Ethical Practice and Reflective Nursing

This assignment delves into the crucial aspects of ethical practice and reflective practice in nursing. It examines various frameworks and theories underpinning ethical decision-making within healthcare, emphasizing the significance of nurses' adherence to professional codes of conduct and best practices. The assignment further explores different models of reflective practice, such as Schön's model, and their application in enhancing nurses' professional development, critical thinking skills, and patient care delivery.

Nursing Assignment
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Reporting:
Ms. A, a senior nurse in the psychiatry ward usually arrive before me. On that particular day,
I had spoken to her and asked about her wellbeing. She replied she was not happy with
support workers in the unit. She used to be very cardinal with all the support staff and support
staff also used to support her in most of the aspects. She claimed that Mr. B, one of the
support staff broken my laptop. He was trying to charge his mobile and in this process
unintentionally he touched laptop and it fallen form the table. During this conversation Ms.
A was becoming progressively agitated, she was appearing tense and restless. Her speech was
becoming repetitive. Her worried behaviour was justifiable because she knowns the
importance of this particular laptop. My all the case studies, plans for the existing patients
and few very important learnings in the medical profession were properly documented.
Documentation is very important aspects in the nursing profession for safe, effective and
ethical nursing intervention. Documentation, in any context in the nursing practice has
significant impact on the nursing practice. It can be either in paper-based or electronic form.
This documentation can be used as evidence in the clinical settings (Wang et al., 2014).
Evidence based practice is problem solving approach for appropriate clinical decision-making
in healthcare organisation. Evidence based practice integrates knowledge of scientific
research and experience of actual nursing practice through nurse and patient interaction
(Nicholson et al., 2014). To calm down her, I offered a cup of coffee to her. However, it
didn’t work. She continued shouting at Mr. B. As a result, whole atmosphere of the
psychiatry ward got disturbed. Most of the staff members in the ward were not giving
attention to their work. All of them, gathered and they were trying to convince Ms. A to calm
down. As it was morning session, rounds of doctors for the respective patients were supposed
to happen. However, due to these issues, there were no proper preparations for doctors’ visits.
In the morning sessions, daily activities of the patients need to be completed. However, due
to this incidence these activities got badly affected. In psychiatry ward, most of the patients
might not be in the state of mind to accept such disturbing situation (Helmstaedter et al.,
2013). It is mandatory for the patients with psychological problems to complete their morning
activities. Completion of morning activities in the psychiatric patients is considered as
promoting well-being in these patients otherwise these patients might get more agitated. Due
to this incidence, whole psychiatric department got disturbed (Lu et al., 2007).
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Responding:
In such scenario, it was difficult for me to take stand and take either of one’s side. In the past,
I had very good experience working with both of them. In such cases, leaders should not
exhibit any type of bias towards any one employee. Hence, I decided to call them together
and ask their feelings and opinions about the incident. I didn’t blame either of them and I
took responsibility of the incident. I was worried more about the patient care. According to
the nursing ethics, care to the patients should not be hampered due to other problems (Holt
and Convey, 2012). Moreover, I was more worried about the arrival of the doctors because
on the arrival of the doctors, situation in the psychiatry ward would become more
exaggerated. I felt that patients should not lose respect and confidence of healthcare providers
because it might lead to reduced sustainability and engagement in the nursing intervention
(Chen and Hsu, 2015).
I was also thinking that patients should not feel insecure about their health issues due to
problem among healthcare staff. I had not anticipated such type of behaviour from the senior
nurse like Ms. A. I felt it was wise to give reassurance to Ms. A that such incidence would
not occur in future. Regarding laptop, I gave her assurance that we would make some
alternative arrangement to feel the gap occurred due to damage of this laptop. For several
times, I had asked Ms A to stop this. Most importantly, I was able to keep myself calm. I
observed that Ms. A became more emotional during this incident. I became anxious during
this incidence. I was shocked and frightened because I never experienced such incidence in
my total experience. I was asking myself, why this incidence occurred. Whether this
incidence occurred accidently or it was intentional act. I was asking my-self question whether
there is deficiency in my leadership qualities. Whether this incidence could have been
stopped, if I would have different leadership approach. In nursing practice, leaders should
organise and direct the nursing interventions in proper direction. Nurse leaders should
delegate activities to the right person and have vision so that all the activities would complete
without occurrence of any complications (Mills et al., 2012). Hence, because of this
incidence, I was low with my confidence. However, I managed myself and tried to intervene
in the incidence. Trying to resolve any type of issue in the organisation is the most important
quality of the leaders. Conflict can produce adverse emotional state of mind which would
hamper normal activities. However, I kept my mindset open and handled this incidence in a
very positive way (Johns, 2013).
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Relating:
I got confidence of handling this experience because my mentor in my initial days used to get
such experiences. I should be thankful to him, he taught me to handle such type of
incidences. Now, I could corelate this incidence with earlier happenings. In nursing practice,
more than classroom teaching, practical or evidence based experience is more important
because along with therapeutic knowledge nursing professional should be capable of
handling person specific and social issues (Aliakbari et l., 2015). I co-related this incidence
with my learnings which I got through case studies. I studied different case studies related to
leadership through videos. I learned that leaders should take responsivity to resolve conflict
issues among sub-ordinates. I understood that leader should either neutralize or minimize the
conflict issue among the sub-ordinates (Zydziunaite et al., 2013).
