Reflective Practice on Patient Care

The assignment delves into a student nurse's reflective practice on two distinct patient cases: treating a urinary tract infection and providing care to a patient undergoing mastectomy due to breast cancer. The document analyzes the challenges faced, lessons learned, and strategies employed in each situation. It highlights the importance of critical reflection for professional development and emphasizes the need for holistic patient care encompassing both physical and psychological aspects.

Assessment 2: Case Study Reflection Template
Introduction:
In contemporary nursing, critical reflection is an important virtue that a nurse practitioner
must possess in order to take charge of a situation in an accurate manner. Contemplating a
scenario by reverting to the scenario and understanding of the context through modification
of future outcomes is performed through critical reflection. Driscoll’s Model of Refection
renders a suitable framework is appropriate in this regard. According to this model, reflection
to one’s professional experience is achieved through three vital processes that attend to
questions ranging from what, so what and now what (Bulman 2013). Therefore, in nursing
practice it is possible to link theory with practice through this model of reflection. Ability to
demonstrate various nursing skills is made possible through this model thereby depicting a
thorough understanding and insight on the given scenario (Kelly et al.). As part of my
professional practice in nursing, I came across certain demanding situations in which I had to
apply my prudence and pragmatism to arrive at pertinent conclusion through accurate
decision-making skills. Analysis, review and evaluation of my experience will be done by
virtue of applying this Driscoll’s Model of Refection (Morton et al. 2017). Considering the
fact that critical reflection is an essential attribute in nursing practice, I will try to interpret
my experience in a way so that there remains ample scope for improvement through
identification of the gaps in practice. All discussions will be made in line with the accepted
codes of conduct and professional standards. In the following section, discussion will be
made with respect to a patient admitted at the urology ward of clinical practice. Further, a
scenario with respect to a patient undergoing mastectomy due to breast cancer admitted in
breast endocrinology ward will be discussed.
What?In this section, give a thorough description of the clinical scenario/encounter. This

should be something that challenged you on a professional or personal level whilst
undertaking your first PEP.
In course of my PEP, I came across an 80-year-old female patient who was admitted in the
urology department following complaint of urinary tract infection with history of dementia,
hypertension and hyperlipidemia. Cath examination of urine confirmed urinary tract
infection. One morning while assisting her for toileting, I found her to be somewhat
disoriented and confused. She also had arthritis, ambulated with the aid of walker, and sat on
chair for most of the day. Patient reported pain at the suprapubic site and in pelvic region
with sensation of burning pain during urination that was indicative of urinary tract infection
(Nicolle 2013). Therefore, I found it challenging to tackle her situation with priority being
reducing and reliving her sensation of pain and discomfort to account for optimal wellbeing.
Further, in course of my professional experience placement, I came across a 50 year old
lady who survived breast cancer and underwent modified radical mastectomy in her right
breast following 6 cycles of chemotherapy. However, 4 months after operation she
complained of a lump formation nearby the incision area without any discharge and was
admitted for performing further surgery. The patient also had symptoms of nausea and
vomiting that severely impaired her quality of living. Besides these, she suffered from hair
loss that lead to distorted body image. Fatigue and loss of appetite was also reported in her
(Cheng et al. 2014). On interacting with her, I was of the opinion that she suffered from
depression owing to her condition and refrained from communicating with anyone while on
admission to the ward. Moreover, she also refused to take prescribed medications and showed
reluctance to follow instructions as suggested for her to abide by. Hence, I faced particular
challenge interacting with her and making her act in compliance with the prescribed
medications.

So What? This is an analysis of the event. How did you feel at the time and is this different to
your feelings after the event? What did you do well and what could you have done better?
What were the effects of what you did or didn’t do?
On encountering the situation relevant to the patient, I was a little perplexed as how to
approach it. I prioritized pain reliving for the patient to offer better outcomes. I promptly
resorted to applying heat through hot water bag in the pelvic region to provide mitigation of
pain sensation alongside relief from spasm. Within 15 minutes the pain subsided and patient
reported feeling better. Further, I administered her with Ciprofloxacin as prescribed by doctor
to accentuate her recovery. Research has provided empirical evidences that antispasmodic
agents are effective in bladder irritability and analgesics are suitable for pain mitigation
(Flores-Mireles et al. 2015). Patient expressed positive responses on administration of the
medicine as she was visibly in a better position without any sign of grimacing pain or
discomfort. However, I feel that besides medications I could have encouraged her to
frequently void by increasing her fluid intake to promote renal blood flow thereby allowing
bacteria to be eliminated from urinary tract.
Reviewing and carefully analyzing the case history of the patient, I became sure about the
present situation of her. Physical pain associated with her treatment for breast cancer was
followed by feelings of depression and confusion. Therefore, adjunct to the physical therapy,
I also resorted to counsel her for complying by the prescribed medications and follow general
guidelines imperative for her health and wellbeing. I encouraged her to take small meals
frequently so that the symptoms of nausea and vomiting may be kept under control. I also
explained to her the course of treatment that might exert beneficial effects in treating her
condition. Side effects following administration of drug tamoxifen that might lead to hair loss
were also clarified to her so that she does not have any misconceptions about the therapeutic
effects directed to her. Moreover, I also encouraged her to perform frequent ambulation so
that fatigue may be well managed. Within one week, I found visible signs of improvement in

her condition as she gradually made efforts to walk by her own and started taking meals at
frequent intervals. Nausea and vomiting signs declined considerably. However, I feel that I
could have consulted with a registered psychiatric nurse to intervene in the situation and
harbor positive outcomes at earliest possibility. Breast cancer survivors are most likely to
suffer from misconceptions due to lack of knowledge and hence nursing interventions must
be directed to treat their condition effectively (Bayram, Durna and Akin 2014).
Now What? You should identify what is the main learning you took from reflecting on your
practice? What are the implications for you in future clinical practice based on what you have
described and analysed? What two key areas within your practice can you improve and what
help/strategies can you identify to assist you to modify your practice if a similar situation
arises in your next PEP?
Reflecting on my practice, I came to acknowledge the urgency of administering medication
depending upon case situation to facilitate speedy recovery and healing of the patient. In my
future clinical practice, I aim to apply this knowledge of medications in treating urinary tract
infections in case of elderly female patients who are more prone to acquire the condition
because of their advanced age and other hormonal imbalance states (Castle et al. 2017). The
two areas within the scope of practice which I feel can be improved are that of staff training
and clinical governance as both has the potential of strengthening the services available in the
context of healthcare unit. If similar situation arises in course of my professional experience
placement, I would prefer consultation with the attending physician to ensure maximal
positive outcomes and able guidance.
On evaluating the patient condition, I came to know that it is crucial to undertake a person
centered approach to render holistic care to the intended audience (Kang and Suh 2015).
Thus, evidence based practices in alliance with person centered care may be beneficial for
breast cancer patients. Two key areas which I feel have scope of improvement in this regard
are clinical supervision and multidisciplinary approach to therapy. Breast cancer might

account negative repercussion and therefore clinical supervision and collaboration among
healthcare professionals might assist in clinical practice in similar situation (Zhou et al.
2014).
Conclusion
In future practice, I will be able to apply the knowledge gained for treating urinary tract
infection in case of similar situations for other client by addressing the signs and symptoms
judiciously. Further, in course of the experience gained from treating the patient suffering
from breast cancer and undergoing mastectomy, I understood a different aspect associated
with this threatening illness. Addressing of the psychological dimension to any illness is also
of importance in achieving holistic outcomes for the patient. Hence, critical reflection to
these events will be of paramount significance to imply definite changes.
Reference List
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