Gibbs Cycle of Reflection - Essay Example

?Introduction It is the primary goal of this paper to offer an extensive analysis of at least two core dimensions, Level 2 from the Knowledge and Skills Framework in the post-operative recovery care unit in the NHS Trust. This reflective essay focuses on the use of Gibbs Cycle of Reflection in order to properly analyse the practice of the post-operative recovery care unit in the NHS Trust. In view thereof, this paper is thus divided into the following sections: (1) description, (2) feelings, (3) evaluation, (4) analysis, (5) conclusion and (6) action plan. Description A sixty year old woman was recently operated because of a heart disease. A colleague and I received the recently operated woman into the post-operative recovery care unit. Upon seeing the woman, my colleague and I were unsure as to how she coped with the surgery and whether or not she has fared well in this regard. She looked a little pale and was not really showing distinct signs of whether she is alive or not. However, we are sure that she was still alive since this has been guaranteed by the surgeon and his team. My first instinct was to determine the vital signs of the patient as obviously, these were greatly affected because of the surgery and the anesthesia applied to the patient. In analysing the vital signs of the patient, I focused on its frequency and duration, depending on the condition of the patient who has recently undergone surgery and the normalcy thereof. When I first conducted this, we noticed that whilst the female displayed good vital signs, we were not however sure as regards the normalcy thereof. Because of this, we had to undergo other tests so as to ensure that the operation was indeed successful. Aside from merely checking the vital signs of the patient, my colleague and I also assessed the level of consciousness of the patient. In conducting this test, we were able to determine that the patient was relatively conscious and we must only wait for a longer time before her vital signs begin to normalize. Moreover, we also focused on the following were determined: (1) the patient’s heart rate, (2) the ECG levels, (3) the respiratory rate of the patient, (4) oxygen saturation, (5) non-invasive blood pressure and (6) the skin temperature. In conducting these tests, we were able to determine that there is nothing wrong with the patient and she is merely recovering from her surgery. We also followed a simple procedure by which we can determine the improvement of the vital signs on the patients. In fact, this procedure entails that the vital signs be recorded every thirty minutes for at least two hours and hourly thereafter. This was continued on until the woman was awake and has begun eating and drinking. We also monitored the temperature of the patient. Remarkable improvement was seen from the patient during the first two hours. Her vital signs continue to rise significantly every thirty minutes. After the second hour, we monitored her hourly and it was shown that her vital signs continue to rise towards normalcy. Six hours after her operation, the woman woke up. However, she was not ready to start eating and drinking anything. It was only two hours after she woke up that she expressed thirst and was given a drink. She also started eating after consuming her first drink. Considering the gravity of the operations performed on the patient, my colleague and I also performed other tests. These tests also focused on the fluid loss experienced by the patient. Generally, we were not able to actually determine something abnormal as regards her fluid loss. In fact, our observation showed that she was not really losing too much liquid than what is considered as average. Moreover, we also looked into whether there is actually excessive bleeding but there was no sign in relation to this. Aside from the physical condition of the patient, my colleague and I also focused on her physiological and psychological conditions. Basically, upon close examination of the patient, we did not find anything wrong as regards her physiological and psychological condition. She was relatively stable but was nevertheless tired due to the process that she recently underwent. Because of her surgery, we also expected the patient to experience pain every once in a while (Briggs 1998). Hence, my colleague and monitored our patient, administer pain relievers every time she experiences pain. Aside from this, we also sought monitored the tendency of the patient to vomit after the surgery. In view of this, we also responded properly to minimize their physical discomforts and at the same time, we also take into consideration the different instructions and requirements set forth by the patient before she underwent surgery. Relatively, the patient was shown to have fared well with the surgery that was also properly recovering. Throughout the entire process, my colleague and I maintained a high level of communication between both of us in order to properly determine how we will respond to the needs of the patient (Healey, Undri and Vincent 2010) In addition, we also communicate effectively with the patient so as to properly determine her needs. We also communicated with other members of the health care institution so as to obtain the aid we need whenever it is necessary. Lastly, we kept records of our observations so as to properly monitor the patient as she undergoes through recovery (Manser 1999). Feelings As mentioned, at first, I was concerned with the patient’s state as she was relatively pale when she first came out of the operating room. I was concerned as to whether or not her vital signs have returned to normal considering the grave effect of the operation. In addition, I was also worried as to whether or not her recently concluded surgery has grave effects on her, most especially as regards her blood pressure, the pain she experienced after her surgery, her tendency to vomit and other physical discomforts associated with post-surgical operations. According to the different studies conducted, post-operations usually experience various complications such as problems related to airway, breathing, and circulation; the experience of pain because of the surgery, the tendency to acquire injuries as the patient regains consciousness, and lastly, psychological and physiological effects that are related to the surgery (Howes 2007; Gan, Sloan, de L Dear, El-Moaelm and Lubarsky 2001). Because of my concern to this patient, I was also determined to find the appropriate measures by which my colleague and I