Clinical Reflection on Registered Nurse Standards of Practice

This essay is a clinical reflection on the fourth standard of the Registered Nurse Standards for Practice, focusing on comprehensively conducting assessments in clinical care using Gibb’s reflective framework. It describes a practitioner engaging with the standard through holistic and culturally appropriate assessments, respecting patient dignity and utilizing various assessment techniques for clinical decision-making. The reflection covers the practitioner's feelings, evaluation of the practice, and analysis of the application of the standard, including communication and patient engagement skills. The conclusion emphasizes the importance of these skills for improved outcomes and suggests further development in communication and probing techniques. The action plan highlights the need for improved patient engagement strategies through training and skill development to enhance clinical processes and patient satisfaction.

Running head: CLINICAL REFLECTION
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Clinical Reflection
Student’s Name
University

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Clinical Reflection
Australian nurses are guided by the registered nurse standards for practice which were effected
from 2016 to define the standards that form the way practitioners engage in the field of practice
(Nursing & Midwifery Board of Australia, 2018). This is a set of seven standards that are
interrelated to define the way the practitioner meets the needs of the profession. These standards
describe the competent level of care that practitioners need to engage in each phase when dealing
with patients. Lockhart (2015) suggests that the standards form the critical pathway that define
the way professional conduct themselves in the field of practice. This is the desired performance
that is promoted through a safe healthcare environment requiring accountability of nurses for the
actions. This centred approach defines the way practitioners engage each other and how they
meet the needs of the organization. This essay is a reflection of the fourth standard of
comprehensively conducting assessments in clinical care using the Gibb’s reflective framework.
Description
From the case, the practitioner is engaging with the fourth standard of care by comprehensively
conducting assessments through a holistic and culturally appropriate process. The practitioner
respects the dignity of the patient and attempts to assess without necessarily interfering with the
patient. Through use of different assessment techniques, the practitioner ensures that the right
measures are taken for clinical decision making. This entails measuring of vital signs and follow
up with verbal questions to make observations about what the patient has been experiencing in
the recent times. The practitioner also takes a collaborative approach by working with the patient
to understand the wellbeing. Since the assessment is measuring only vital signs, the practitioner
uses questioning as a way of understanding the wellbeing of the patient to determine the

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challenges that the patient is facing. In the absence of psychological measures of wellbeing like
questionnaires, the practitioner can engage the patient in a set of questions that asses their
wellbeing (Flannery, Glew, Brewster, & Christie, 2018). This is seen in how the practitioner asks
the patient about how he has been and how long he has been in the clinical process. Since
wellbeing is a measure of healthcare, the practitioner is supposed to assess how the patient is
doing using any relevant clinical care resource. Where there are no resources, the practitioner is
supposed to improvise as seen in the case where verbal questioning is used.
Feelings
Form the case, I thought the practitioner will have difficulty carrying out the comprehensive
assessment since patients display different behaviour characteristics during healthcare processes.
Without proper strategies, there can be challenges gathering assessment information from some
patients. The principle of autonomy gives patients the power to refuse certain clinical processes
if they feel they are against their beliefs and a threat to their health. To solve this problem, the
practitioner uses Communication skills to engage the patient in advance as a way of requesting
permission to carry out the assessment (Gillam, 2016). This yields the desired results since it
allows the practitioner to build rapport with the patient that allows him to carry out the
assessment. Further, a range of assessment techniques are used to take vital signs from the
patient as a way of ensuring that the patient is comfortable with the whole process. The
practitioner also used the engagement approach to ensure that the patient is informed with all the
processes that are taking place. Vahdat, Hamzehgardeshi, Hessam, & Hamzehgardeshi (2014)
suggests that patient participation is used to improve clinical outcomes through involving the
patients to ensure that they understand the care process being done on them. By sharing

