Reflection 1

I am mostly assigned to care for patients undergoing intestinal obstruction surgery in the surgical ward. Stomas are attached to patients during the recovery phase following surgery since it takes some time for their stomach and intestines to return to normal activity. In order to provide the patients with effective treatment, it was my duty to oversee and periodically replace the stoma bags. This is due to the fact that premature stoma bag changes induce skin discomfort and leakage. I made sure the stoma bags were changed once a day while I was in charge of their management. In order to maintain cleanliness and make sure the patients’ skin remained completely dry after replacing the stoma bags, I also cleansed my hands both before and after. Understanding these practical facets of patient care can be essential for people looking for nursing dissertation assistance in order to handle real-world research issues.

Reflection 2

One of the six patients I was tasked with caring for in the bay during my placement had pressure sores. The patient had arthritis. In order to prevent the formation of further pressure on the already existing sore, which could exacerbate the problem, I made sure the patient was given an air mattress. To have a comfortable sleeping experience, the patient requested a regular foam mattress after expressing dissatisfaction with using an air mattress. I recognised his request and promptly provided for it. I did advise him not to lie on the side of his pressure sores, though, since this could impede the healing process. In addition, I made sure he switched positions every two to three hours while switching mattresses to prevent pressure sores from developing on other areas of his body and from aggravating the place that was already hurting.

Reflection 3

Working in the surgical ward as a registered nurse, it was my duty to keep an eye on patients’ vital signs so that the medical staff could assess their progress and overall health. In this situation, I made sure to regularly record the patients’ vital signs on the board that is affixed to the end of the bed at specific intervals. To make sure the expert understands how the patients’ vital signs have changed and can identify any risks, I include the time the vital readings were collected in the vital signs report. Additionally, vital sign data are continuously maintained for the health experts’ reference in order to monitor the patients’ post-operative response.

Reflection 4

In my capacity as a registered nurse, I inform patients undergoing bowel obstruction surgery about the types of foods and beverages they must consume in order to preserve their improved health and prevent future intestinal blockages. I explained to them why it’s better to eat smaller pieces of solid food more frequently rather than consuming larger amounts at once. I advise them to chew their meal thoroughly so that it can be efficiently macerated for a smooth passage through the intestines and stomach. I also advise them to drink more water frequently and limit caffeine because it can irritate their bowels.

Reflection 5

As a nurse on the surgical ward, it is my responsibility to inform patients about the particular surgery that the medical staff has decided is best for them. I accomplish this by informing them of the necessity of the operation in light of their current state of health and how it will help them have a healthier and better life following the procedure. In order to provide sufficient proof to raise patients’ awareness of the procedure, I personally learn about and analyse the most recent research findings. This is due to my belief that patients cannot be informed of the necessity of surgery in the absence of strong evidence.

Reflection 6

I made sure that patients undergoing intestinal obstruction surgery had improved treatment in the surgical ward. As the registered nurse, I establish this by listening to the patients’ needs and establishing prompt communication with them. Additionally, I present them with information about the care options so they can give their informed consent. This is because it gives me useful guidance on how to include the patients’ preferred care activities into the treatment to provide them greater care satisfaction. In this situation, I spoke with him in a kind and courteous manner about how I could protect his privacy by employing a movable divider to keep people from looking at him while he changed clothes. I also start talking to him about how he may assist me in changing his attire without jeopardising his privacy. The patient was able to follow my instructions and prevent other problems as a result.

Reflection 7

I often have to dress the patients’ surgical wounds during the placement to guarantee improved wellness and prevent infection. In order to facilitate better healing, I make care to keep the wound surroundings wet. Additionally, I frequently examine the wound area to look for any excess exudates that can cause the wound to macerate and need to be removed. This is due to the fact that clearing the wound of excess exudates improves the skin’s defences against bacterial development or fluid contamination.

Reflection 8

I often have to dress the patients’ surgical wounds during the placement to guarantee improved wellness and prevent infection. I make sure to keep the wound surroundings wet for this reason since it encourages faster healing. Additionally, I frequently examine the wound area to look for any excess exudates that can cause the wound to macerate and need to be removed. This is due to the fact that clearing the wound of excess exudates improves the skin’s defences against bacterial development or fluid contamination.

Refection 9

As a registered nurse in the surgical ward, it is my duty to care for patients following surgery. I was given the task of clearing a surgical patient’s chest drainage. Prior to starting to remove the chest drain, I made sure the patient’s sedative and pain medication were properly administered by adhering to instructions. Before starting the procedure, I made sure to wash my hands thoroughly to prevent the patient from getting hurt by dirt or germs. In order to prevent the patient from suffering any further bruising during the evacuation of the chest drain, I kept the traction steady and smooth while pinching the skin’s edges together. In order to preserve immediate wound hygiene and avoid blood loss, I promptly covered the hole with an occlusive bandage after removing the chest drain. In order to restore effective breathing, I also advised the patient to attempt breathing normally.

Refection 10

It is my duty as a registered nurse in the surgical ward to make sure that patients undergoing bowel obstruction surgery receive the right kind of medication in order to effectively manage their health. I adhere to the five rights the appropriate drug, the right patient, the right dose, the right method, and the right time when giving patients their medication. This is to guarantee that there are no mistakes made when administering medications that could impair the patients’ health.