could properly respond to the needs of the patient assigned to us. I was also inspired to give her the requirements that she expressly stipulated before she went through the surgery. It was only when she regained her consciousness that I became more satisfied with how she dealt with the surgery. Nevertheless, I continued to observe her in order to ensure that she is properly nursed back to health. Evaluation There were generally two aspects that describe the situation: the good and the bad. At first, I felt concerned with the situation of the patient right after being subjected to the surgery. However, I was also pleased to see that notwithstanding the fact that the patient went through a major surgical operation, she coped with the process in a good manner. Her vital signs returned to normal in a few hours. In addition, she did not really experience too much complication as a consequence of her surgery. I also felt relieved that the members of the staff of the post-operative recovery unit possess the appropriate training and education needed to respond to the needs of the patients in the post-operative recovery units. Furthermore, I was also relieved that the unit has the appropriate medical equipment and tools that would address the needs of the patients under our care. On the other hand, I still feel concerned with respect to the psychological and physiological effects of the surgery on the patient. I feel that the psychological and physiological concerns of the patient right after undergoing surgery must be addressed in other avenues to ensure that the latter is restored fully back to health. Analysis The manner by which we responded to the needs of the female patient who was brought to our unit following her surgery highlights the quality of the services that we provide in the post-operative recovery unit. Aside from this, the extensive analysis of the situation at hand also reveals the proper manner by which the unit carried out communication strategies in order to determine the needs of the patients. The situation was analysed in relation to the first and fifth core dimensions included in the NHS Knowledge and Skills Framework: communication and quality. The first core dimension, communication, is considered as one of the most important aspect of jobs in the NHS. In fact, it even affects all the other dimensions contained within the NHS Knowledge and Skills Framework. Communication is necessary for the development of good relationships. It usually involves the identification of what others are communicating through listening as well as the expression of one’s self. In our setting, we are more focused on the opening of communication lines between the health care professionals and our patients in order to afford the latter a better service that would help in curing them (Howes 2007). Generally, through the form of a written document, the healthcare organization solicits the requirements of the patients that are needed in their post-operative recovery stage. We then take note of what the patients have stipulated in the said document when we determine their needs once they are in the process of healing from their surgery. While within the post-operative recovery unit, the members of the latter also make it a point that they communicate with the patients to determine what they are feeling and the remedies that they could apply to ease their pain or discomfort or to at least speed up their healing process (Briggs 1998; Howes 2007). In addition, the nurses within the post-operative unit also maintains a record of the patient, his or her response to the treatments, an extensive observation with respect to vital signs and regaining consciousness, blood pressure, etc. These information are likewise reported to the family and friends of the patient. The members of the post-operative recovery unit also make sure that only those who are entitled to the said information receive the data (Orkin 1992). The information received by the members of the post-operative recovery unit from other members of the organization and from other sources is likewise first validated to ensure its validity and reliability (Orkin 1992). However, it is still acknowledge that much has yet to be included with respect to the communication process in order to ensure its compliance with the NHS Knowledge and Skills Framework (Healey and Vincent 2010). According to the NHS Knowledge and Skills Framework, the quality core dimension on the other hand, refers to the aspect of the job that deals with the quality of their work. It is in this regard that the following levels are associated to this dimension: (1) the maintenance of the quality of one’s work, (2) the maintenance of quality in one’s work and encouraging others to do the same, (3) the contribution of one to the improvement of quality in the organization, and lastly, (4) the development of culture that improves quality. Generally, this level promotes the need to maintain high quality in all the aspects of work and practice most especially in relation to effective team work (Howes 2007). Usually, the core dimension of quality is maintained and supported through the adoption of various approaches such as the promulgation of codes of conduct and practice, enhancing practice that is based on evidence, guidelines, legislation, protocols, procedures, standards, systems and other policies. The effective application of the quality dimension usually entails the development of the necessary knowledge and skills that are needed by the team. In addition, quality is also demonstrated by ensuring the proper identification of the issue at hand and providing the necessary remedies in relation to it. Also, quality is highlighted with one’s recognition, respect and promotion of the different roles that certain individuals have in the team. Finally, it is also concerned with the demonstration of support for all the members. Healey, Undri and Vincent (2010) mention the importance of team performance in ensuring the success of the post-operative recovery unit. The examples enumerated on the NHS Knowledge heaand Skills Framework were undeniably present in our delivery of services in the post-operative recovery unit. As clearly enunciated in the previous sections of this reflective essay, we were able to properly determine the main sources of the problems of our patients. In fact, we are aware of the different effects of surgery that they might be currently experiencing and consequently, we provide our patients with the necessary remedies to their problems. For one, the environment