Scott and Ely (2008) suggest that the purpose of reflection in nursing practice is to develop awareness of how and what can be learned from new experiences.
One of the models of reflection will provide the framework for this essay. There are several models of reflection but the reflective model I have chosen is Gibbs Reflective Cycle (Gibbs 1988), with which I am familiar and I find it to be the most clear and concise than the other choices. The Gibbs Reflective Cycle (Gibbs 1988) will be applied throughout the essay to facilitate analytic thought and to assist in evaluating and relating theory to practice where possible. I have chosen to reflect on violence and aggression towards nurses in relation to patients with mental health and alcohol dependence issues. I will attempt to explore the elements that trigger violence and aggression. Besides, I will also dwell on the strategies that nurses may adopt in response to violence and aggression. This reflection will also include literature search and its detailed discussion. According to Jasper (2003), the Gibbs Reflective Cycle consists of the following stages: description, feelings, evaluation, analysis, conclusion and an action plan (Gibbs 1988).
Therefore, I will begin with the first stage of Gibbs (1988) Reflective Cycle which necessitates a description of events. A pseudonym will be used to maintain anonymity and confidentiality as laid out by the Nursing and Midwifery Council (2010) in their standards of conduct for nursing students. The event occurred whilst I was undertaking a practice placement in the Accident and Emergency Department, where there was a high turnover of emergency patients. Miss March was a 42 years old patient, and suffering from depression and alcohol dependence and was prescribed medication for her depression. She was admitted to the department following an incident at home in which she had taken too many of her prescription drugs whilst under the influence of alcohol. I had not met or had any interaction with Miss March as I had been assigned to another area of the department for the morning. Miss March had already been stabilised in the resuscitation room and was just arriving in the area I was working in. I noted that she was confused and she appeared to be drowsy. My mentor told me that Miss March, while being moved, had an episode of urinary incontinence and asked if I would wash and change the patient. My mentor also asked to me to deal with this without delay as during assessment there were small areas of red, chafed skin found around Miss March’s vaginal area. Therefore, her skin integrity was already compromised. Before going ahead, I took a few minutes to read Miss March’s nursing notes and found a history of verbal challenging behaviour but no indication of any physical violence. Having collected the necessary equipment I made my way to Miss March’s cubicle to assist her in washing and changing. Miss March was sitting on the edge of the bed and I explained the reason for my visit. I continued to talk to her as I positioned everything to assist her but she did not respond in any way. Just as I lifted the wet sheet from the top of the bed to put it in the clear bag I had brought with me, Miss March yelled abuses at me then raised her arm to hit me. I attempted to reassure her