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Clinical Nurse Reflection: Gibbs Reflective Cycle
Introduction
Gibbs Reflective cycle is a method of learning that enables people who are on mentorship, training, or undergoing a coaching process to internalize lessons (Gibbs, 1988). It enables the mind to undergo a systematic thinking immediately after an activity so that he/she can retain the lesson. Through the method, a learner is able to go through all the stages involved in an experience or activity enabling him to analyze all components of an event so that he/ she can facilitate a wholesome decision on a matter. Gibbs Reflective Cycle is a modern method of teaching that directs the learner to a controlled process of activity through participation that leads to an in-depth understanding of a concept.
The following narrative illustrates the concepts of the Gibbs Reflective Cycle. A nurse had resumed her shift at a heart hospital in ward B and was assigned to a patient who was suffering from ejection fraction. Concerned about the patient’s welfare, a caretaker, who was the patient’s son, inquired about the situation and the possible chance of his/ her recovery. The nurse told them him that she could not give a precise answer unless she read the patient’s file to understand its details. After the nurse left to go and view the file, the caretaker (the patient’s son) followed the nurse and informed the nurse that he felt that she was unable to disclose the assessment of the patient in the patient’s presence and that he wanted the assessment done in privacy. The nurse once again insisted that the only way to find such details was by going through the patient’s file. Additionally, she informed him that: she was still a trainee nurse and the hospital rules prevented her from giving out such information, the patient would be attended to by the doctor who would conduct a surgery on the patient, the doctor will be in an hour’s time and that they should wait for him/ her. As expected, the caretaker was getting concerned because the patient was becoming weaker and required support from a battery. Later, the nurse learned from her supervisor that patient’s heart EF was at 20 percent, which is very low.
Feeling and Reaction
The trainee nurse empathized with the patient’s son and acknowledged that she would have reacted in the same manner if she were in his situation. The caretaker’s anxiety and concern were due to the deteriorating condition of his patient. Therefore, he wanted to be reassured that his ailing father would heal.
Analysis
The described situation was marked by a few positive factors. It was wise of the caretaker to follow the nurse into the private room where he inquired about the true assessment of their patient. As a result, the caretaker achieved two objectives: he understood that however severe the patient’s condition was, they needed hope to enable him to continue fighting for his life and he received an honest assessment of the severity of the injuries. This information protected the patient from any negative report from the nurse, in case she accidentally gave such a report. Obviously, a wise nurse would not give a negative report in the presence of a suffering patient. In light of this, the move to approach the nurse in private was to make her work easier (Woodall, 2006).
Another positive thing about the story is that there was the availability of the battery to support the patient’s heart beat. Notably, the battery was available just at the right time to sustain the life of the patient and also give hope to the caregiver. Moreover, it also illustrated the hospital’s preparedness to handle this case professionally (Armstrong, Ryan, & Feigenbaum, 2010). Additionally, it demonstrated that the caregivers were making all attempts to save the patient’s life before the arrival of the doctor. The lesson learned from this story is that patients and caregivers are always willing to provide the necessary service to a patient even if healing is not a guarantee. The caretaker believed that the nurse’s skills and experience enabled her to give an estimated position of the patient.
The presence of the head nurse in the hospital was a positive feature since she was able to coordinate how the operations of the hospital were done. To elaborate, the head nurse had a report about the patient’s condition and she shared it with the trainee nurse. Therefore, the trainee nurse, who had not gone through the patient’s report then understood about the severity of the patient. As a result, the trainee nurse empathized with the patient and caretaker. It also demonstrated that the head nurse was supervising their juniors adequately. This form of training not only improves learning on the side of the trainee nurse, it also reduces the levels of errors that she made. A negative scenario would have been the caretaker finding a trainee nurse, who had not developed confidence and emotional maturity, alone. If this scenario had occurred, maybe the trainee would have been unable to address the caretaker.
It is easier to relate to the caretaker’s situation and how the mature nurse would have reacted to his emotional needs. Generally, she would have tried to console and reassure him everything was under control (Maceira, 2006). If the nurse lied to the caretaker and informed him that the patient’s conditions were not severe she would not have helped because it would have made her appear to be dishonest and advancing false hope. The continued probe by the patient’s caregiver emphasizes the importance of proper communication. In particular, the trainee nurse demonstrates the importance of communication in enabling all parties to understand what is happening. For example, she requested that the caretaker should be patient and wait for the doctor to examine and give a conclusive opinion on the patient’s health status.
Conclusion
The above case is a good example of proper communication in times of anxiety and pressure. Although we do not have any evidence about the trainee’s nurse on whether she had undergone any training on communication when under pressure, she handled the situation perfectly. Moreover, she was able to empathize with the patient and the caretaker. Her ability to acknowledge that she is not in a position to speak on issues that were to be handled by the doctor showed that she was humble and respected senior authority.
Action Plans
Faced with a similar situation in future, a lot of emotional intelligence should be exercised. In addition, the nurse should avoid giving direct answers that can lead to speculation. Instead, the trainee nurse will focus on the relationship between the patient and the caretaker and previous management of the condition that would be administered. Furthermore, the trainee nurse will spend more hours in the hospital and confront similar situation to strengthen her emotions and improve the management of such situations in future. Finally, the trainee nurse should work closely with the head of the unit (supervisor) to learn alternative ways of handling a similar situation like asking them if they would wish to speak with the specific doctor attending to the case. The approach would calm them and also avoid unnecessary questions.
 
 
References
Armstrong, A.F, Ryan, T. & Feigenbaum, H.  (2010). Feigenbaum’s Echocardiography.
Philadelphia: Lippincott Williams & Wilkins.
Gibbs, G. (1988). Learning by doing: A guide to teaching and learning methods. Further
 education unit. Oxford: Oxford Polytechnic.
Woodall, M.K. (2006). Thinking on your feet: How to communicate under pressure.
HarperCollins Publishers
Maceira, A. (2006). Normalized left ventricular systolic and diastolic function by steady state
free precession cardiovascular magnetic resonance. Journal of Cardiovascular Magnetic Resonance, 8, 417-426.