Nursing Reflection: Episode of Patient Care

Added on -2022-08-25

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Name of the Student:
Name of the University:
Author note:
Reflection allows nurses as well as healthcare professionals like health support workers
to identify their potential strengths and weakness as well as areas upon which they can improve
themselves (Pai et al. 2017). In addition to personal reflection, a key clinical practice which
nurses must imbibe is the implementation of a holistic needs assessment (HNA). Nursing
engagement in holistic care involves the practice of comprehensively addressing and clinically
managing the multifaceted healthcare needs of the individual (Williamson et al. 2018). The
following reflective paper will hence discuss upon an experience of participating in an episode of
patient care and the strategies with which, a chosen patient’s psychological, physical and
sociocultural needs were assessed holistically.
I have worked previously as a healthcare support care since the year 2015, within adult
mental healthcare settings within a healthcare organization of my locality (Worcester NHS
Mental Health). Currently, I am engagement in my nursing placement area where I am working
as a nursing student in the B'ham & Solihull Mental Health. As a healthcare support worker, my
daily activities were similar to those outlined by the National Health Service (NHS 2019), which
included: engaging in holistic assessments across patients with challenging behavioral issues,
collaborating with patients and families, provision of referrals, participating in professional,
interpersonal and therapeutic forms of communication, developing holistic support programs and
care plans and participation in timely and comprehensive patient documentation.
Currently, as a part of my daily functioning as a healthcare nurse, I am required to
therapeutically work with patients presenting with diverse mental health needs as well as
collaborate with a range of interdisciplinary professionals such as psychologists, general
practitioners, occupational therapists, psychiatrists, healthcare assistants, social workers as well
as general practitioners.
Recently, as a part of my curriculum, I was required to conduct an HNA on a 60 year old
man who was admitted with concerns of multiple suicide attempts and depression, under the
supervision of the registered mental health nurse I was assigned to. Despite performing the entire
exercise confidently and successfully, I did inquire with my supervisor concerning reasons why
an HNA is so lengthy and is filled with multiple questions. Additionally, I was also stopped by
my supervisor just prior to the commencement of the exercise concerning the fact that I had not
communicated with the patient effectively or introduced the details of the HNA to him. This was
also another incident which prompted me to question my supervisor concerning the importance
of communication prior to the assessment. After the exercise, while the supervisor did clarify my
concerns, she also encouraged me to engage in personal reflection concerning the same, which I
have expounded upon in the following sections.
Before I commenced the exercise, I was a little confused as to how will I being the HNA
considering the range of sections and subsections which I had to cover, with respect to the
patient’s concerns pertaining to physical, practical, emotional, family, relationship, spiritual,
support and information issues. Such a contribution could be a reason behind my ignorance
towards the need to introduce myself or establish a therapeutic communication with the patient.
Indeed, it has been evidenced by Galletta et al. (2017), that nursing ambiguity or a sense of
confusion and unpreparedness concerning one’s role, is a common feeling felt by nursing
students during transition to professional practice when they are met with critical job roles, work
pressures and the demands of medical emergencies. Still, one of the key thoughts which
concerned me was reason why a nurse may need to still engage in such extensive communication
when he or she already has to elaborately communicate with the patient during performance of
an HNA. Another key thought which prompted me to reflect was concerning the importance of
conducting such an elaborate and comprehensive assessment in the form of an HNA where
instead, a nurse can already engage in a range of separate clinical screening tools such as vital
signs, musculoskeletal assessments, chest examinations and abdominal assessments.
Like all initial personal experiences, recollecting this episode of care assisted me in the
identification of both negative as well as positive experiences (Yu, Ling and Hu 2019). A key
negative experience while performing this episode of care was when I was abruptly interrupted
by my supervisor prior to commencement of the HNA. This is because despite the initial
confusion, I still felt confident and knowledgeable enough to proceed with the exercise and thus,
being interrupted merely because I avoid initiating an introductory communication with the
concerned patient seemed irrelevant and unnecessary to me. However, a key positive experience
which outweighed the negative incident was the fact that my supervisor effectively
communicated and clarified my doubts concerning the importance of communication and an
HNA. Indeed, it has been evidenced by Grant and Goodman (2018), that the prevalence of open
and transparent interpersonal communication between supervisors and nursing students paves the
way for a supportive and harmonious environment of continuous learning, timely identification
and prevention of errors as well as an increased sense of motivation for future nursing students to

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