Critical Reflection on Professional Development

In nursing, reflection is crucial because it helps people evaluate their experiences critically and consider their strengths and weaknesses in terms of practice-related knowledge and skills. The care of the stoma bags that are connected to the majority of patients on the surgical ward will be examined in this study. Gibb’s reflective cycle should be applied in this situation. This is due to the fact that it enables nurses to evaluate their experiences in healthcare over time in order to identify the strengths and weaknesses of their various practical abilities. Li and colleagues, 2020). Nursing practice and decision-making, as well as professional values, are the two chosen nursing domains on which the reflection is to be conducted.

The Reflective Cycle of Gibb

The six stages of the Gibb’s reflecting cycle are as follows:

Description: The specific incident is reflected in the description phase. In order to prevent waste products from overflowing, I made sure that the stoma bags that were linked to the patients undergoing bowel obstruction surgery were taken out and replaced on a daily basis. For this reason, I record the moment that each patient’s stoma bags are examined for the final time and personally check the stoma bags’ condition once they are connected to the patient. This is to guarantee that patients have adequate roomy stoma bags linked to them.

In order to prevent infecting the patients, I also made sure to wash my hands both before and after replacing the stoma bag. I cleaned the stoma area with warm water and then gently patted it dry with a dry cloth to remove any remaining moisture close to the stoma’s skin. This is done to protect the patient against bacterial growth that could infect the area.

To dispose of the stoma bag, I first empty the urine and faeces in the toilet and then dispose of the bag in the clinical waste area. It was seen, although, that I neglected to check for stoma bag leaks prior to giving them to the patient. As a result, I once hooked a leaking stoma bag to a patient out of negligence, which resulted in an unsanitary situation with pee all over the patient’s bed. In order to replace the stoma bag and prevent any more leaks, I took prompt action. I also changed the patient’s bed linens to ensure hygiene. Additionally, in a different case, it was discovered that patients were experiencing bleeding from the stoma’s attachment site. Later, it was discovered that I had massaged the area rather than wiped it, which showed that I had caused harm to the region due to my negligence.

Feelings– I believe that I successfully adhered to the nursing profession’s professional values domain during the feeling phase, when thoughts about the experience are discussed and pondered with relation to bowel blockage surgery. According to nursing’s professional ideals, nurses should always provide patients with better care and protect them from abuse or harm. I believe it is evident that I have made sure the patients’ stomas are promptly replaced and removed in order to prevent urine and faeces from overflowing, which compromises the patients’ ability to maintain a hygienic environment.

I believe I have successfully upheld the professional values in the current care setting as I take responsibility for fixing mistakes made in stoma management that affect patients and manage and care for stomas on my own. However, I believe I am not competent enough to make decisions about how to guarantee patients receive improved nursing care for their stomas. This is because I neglected to identify all the factors that needed to be taken into account, such checking the stoma bag for leaks before affixing it to the patient and preventing skin irritation.

Evaluation- In accordance with nursing professional ideals, nurses are expected to work independently and to be accountable for providing patients with safe, person-centred, and compassionate care while upholding their rights and dignity. I concluded from the experience that, despite my ability to independently manage the patients’ care, I was unable to guarantee safe treatment. This is because I touched the stoma area carelessly, which caused the patient to bleed needlessly. Nurses must understand the limitations and risks of common interventions, according to the Nursing Practice and Decision-Making Domain (NMC, 2018). In this regard, it can be said that I did not make the best choices for the patients’ stoma care. This is because I failed to take into account the limitations, such as the possibility of stoma bag leaks, which could cause urine to overflow and put patients in an unsanitary situation.

Analysis- According to the nursing professional values, nurses should provide patient care in accordance with their competency and skill (NMC, 2018). Since I neglected to make sure that the limitations would be addressed and that they could be controlled before they occurred in the care scenario, it can be concluded that I have hampered competency in managing and caring for stomas in surgical patients.
According to the nursing practice and decision-making domain, patients who are at risk should be recognised and treated right away to prevent harm (NMC, 2018). In this situation, it can be concluded that I am capable of making decisions on how to manage and prevent patient risk. This is because as soon as I received a report of urine leaking from the patient’s stoma bag, I took prompt action to protect the patient and maintain a clean environment.

Conclusion – I discovered from my reflection that I am capable of protecting patients and that I am capable of managing and caring for surgery patients’ stomas on my own. But when it comes to identifying and resolving limitations and issues that arise in stoma care, I am lacking in effective nursing practice abilities. I intend to enrol in separate stoma care training in the future so that I can anticipate managing any concerns before they arise and prevent them from being brought up. Additionally, I intend to sharpen my focus when providing care in order to prevent negligence that could worsen patients’ health.

References –

    • Li, Y., Chen, W., Liu, C., & Deng, M. (2020). Nurses’ Psychological Feelings About the Application of Gibbs Reflective Cycle of Adverse Events. American Journal of Nursing, 9(2), 74-78.
    • Markkanen, P., Välimäki, M., Anttila, M., & Kuuskorpi, M. (2020). A reflective cycle: Understanding challenging situations in a school setting. Educational Research, 1-17
    • McKinnon, J. (2016). Reflection for Nursing Life: Principles, Process and Practice. London: Routledge
    • NMC. (2018). Standards for competence for registered nurses. Available at: https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-standards-for-competence-for-registered-nurses.pdf [Accessed on: 15th June 2020].
    • Tanaka, M., Okamoto, R., & Koide, K. (2018). Relationship between Reflective Practice Skills and Volume of Writing in a Reflective Journal. Health, 10(3), 283-288