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information about the clinical processes taking place, the practitioner achieves patient consent
which leads to better clinical outcomes. Practitioner patient partnerships are encouraged in the
fourth standard to have a more insight on the issues of care that affect patients wellbeing and
form the priorities to be put in place for the clinical process.
Evaluation
Every practitioner strives for a better experience with their patients as a way of assessing their
ability to understand how they can apply the clinical knowledge that they have gathered. By
engaging with the requirements of the fourth standard, the practitioner combines clinical
requirements and personal abilities to gather relevant information that applies to the case (Rojek,
et al., 2018). In this case, the practitioner comprehensively assessed the patient using clinical
tools and questioning to ensure that the right information is collected from the patient. The
practitioner used the participatory approach to involve the patient in the clinical process to
increase clinical outcomes. From the beginning of the engagement, the nurse applies the
requirements of the fourth standard by communicating to the patient what needs to be done and
seeking his consent. Further, both measuring of vital signs and questioning are used to asses the
condition of the patient to increase clinical outcomes (Davis, 2014). To understand the patient
well, the practitioner also uses Communication skills to asses the well being of the patient
through asking personal questions like how the patient has been and how long he has been on the
clinical journey.
Analysis
From the process, the practitioner applied the requirements of the fourth standard well by
carrying out the required clinical assessment. Communication and patient engagement skills

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were used to ensure that the patient was proactive in the process to increase clinical outcomes
(Redley, et al., 2018). The practitioner was thus well informed of the requirements of the fourth
standard and their role in quality of care. The video shows that the practitioner was not only
interested in assessing the vital signs and breaking contact with the patient but rather, formed a
professional relationship that informed the outcome of the whole care process. This is regarded
as the application of professionalism in all aspects of care.
Conclusion
The care process went well since the practitioner applied the requirements of the fourth standard
when dealing with the patient. Application of Communication skills and participatory approaches
ensured that the practitioner and the patient enjoyed a relationship that led to improved
outcomes. However,, the practitioner needs to work on Communication and probing skills to
assist in assessing the wellbeing of the patient (Esch, et al., 2016). Although the practitioner
engaged the patient well in the whole process, there is need to work on Communication skills to
assist in gathering other relevant information relating to the wellbeing and outcomes of the
patient.
Action plan
From the reflection, initiating and maintaining contact with the patient through Communication
skills is important in achieving the required clinical outcomes. The practitioner needs to work on
improving patient engagements strategies through training and developing appropriate skills for
working with the patient. Communication is a driver of patient clinical satisfaction since it
connects the practitioner to the world of the patient leading to improved clinical processes.
Therefore, Grunloh, Myreteg, Cajander, & Rexhepi (2018) suggests that the practitioner needs to

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work on communication skills since they are not only used to pass information to the patient but
also to connect and carry out relevant clinical assessments within the field of care. Since nurses
engage with patients at a personal level, then they need to equip themselves with Communication
tools and strategies that they can apply in different situations to achieve quality care.

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References
Davis, C. (2014). The importance of professional standards. Nursing Times, 12(5).
Esch, T., Mejilla, R., M, A., Podtschaske, B., Delbanco, T., & Walker, J. (2016). Engaging
patients through open notes: an evaluation using mixed methods. BMJ Open, 6(1).
Flannery, H., Glew, S., Brewster, A., & Christie, D. (2018). Measuring Outcomes of
PsychologicalWell-Being within Paediatric Health Settings. Healthcare, 6(1).
Gillam, S. (2016). Patient participation groups in general practice: what are they for, where are
they going? BMJ Open, 352.
Grünloh, C., Myreteg, G., Cajander, Å., & Rexhepi, H. (2018). Why Do They Need to Check
Me?” Patient Participation Through eHealth and the Doctor-Patient Relationship:
Qualitative Study. Journal of Medical Internet Research, 20(1).
Lockhart, L. (2015). The pathway to best practice. Nursing made Incredibly Easy, 13, 6-55.
Nursing&MidwiferyBoardofAustralia. (2018). Registered nurse standards for practice.
Retrieved from Nursing & Midwifery Board of Australia:
http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-
standards/registered-nurse-standards-for-practice.aspx
Redley, B., McTier, L., Botti, M., Hutchinson, A., Newnham, H., Campbell, D., & Bucknall, T.
(2018). Patient participation in inpatient ward rounds on acute inpatient medical wards: a
descriptive study. BMJ Quality & Safety, 1-10.
Rojek, A. M., Gkolfinopoulou, K., Veizis, A., Lambrou, A., Castle, L., Georgakopoulou, T., . . .
Horby, P. W. (2018). Clinical assessment is a neglected component of outbreak
preparedness: evidence from refugee camps in Greece. BMC Medicine, 16(43).

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Vahdat, S., Hamzehgardeshi, L., Hessam, S., & Hamzehgardeshi, Z. (2014). Patient Involvement
in Health Care Decision Making: A Review. Iran Red Crescent Medical Journal, 16(1).