Provide Critical Discussion Explained for Students (Easy Guide)
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Provide a critical discussion of the given episode of care experienced within practice with a focus on effective communication to provide safe and high quality care. Using Level 5 3rd person language. Student Reflection on an Episode of Care Within your reflection describe the episode of care and how you assessed, planned, delivered and evaluated person-centred care. I am reflecting on communication skills and doing a handover from one ward to the other. Description During my placement in an acute ward as a second-year student nurse, I was assigned by the registered nurse (RN) to hand over a patient who was being transferred to the gastroenterology ward. The patient had been admitted to the acute ward with severe abdominal pain and vomiting. The patient had a history of Crohn’s disease and had been receiving treatment, that is, managing pain and controlling vomiting in the acute ward. I had to communicate key details about the patient’s ongoing treatment and any concerns to the receiving nurse in the gastroenterology ward. Although this was not my first time giving a phone handover, I felt nervous and unsure about whether I would provide all the necessary information clearly and concisely. I followed the SBAR (Situation, Background, Assessment, and Recommendation) framework to give my handover. Situation: I introduced myself, my position, and where I was calling from; confirmed who I was talking to; and gave the patient’s name and age. Background: I stated what patient was admitted with, their past medical history, who they lived with at home, their mobility, skin condition, and if they needed support with their daily living activities. Assessment: I explained their observations, their pain in which the patient was in so much pain and had received morphine and antiemetics, Recommendation: I state to continue monitoring the patient. While I managed to communicate the main points, I noticed that I hesitated at times and struggled to recall certain details; for example, I forgot to mention if the patient was on any antibiotics, which led to some clarification questions from the receiving nurse. I also forgot to mention the patient had received antiemetics and what time it was given. However, my supervising registered nurse reminded me before I finished my handover. Feelings. Initially, I felt anxious about delivering the handover as I was worried about missing critical information. However, I also felt a sense of responsibility, knowing that effective communication is crucial for patient safety and continuity of care. Furthermore, the Nursing and Midwifery Council (NMC) (2018) expects nurses to be able to communicate patient needs and care clearly and effectively to prevent errors. After completing the handover, I felt relieved but also aware that I needed to improve my confidence and fluency in communication. The receiving nurse was patient and understanding, which reassured me, but I recognised areas for improvement in my delivery. Evaluation. The handover experience had both positive aspects and areas for improvement. One of the key strengths was adhering to the SBAR framework, which provided a systematic approach to my communication and ensured that I included essential details about the patient’s information, condition and treatment. This helped maintain clarity and organisation during the handover process. Additionally, I successfully covered important information, which could ensure patient continuity of care. Through this experience, I gained a deeper understanding of the importance of effective handover communication in preventing errors and ensuring continuity of care. However, there were areas where I could improve. I noticed that I hesitated at times and lacked confidence, which affected the fluency of my handover. This hesitation may have made my communication seem less assured, leading to clarification from the receiving registered nurse. I also struggled to recall certain details about the patient, which highlighted the need for better preparation and organisation of information before handing it over. In the future, I aim to improve my clarity by using more concise and confident language, which will enhance the effectiveness of my communication and ensure a smoother transition of care. Analysis. Effective communication is a fundamental nursing skill, especially during patient handovers, as it ensures patient safety and continuity of care (NMC 2018). This experience highlighted the significance of systematic communication, as using SBAR helped ensure I covered all relevant points. However, my hesitation and lack of confidence impacted the fluidity of my handover. In addition, I realised that preparing beforehand, such as reviewing patient notes and anticipating questions, can improve the effectiveness of communication. The experience also reinforced the importance of active listening, as the receiving nurse’s clarification questions helped ensure a complete understanding of the patient’s needs. Conclusion. This experience made me more aware of the importance of effective communication in nursing practice. While I felt I successfully delivered a systematic handover, I need to work on improving my confidence, fluency, and preparation. The feedback from the receiving nurse was valuable, and I now recognise the need to develop stronger communication skills to enhance patient safety. I plan to continue practicing systematic handover using the SBAR framework to improve fluency and confidence. I will also continue to observe and learn from experienced nurses during handovers. Finally, seek more feedback from my assessor, supervisor, and other registered nurses on my handover techniques to improve clarity and delivery. What did you do well? I adhered to the SBAR framework, which helped to ensure the handover was systematic. I was able to handover key information about the patient’s condition and treatment. I learnt the importance of effective handover communication in preventing errors and ensuring continuity in patient care What would you have done differently? I would have prepared more and organised patient information better by reading patient notes to avoid forgetting some information. Although I followed SBAR framework I would have clarified with the supervising nurse the information I needed to include in my handover . Describe how you have begun to work more independently in the provision of care and the decision making process. Throughout my placement, I have taken on more responsibility for patient care, including conducting patient assessments, administering medications under supervision, and recognizing changes in a patient’s condition. By actively engaging in these tasks, I have developed a greater sense of autonomy while ensuring that I always adhere to evidence-based practice and patient safety protocols. One key area where I have gained independence is in prioritizing patient needs. For example, when caring for many patients, I have learned to assess which tasks require immediate attention, such as responding to deteriorating observations and escalating concerns to the registered nurse. This has helped me strengthen my clinical reasoning, time management skills and communication skill. Additionally, I have become more confident in decision-making, particularly in situations where I need to escalate concerns. For example, I recently identified that a patient had not passed urine for several hours and made the decision to report this to the registered nurse. This proactive approach reflects my growing ability to recognize potential complications and contribute to patient safety. Furthermore, I have improved my communication skills by participating in handovers, liaising with the multidisciplinary team, and explaining to patients on their care plans. Although I still seek guidance from registered nurses when needed, I have become more proactive in making decisions based on my assessments and clinical knowledge. Moving forward, I will continue to develop my independence by enhancing my critical thinking skills, improving my ability to anticipate patient needs, and increasing my confidence in making clinical decisions. Seeking constructive feedback from my supervisor, assessor, other registered nurses and engaging in further learning opportunities will help me transition smoothly into a more independent nursing role while ensuring safe, high-quality patient care. What learning from this episode of care could be transferred to other areas of practice? The importance of clear, structured, and confident communication in nursing practice, especially during patient handovers. Learning to prioritize key points and deliver them in a systematic manner will enhance clarity and ensure the receiving nurse fully understands the patient’s needs. Seeking feedback from experienced nurses and actively engaging in handover opportunities will help build confidence and refine communication skills.
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