Reflecting on Clinical Integration Specialty Practice

This article discusses the challenges faced by clinical nurses in providing appropriate patient care and how to address them. It covers safety issues, confidentiality, and public domain view on healthcare. The Five Rs framework is used for a reflective analysis of the issues. Solutions to improve healthcare practices are also provided.

RUNNING HEAD: REFLECTING ON CLINICAL INTEGRATION SPECIALITY PRACTICE
REFLECTING ON CLINICAL INTEGRATION SPECIALITY PRACTICE
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Module: Clinical Integration Specialty Practice
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RUNNING HEAD: REFLECTING ON CLINICAL INTEGRATION SPECIALITY PRACTICE
Table of Contents
Introduction......................................................................................................................................3
Part A - Online Module...................................................................................................................3
1) Module 1: Safety Issue In Aged Care......................................................................................3
2) Module 2: Confidentiality........................................................................................................4
Part B - Online Module 3: Reflection using the Five Rs.................................................................6
Reference Lists................................................................................................................................7
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RUNNING HEAD: REFLECTING ON CLINICAL INTEGRATION SPECIALITY PRACTICE
Introduction
Clinical nurses possess immense responsibilities in order to provide appropriate patient
care (Shields, 2013). While clinical nursing includes various aspects of care, there remain certain
challenges in clinical nursing that need to be addressed. In the current scope of discussion three
online module related discussions has been included, one related to safety issue in patient care,
another issue is related to confidentiality and the last reflective analysis is related to public
domain view on health care (Daskein, Moyle & Creedy, 2009). The three reflective analyses
provide in-depth information related to the various challenges that are facing current scenario of
health care.
Part A - Online Module
1) Module 1: Safety Issue In Aged Care
Clinical practicing nurses possess several responsibilities and specific rights related to
aged care (Fleischer, Berg, Zimmermann, Wüste & Behrens, 2009). It is the responsibility and
right of nurses to keep patients/clients physically and emotionally safe. In the current scope of
discussion identified safety issues specific to aged care is being discussed. Providing safety to
patient and clients is the primary motive and ultimate goal for any clinical nurse. Nurses need to
ensure trusts in patients by ensuring their health as much as possible. There exist several safety
issues that might threaten patient’s safety. With rising costs of patient safety, hospital and their
care givers need to ensure that all adverse events of patient safety can be analysed and reduced as
much as possible. Nurses need to ensure patient’s medication safety concerns. Innovation in
medicine management in health care is seldom used (Bauer, Nay & McAuliffe, 2009). Though
hospitals and clinics need to use them however, seldom such practices are adopted. Often nurses
administer inappropriate medications at inappropriate time frames. Moreover, nurses administer
dosage without having prior knowledge related to the patient’s allergic or tolerance related
information. This might lead to a significant challenge as patient health might suffer or he might
be at risks from developing other ailments. Medication safety related issues are specifically
integral in case the patient faced comorbidity (Lim, Bogossian & Ahern, 2010). At such
instances clinical nurses has to take special care to ensure that medicines administered are
absolutely in line with patient needs.
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RUNNING HEAD: REFLECTING ON CLINICAL INTEGRATION SPECIALITY PRACTICE
Nurses aid in assisting and providing healthcare services to their patients. Medication
safety is a serious concern that nurses need to take care off. I feel that clinical nurses need to
possess knowledge and skills so as to render appropriate medication to patients such that they do
not suffer in the long run. Only providing patient’s safety can assure them and help re-assign
their trust in the medical system. Safety related issues can erode trust of patients and lead them to
avoid the medical institution which has committed such errors. Moreover, such errors might lead
to ethical issues. In short term period the patient might suffer and in long term period, there
might arise issues related to health impacts. Therefore, clinical caregivers and nurses need to
view schedules and gain detailed insight into the medical treatment being rendered to. Apart
from medicine safety issues, a patient might also face dilemma related to financial insecurity and
diagnostic challenges as they are inter-related (Carryer & Yarwood, 2015). Inability to maintain
confidential information related to patients or not being able to provide adequate security in aged
care facilities are some of the deeper concerns facing healthcare. Aged care facilities have older
people hence healthcare centers need to adhere to norms such that they are able to provide best
possible care. Often patients are given expensive medications and less expensive and equally
effective medications are avoided. Nurses need to take care to see that patients are given a
medication with correct components rather than deciding upon particular brand name for
medicines. Such expensive medicines might impose financial challenges for the patient, who in
turn might become defendant to face such troubles.
2) Module 2: Confidentiality
In healthcare every client has some rights of clients in the process of treatment and
recovery. Nurses being primary caregivers to patients and clients, there remain some questions
regarding ways the nursing profession views and deals with the rights of the clients (Tarzia,
Fetherstonhaugh & Bauer, 2012). The need for information, particularly in the context of
patients/clients who may lack insight in their care needs has to be diagnosed and attended to.
Confidentiality is one of the primary duties in medical practices, where health care providers
need to retain personal health information privately unless the patient provide consent to release
such information. In critical cases nurses and careers might face sometimes dilemma in
providing information to anyone else. Patient’s while resorting to healthcare regularly share
various personal information with health care providers, especially nurses. In case confidentiality
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RUNNING HEAD: REFLECTING ON CLINICAL INTEGRATION SPECIALITY PRACTICE
of this information is not protected they the relationship with nurses would diminish. In such
cases patients would be apprehensive in sharing sensitive information that would in turn hamper
their care (D’Souza, Venkatesaperumal, Radhakrishnan & Balachandran, 2013). Creation of a
trusting environment for the patient is important for respecting patient privacy and it allows the
patient to be honest during the time of healthcare. The trusting environment provides and
encourages patients to be honest during health care visit and also allows the patient to seek care
when needed. Confidentiality is particularly important in cases of sexual, public health,
reproductive and psychiatric health concerns.
