Reflective Practice: Managing Challenging Behaviour in Community Nursing

Contents
Introduction...........................................................................................................................................1
Description-...........................................................................................................................................1
Feeling-..................................................................................................................................................2
Evaluation-.............................................................................................................................................3
Analysis-................................................................................................................................................4
Conclusion-............................................................................................................................................5
Action Plan-...........................................................................................................................................6
Conclusion.............................................................................................................................................7
References.............................................................................................................................................9
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Introduction
This assignment deals with the reflective writing of the incidence that took place when I was
placed in the District Nursing Healthcare in a Community setting. Using the Gibbs reflective
cycle I would like to share my experience with the patient and what the incidence taught
me. This reflection will help in easy explanation of the incidence and the effect of such
incidence on y clinical practice in both positive and negative manner. By means of this essay,
the nursing practices will be analysed according to the Nursing and Midwifery Council
Professional Code of Conduct. Reflection is an essential part of practice as it enables the
students and future healthcare professionals to enhance their practice by sorting the
strength and weaknesses based on various incidences and their reflective index (Sharp,
2018). The Gibbs cycle has following parts which will be introduced as the heading of the
essay description, feeling, evaluation, analysis, and conclusion and action plan (Smith, 2016).
The incidence that took place was with a patient who will be referred as Mr FX as taking in
consideration the policies and code of conduct of professional nursing practice and keeping
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the confidentiality and information of the patient intact. The patient had a violent outburst
at me and my mentor while we were providing him lessons regarding the insulin
administration. This essay reflects how this incident helped me finish my skills and learn new
things to handle various situations in nursing practice.
Description-
Throughout my nursing practice, I encountered various behaviours and kinds of people and
have developed skills to effectively communicate with each one of them as per their
communicating capability and understanding. The incidence being reflected took place
when I was placed at the District Nursing Home in a community setting. The patient Mr FX is
an elderly man who lives alone in his flat and is recently discharged from the hospital. He is
mentally stable and no signs of mental incapacity are reported by the hospital. He is doing
well with the use of his medication till now when he is being prescribed new medication
during discharge. He is being referred to the District Nursing Care for medicine compliances
and to make him aware of and teach him the technique of using self-administered insulin
for blood sugar regulation and monitoring of the blood sugar at home. The nursing home
was advised to refer this patient at home and visit him for following his care plan. The care
plan of the patient included healthcare teaching for self-administration of the insulin and
blood sugar monitoring procedure and supervising the patient while he performs the
procedure by himself.
It was the first day of my placement at community healthcare with my mentor I visited Mr
FX's house for the following healthcare practice. As we reached there he was not seemingly
happy to attend us but we introduced ourselves took consent from him and marked our
presence. We tried to explain him the procedure and me and my mentor communicated
with him as effectively we can to make him learn the self-administration process. Suddenly
he got upset and started shouting abusive words towards us. The situation got really
uncontrolled but as my past experiences with such situations and knowledge as a student
nurse, I was able to control the situation and handle the inappropriate behaviour of the
patient. It is normal for the elderly and patients who live alone to get outburst when they
have or need to convey something to someone. In such situation, it is important to
communicate effectively and not use restraining approaches at first. The respect and dignity
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of the patient were maintained and proper effective communication was set by my mentor
to calm the patient and explain him the needful (Kaplan-Liss et al, 2018). Proper verbal and
non-verbal communication is essential and the reason for the outburst of the patient or
showing such challenging behaviour should be assessed.
Feeling-
As the incidence took place it was very frightening and made me anxious at first. It showed
negative impacts on the whole setting and on me as it was my first day as the district
student nurse placement. As I never before encountered a patient and such situation in
another setting than the hospital care it was all new and challenging for me. As this incident
took place I felt that usually, the community nursing avails a person to work lonely and in
such situation, one has to have proper and assertive nursing skills to manage such situation
and have a problem-solving attitude towards it. At first, I was afraid to communicate with
the patient after his abusive clauses towards us but as my mentor started to use proper
communication techniques with him he started to calm down and my fear converted to
confidence (Neville & Roan, 2014). This incidence made me feel that no matter how
inappropriate behaviour the patient present to us still he is eligible to be treated by the six
C's of nursing codes that includes, care, compassion, courage, communication, commitment
and competence. The competency of the nursing practice depends on how better I did
manage the situation and was able to calm the patient down and explain the procedure to
him effectively (Riley, 2015). Communication is the key to solve the utmost problem in
healthcare. I felt that the way my mentor communicated with the patient was breakthrough
of the situation. It solved the heat up the situation and made patient calm down. I felt that
there was some underneath reason for the behaviour of Mr FX that he was being resistant
to new change in his life. Also, it was felt that the patient was independent and did not like
prolong visit of any stranger as he did not welcome us with friendly gestures. The incidence
was sudden and made me feel that we should have identified all these verbal and non-
verbal messages from the patient and should have reduced the time of visit and used much
better communication strategies to avoid such situation (Kourkouta & Papathanasiou,
2014).
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