2018). In order to resolve stress at work, I intend to perform yoga. This is because yoga helps in better control of mind and body along with assist in controlling personal emotions that leads to stress (Hilcove et al., 2021).

References

Brohi, S., 2021. Future of nurse leadership. J Health Pol Manag Vol, 4(1), p.6.

Chiafery, M.C., Hopkins, P., Norton, S.A. and Shaw, M.H., 2018. Nursing ethics huddles to decrease moral distress among nurses in the intensive care unit. J Clin Ethics, 29(3), pp.217-226.

Devine, C.A. and Chin, E.D., 2018. Integrity in nursing students: A concept analysis. Nurse education today, 60, pp.133-138.

Elbejjani, M., Abed Al Ahad, M., Simon, M., Ausserhofer, D., Dumit, N., Abu-Saad Huijer, H. and Dhaini, S.R., 2020. Work environment-related factors and nurses’ health outcomes: a cross-sectional study in Lebanese hospitals. BMC nursing, 19(1), pp.1-11.

Hilcove, K., Marceau, C., Thekdi, P., Larkey, L., Brewer, M.A. and Jones, K., 2021. Holistic nursing in practice: Mindfulness-based yoga as an intervention to manage stress and burnout. Journal of Holistic Nursing, 39(1), pp.29-42.

legislation.gov.uk 2010, Equality Act 2010, Available at: https://www.legislation.gov.uk/ukpga/2010/15/contents [Accessed on: 4 January 2022]

Li, Y., Chen, W., Liu, C. and Deng, M., 2020. Nurses’ Psychological Feelings About the Application of Gibbs Reflective Cycle of Adverse Events. American Journal of Nursing Science, 9(2), p.74.

Nightingale, S., Spiby, H., Sheen, K. and Slade, P., 2018. The impact of emotional intelligence in health care professionals on caring behaviour towards patients in clinical and long-term care settings: Findings from an integrative review. International journal of nursing studies, 80, pp.106-117.

NMC 2018, The Code, Available at: https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf [Accessed on: 4 January 2022]

Reljić, N.M., Pajnkihar, M. and Fekonja, Z., 2019. Self-reflection during first clinical practice: The experiences of nursing students. Nurse education today, 72, pp.61-66.

Sharples, K. and Levett, S., 2020. Reflecting in and on practice. How to Succeed on Nursing Placements, p.175.

Steele, L., Swaffer, K., Phillipson, L. and Fleming, R., 2019. Questioning segregation of people living with dementia in Australia: an international human rights approach to care homes. Laws, 8(3), p.18.

White, D.E. and Grason, S., 2019. The importance of emotional intelligence in nursing care. Journal of Comprehensive Nursing Research and Care, 4(152), pp.1-3.