Health cares professionals especially nurse have the duty of confidentiality, which prohibits them
from disclosing any information regarding patients to anyone else without permission. Nurses
need to assist in the healthcare system which ensures that only authorized persons are able to
access reports and other information related to patients. Healthcare team members including
nurses and other professionals need to undertake special care to ensure that no data relative to
patients is disclosed in front of anyone who is not a member of the healthcare team. It is the
primary duty of nurses to protect information of their patients and protecting such information
from those who should not have access to the same (Tilse & Wilson, 2013). Healthcare systems
which make use of Electronic medical records (EMR) can face significant challenges while
preserving confidentiality of information. In cases only where nurses feel that they can share
information of the patient with that of their family, then they can do so. In case the information
related to patient has not obtained explicit permission then such information cannot be ethically
justified to be shared with family members also. Only in case of a medical emergency or when
the spouse is at risk of harm which is directly related to diagnosis then only he or she can be
informed as in such cases ethical challenges might not appear (Por & Barriball, 2008). However,
generally the issue of confidentiality possesses enormous challenge in itself. The most integral
challenge in health care related to confidentiality is ethical challenge. As disclosing of private
and confidential information of patient is not at all ethical and might lead to breach in ethicality.
Concern for safety might arise in various cases in case the healthcare provider is unable to adhere
to confidentiality concern. Providing access to medical reports or other health documents might
be legally challenging and impose grave ethical concerns.
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Part B - Online Module 3: Reflection using the Five R’s
The public domain on how people have made meaning of their health-related issues. The
5 R’s of Reporting, Responding, Relating, Reasoning and Reconstructing framework according
Bain, Ballantyne, Mills and Lester (2002) has been undertaken for arriving at a reflective
practice. The reflective practice has allowed changing perspectives and developing perception,
morals and ethics related to health. Diagnosing illness of an individual is best undertaken by
means of 5 R’s such as reporting, responding, relating, reasoning and reconstruction (Gifkins,
Loudoun & Johnston, 2017). The article by Tarzia, Fetherstonhaugh and Bauer (2012) which
reflected various challenges related to dementia and confidentiality in aged care facility was
discussed. In order to understand the situation of patients in such conditions it becomes integral
to have a systematic thinking or step by step practice through the experience or situation. The 5
R’s provide suitable framework for in-depth and meaningful analysis related to the experience.
In the first step of 5 R is reporting where a brief description of account of the situation or issue is
discussed. As in the current article various issues that aged people were facing at the facility was
discussed, who had dementia or sexual problems. There was lack of trust and confidence
amongst people residing at various aged care facilities. They did not like their stay in the facility
and the situation primarily had arrived due to healthcare professionals and nurses especially not
being aware of the various healths related ethical behaviours which they needed to maintain. At
the second step responding to the situation is undertaken. In the current scenario it can be said
that the situation is rather sad and unwanted as healthcare professionals could not provide
adequate care that they should have provided. Not only were they unprofessional rather the
institute did not have any code of conduct. This led to a grimmer situation and prevented patient
and client of the institute from getting appropriate care.
In the next step of relating, personal or theoretical understanding of the event is
undertaken (Plank, Mazzoni & Cavada, 2012). I being a professional in the healthcare industry
did not like the approach that was undertaken by the nurses and health care professionals.
According to Health Information Portability and Accountability Act of 1997, institutions need to
have policies for protecting privacy and confidentiality of patients. All policies and procedures
were breached in the current scenario and there was no adherence to any standards. The fourth
step of the process involved reasoning, in this step explanation of the issue is undertaken. The
theory which can be evaluated here relates to confidentiality and safety issues that need to be
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present in aged care. However, no adherence to any of the issues has taken place. In the last step
reconstructing or drawing of conclusion and then developing a future course of action was
planned. At this step a deeper understanding of the issue and reframing of future practice is
undertaken. It can be said at this stage that, in future I will take possible note to avoid any such
situation that might conflict with code of conduct in my practice.
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Reference Lists
Bauer, M., Nay, R., & McAuliffe, L. (2009). Catering to love, sex and intimacy in residential
aged care: what information is provided to consumers?. Sexuality and Disability, 27(1),
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Carryer, J., & Yarwood, J. (2015). The nurse practitioner role: Solution or servant in improving
primary health care service delivery. Collegian, 22(2), 169-174. Retrieved on 2nd October
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D’Souza, M. S., Venkatesaperumal, R., Radhakrishnan, J., & Balachandran, S. (2013).
Engagement in clinical learning environment among nursing students: Role of nurse
educators. Open Journal of nursing, 3(01), 25. Retrieved on 1st October 2018, from
https://file.scirp.org/pdf/OJN_2013031814415858.pdf
Daskein, R., Moyle, W., & Creedy, D. (2009). Aged‐care nurses’ knowledge of nursing
documentation: an Australian perspective. Journal of Clinical Nursing, 18(14), 2087-
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Fleischer, S., Berg, A., Zimmermann, M., Wüste, K., & Behrens, J. (2009). Nurse-patient
interaction and communication: A systematic literature review. Journal of Public
Health, 17(5), 339-353. Retrieved on 30th September 2018, from
https://link.springer.com/article/10.1007/s10389-008-0238-1
Gifkins, J., Loudoun, R., & Johnston, A. (2017). Coping strategies and social support needs of
experienced and inexperienced nurses performing shiftwork. Journal of advanced
nursing, 73(12), 3079-3089. Retrieved on 6th October 2018, from
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Plank, A., Mazzoni, V., & Cavada, L. (2012). Becoming a caregiver: new family carers’
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Tarzia, L., Fetherstonhaugh, D., & Bauer, M. (2012). Dementia, sexuality and consent in
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