in the post-operative recovery unit allows the patients to properly recover from their surgery. The staffing levels therein also allow an unconscious patient to have at least one registered nurse to take care of his or her needs. The members of the post-operative care unit also monitor the patients effectively by looking into their breathing, the circulation of their blood and other disabilities that the patients might have experienced because of the surgery (Howes 2007; Orkin 1992). The observations of the members of the post-operative recovery unit are properly documented (Gan, Sloan, de L Dear, El-Moaelm and Lubarsky 2001). The nurses within the post-operative recovery unit also communicate with each other so as to properly determine the needs of their patients (Eberhart, Morin, Wulf and Gerdner 2002). Moreover, they also make it a point that they seek the help of the other health care professionals in dealing with the different problems encountered by our patients. Nevertheless, we remain properly educated and trained as regards the observation of a patient to determine the normalcy of his or her vital signs, the cardiovascular status and the maintenance of temperature. The nurses also possess the necessary training to determine the right remedies for the pain being experienced by the patient (Eberhart, Morin, Wulf and Gerdner 2002; Gan, Sloan, de L Dear, El-Moaelm and Lubarsky 2001). The possession of patient records, however, does not merely focus on the observations that the nurses have with respect to the patients under their care (Manser 1999). Instead, these records also deal with the treatments and other remedies received by the patients, focusing on what the healthcare professionals gave them and how these were administered (Eberhart, Morin, Wulf and Gerdner 2002).. Also, to comply with the requirements set forth by our organization, we also maintain a record of how our patients respond to the treatment that we provide them. Basically, this enhances the quality of the healthcare that we provide in a sense that it enables us to keep track of the manner by which we must respond to certain situation and its effectiveness. On the contrary, however, the members of the post-operative recovery unit have relatively failed in terms of contributing for the betterment of the services. Without a doubt, the healthcare professionals therein have merely focused on what they have been practicing for the past years taking into consideration the fact that this has been effective and has positively affected the patients. However, it is recognised that to fully comply with the NHS Knowledge and Skills Framework, it is of paramount importance for the members of the post-operative recovery unit to adopt measures by which they could improve their services to the patients and in the same manner, to increase the satisfaction of the public with respect to their services. Conclusion These reveal the strengths and the weaknesses of the post-operative recovery unit in dealing with the patients as soon as they are released from the operating room. I consider the fact that the entire post-operative recovery measures went smoothly as we were able to nurse the patient back to health. Undeniably, we have responded properly to the needs of the patients by providing an extensive analysis of her condition as well as the remedies that are necessary to nurse her back to health. However, as reflected in the previous section in this essay, it is nevertheless of paramount importance to take various points into consideration, including the constant improvement of communication and quality in the post-operative recovery unit that would also improve the services rendered by the health care institution to their patients. In addition, we could have also applied various steps by which we could have helped in strengthening her psychological and physiological health after she regained consciousness. Also, we could have included her family and friends in the process of healing in order to ensure a more holistic approach. Finally, the healthcare institution must also come up with other communication strategies to positively affect the communication and quality dimensions in the hospital. Action Plan This section deals with the action plan that must be adopted upon the rise of another situation. If this situation happens again, I believe that I possess a better understanding of the issue at hand and thus, I am more effective in terms of catering to the needs of the patient. Just like what I have done, I will focus on the determination of the needs of the patient, depending on his or her needs as espoused in my observation. I will continue to engage healthcare professionals as we ascertain the needs of our patients. However, I will ensure that the quality and communication aspects set forth in the NHS Knowledge and Skills Framework be properly adopted in a sense that the nurses be more effective in dealing with their patients by allowing the participation of their family and friends. Aside from this, I will also push for the improvement of the services that we render to our clients to guarantee customer satisfaction. Finally, we will also come up with various customer satisfaction measures that would enable us to ascertain the perceptions of our clients in relation to the services that we provide. It is through these that our ability to enhance the communication and quality dimensions is guaranteed. References Briggs, M. 1998. A Qualitative Analysis of the Nursing Documentation of Post-Operative Pain Management. Journal of Clinical Nursing, vol. 7, no. 2, pp. 155-163. Eberhart, L., Morin, A.M., Wulf, H. and Geldner, G. 2002. Patient preferences for immediate postoperative recovery. British Journal of Anaesthesia, vol. 89, no. 5, pp. 760-761. Gan, T.J., Sloan, F., de L Dear, G., el-Moalem, H.E. and Lubarsky, D.A. 2001. How much are patients willing to pay to avoid postoperative nausea and vomiting. Anesthesia & Analgesia, vol. 92, pp. 393-400. Healey, A.n., Undri, S. and Vincent, C.A. 2010. Developing observational measures of performance in surgical teams. Quality and Safety in Health Care, vol. 12, pp. 122-140. Howes, L. 2007. Post-operative patient care in the operating department. Royal United Hospital Bath NHS Trust, UK. Manser, T. 2009. Teamwork and patient safety in dynamic domains of healthcare: A review of literature. Acta Anaesthesiologica Scandinavica, vol. 53, no.2. pp. 143-151. Orkin, F.K. What do patients want? Preferences for immediate postoperative recovery. Anesthesia & Analgesia, vol. 74, p. 225. Read More