Reflective Practice in Nursing

Reflective practice is the ability to examine ones actions and experiences with the outcome of developing their practice and enhancing clinical knowledge. Reflective practice is also a very important component of the nursing curriculum.

Joe does not complain about the state he is in, he doesn’t complain about the way the care home is run as in the interview he says “that is just the way things are”. This is meaning that Joe thinks this is what the normality should be and hasn’t recognised that he is receiving bad practice and therefore being neglected and something needs to be done about it··.

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NHS essence of care states that people feel care is delivered at all times with compassion and empathy, a system for continuous improvement of quality of care is in place.

Joe is not receiving care with compassion and empathy, quite the opposite almost. He is lacking in the amount of competency that the care provider should have which is making the quality of care extremely poor.

He also stated in the interview that before he came to the care home “I was still walking, with a frame”. He now feels that his independence has been taken away from him as he is constantly wheeled around in his chair. This has not just affected his personal care, but he cannot interact with anyone else in the home now·.. (Nursing Practice, Bad Practice) (Brooker & Nicol 2003) (Nursing Adults: The Practice Of Caring)

Joe then goes on to explain how his catheter bag is full and pulls.

This is stating that Joe is in quite a lot of discomfort. This again is seen as neglect and could also be emotional abuse. Reasoning for this is Joe could feel depressed and sad because no one is caring for him and his life has dramatically changed since living at home. He feels his whole lifestyle has changed but not because he wanted it to but because it is easier for the home. (NHS) Having your catheter on show is not very dignified. As a result of Joe’s reduced mobility, he has a higher risk of infection if his catheter bag is not emptied regularly. This is so they can maintain infection control (RCN 2008).

He then states that because of his old age he “expects things to start packing up” meaning he feels that he shouldn’t be cared for anymore as he is old and feels very unwanted and unloved.

Joe wants a nice hot cuppa, the best he gets here is “lukewarm”. His wishes are not being respected as he has also stated his meal preferences are not being listened to either as all he gets is “porridge everyday”. As well as this he isn’t being called by his preferred name “Joe”. Joe is being very disrespected and therefore his choices are not being considered. He is not being treated as an individual and feeling very worthless (Lipe and Beasley 2004). These mentioned to develop critical thinking as a student nurse.

Joe feels like he has no effective communication with any staff member there, but communication is the building of security and trust between the staff and the patient. For example he asked for his “glasses” on more than one occasion and the staff were not interested in his wish at all. Joe does not want to feel like he is a nuisance “feel like a burden” and doesn’t want to over step any boundaries. Joe is very much slouched in his chair, he has very negative body language. This will be because of the mental state he is feeling, he has very low confidence in himself. (RCN 2008) state how important effective communication is in health care, how Joe is not receiving effective communication at all.

Joe in the video stated that he used to be a very smart man, used to have baths and has a shave all the time. Since coming to the home he sits in his pyjamas all day, doesn’t have baths and sits in this wheelchair unshaven. This again is making his personal hygiene awful. At this point Joe has really low self esteem and he has lost all independence and self-worth. You as the care provider must ensure that you give a bath or shower at least twice a week, wash their face every day. This is so the care you are giving is respectable and makes the care receiver happy. (NHS 2018)

Social role valorisation is the concept that you are perceived by their role that they have in society. For many people, belief is much stronger than the truth, much of our experience and world is socially constructed. For example Joe is seen to have no care given to him which makes him have a very low social status. This is because he doesn’t want to mingle with anyone because of the way he looks and feels. This will influence the way people feel towards him and how others will behave towards him too (Wolf Wolfensburger 2000)

Wolfensberger, W. (2000). A brief overview of Social Role Valorization. Mental Retardation, 38(2), 105-123.

Joe is feeling isolated and lonely. His individual needs are not at all considered and has very basic poor support from the staff members. He is reminiscing about what his life was like back home with his wife. He says “best way to start the day my Ella used to say”. Means back home he got listened to and his wishes were granted, here is awful. Joe is very much not actively involved in his own personal care and is very much lacking in his own dignity (NMC 2010). It is very apparent that there are major issues are neglect and very much abuse towards Joe. Very disrespectful··.

Now what?

Best clinical practice is outlined by the NMC (2010) which stated the importance of anti-discriminatory care towards all patients. To be able to successfully tackle the issues that were raised in the NMC’s video (2010), immediate patient action must take place. This is so the risks can be assessed and to increase positive safety for the service users (The association of Directors of Social Services 2005).

Joe in the video is a very vulnerable adult and therefore he is not able to look after himself in any way at all, which means he relies on carers giving him the best possible care (Department of Health 2000). He is unable to protect himself from harm and any exploitation. Safeguarding adults is all about preventing harm and abuse occurring through providing high quality, effective care. It is also about a person’s care experience and how they are very well supported. How successful you are on preventing abuse from happening depends on the quality of service that the patient is receiving. Safeguarding also requires to provide the approaches and factors which contribute to the result of neglect and how to deal with it in the appropriate manner (Social Services 2005).

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