I also voluntarily entered in the issues and made efforts to manage it. I was aware that I
should not be untrustworthy among the sub-ordinates, hence they could believe on my words
in conflicting situations. I entered in this issues at the right time because I understood that
something hard is going to happen. In learned from my mentor that leaders should not bother
about small issues and allow the subordinates to resolve on themselves. It might reduce value
of leaders’ words also because repeated instructions could saturate cub-ordinates respect
about the leaders. I was well experienced with the fact that I should not take firm action
against any sub-ordinate until I encountered with solid proof about his/her wrongdoing. In
this case also, as this incidence occurred prior to my arrival, I didn’t take action against none
of them. In my service as a professional nurse, I understood that neither leader or sub-
ordinates should cross certain boundaries. It might lead to trigger certain attitudes and
provoke development of negative mindset. I could relate about my conflict resolving learning
with my self-restraining ability from the conflict. Leaders should set standards in organisation
by setting them as example. I was more shocked due to this incidence because I never
expected group members from my unit would ever arrive at such conflict incidences. During
my training on leadership qualities, I understood that in an organisation work should happen
based on hierarchy. However, this work culture of hierarchy should not exhibit anger or rude
behaviour on sub-ordinates. In this case, Ms.A should not scold Mr. B. I was well aware that
understanding differences among people, would be helpful in resolving conflict issues.
Leadership is usually associated with doing the things which most of the other people would
not do. Conflict resolution is one of those things. It has been observed that leaders would
more voluntarily involve in conflict resolution because conflict resolution confront tension
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head-on (Udod and Care, 2011). In this incidence, it was observed that I was the only person
who took part in conflict resolution. It is evident that conflict resolution activates leadership
qualities. Hence, my involvement in this conflict resolution incidence helped me to raise my
leadership qualities (Schön, 2017).
Reasoning:
Winning trust of others and trusting others are the is the most significant trait in my
professional practice. Trusting ability is one of the most significant qualities of leaders. This
trusting ability helped me to convince both the people because both these people had trust on
me. They were confident that, I would not do anything wrong with them. Moreover, they had
strong belief that I would save them from others harm. Generally, it is difficult to address
adversity when it becomes apparent for the first time. However, good leaders can tackle these
adverse conditions and resolve issues in very effective manner. I also handled, this adverse
incidence in a very effective manner and tried to resolve issues between Ms. A and Mr. B. I
was able to handle this incidence because of my self-awareness and wisdom. These are the
significant qualities of leaders which proved useful in diffusing tension and resolving the
conflict issues (O'Rourke and Higuchi, 2016). I had gut feeling to resolve this conflict issue
and I took calculated risk to take part in this incidence. Outcome of this incidence could have
gone in any direction. It could have been either positive or negative. Positive outcome of the
leaders’ efforts are usually appreciated however, negative outcome of leaders efforts are
usually raise question mark on the leadership qualities of the leaders (Beydler, 2017).
From this incidence, I understood that perception is not always real. I had very good opinion
about Ms. A. I was very much confident that, she used to behave very cardinally with her
sub-ordinates and used to take responsibility to resolve the issues at her level. However, this
incidence broke my perception about her and I understood that my opinion about her is not
real. I took the risk by involving in this issue because I wanted to take the whole
responsibility of this incidence. I didn’t wanted to present either of them as the wrong persons
in front of management. Taking blame of the subordinates is one of the most important
qualities of leaders. It not only improves leadership qualities but also produce good working
environment in the organisation. Instead of blaming the incidence, I took it as opportunity to
improve my professional leadership qualities (Reilly and Jurchak, 2017). Leaders should
always look for the opportunity to improve professional growth and to provide good working
environment for patient care.
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Reconstructing:
After this incidence, I decided I would provide training to all the staff members in this ward.
It is evident that coaching and learning along with counselling could resolve conflict issues
among group members (Clausen et al., 2017). These training sessions would be helpful in
identifying conflicts and establishing organisational standards for resolving conflicts in the
organisation. Good care can be given to the patient by healthcare professional by giving great
attention to regulations, structured communication, and central decision making. I decided to
focus on these aspects in future by eliminating occurrences of conflicts in the psychiatric
department. I will implement support plans for the sub-ordinates to enquire about their needs.
If these needs satisfied for subordinates, aggressive behaviour might not arise in them.
Regular team meetings will be arranged and different personal and professional aspects will
be discussed. These discussions will be helpful in identifying thinking and behavioural
aspects of the sub-ordinates. Based on the observations during discussions, counselling will
be provided to them. Main themes of these discussions will be team building, collaborative
work, and conflict resolution (Kim et al., 2017).
It has been observed that staying calm, listening to understand others opinion, emphasizing
on positive attitude, attacking the problem and not the person, avoiding blaming others and
focusing on patients are the strategies which can be implemented in resolving conflict in
workplaces. I am planning to arrange training sessions for the sub-ordinates which will be
given by the professional trainers. These trainers will be from medical profession,
psychological and behavioural profession and social activist. I will conduct debriefing
sessions after the completion of training sessions. These debriefing sessions will be helpful in
their understanding about the aspects on which training will be provided. These training
sessions will be made mandatory and will be arranged on regular basis. Hence, there will be
development of sustained learning culture in the sub-ordinates. Learning cultures starts from
the leaders and leaders have significant role in developing learning culture in the
subordinates. Hence, being a leader, I will take initiative to bring learning culture in sub-
ordinates (Walker et al., 2013). At the time of hiring also, precautions will be taken to address
behavioural aspects of the persons. I will ask management of the hospital to implement
behavioural guidelines for all the staff members in the hospital.
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