CNA340: Developing Professional Nursing Practice Reflective Paper

This reflective paper for CNA340, focusing on developing professional nursing practice, examines a clinical encounter in an elderly ward where a patient exhibited anxiety related to upcoming medical tests. The paper identifies the development of interpersonal skills as a crucial pre-requisite for person-centred care, emphasizing the importance of clear communication and patient education to alleviate fear and build trust. The author relates this to the literature, Registered Nurse Standards for Practice (2016), and discusses the potential risks of poor communication, such as increased anxiety and delayed treatment. The paper concludes with a reflection on the incident, highlighting the need for improved interpersonal skills, active listening, and a better understanding of patient needs to ensure future practice consistently applies person-centred care principles. The author acknowledges the importance of effective communication for patient empowerment and shared decision-making.

CNA340: Developing professional nursing practice Semester Two 2019
Pre-requisites for person centred care: Reflective paper
Please note: The sections shaded grey are for your information only and can be deleted for final submission. You are
only required to type into the white sections. Word counts are suggested (please delete these instructions for final
submission).
Brief overview of situation/clinical encounter
Provide a succinct overview with adequate information in which to contextualise the pre-requisite being discussed
(150 words).
During my placement in the elderly ward, I was assigned to take care of a female patient, who had been admitted
in to the hospital having a Lumbar decompression surgery on Saturday. The patient was admitted in to the
hospital three days before the operation. She was very frightened to have tests like CT scan or the x-rays that has
been ordered. She believed that nothing has happened except that she was having a back pain. The medicine
which she had been using was reduced to a lower dose. She is perplexed and is worried about her pain, as she
thinks that the pain might get severe. The patient was not informed correctly about why the tests were required
or that she won’t be experiencing any discomfort during the tests or no information has been provided as of how
the tests needed to be done. The patient was all anxious and frightened.
Identify relevant pre-requisite/s
Your encounter identifies several pre-requisites that impacted/contributed to the clinical encounter. Please list
these below in dot points (not included in word count).
 Development of the interpersonal skills
 Knowing self
 Clarity of the beliefs and values
Identify and discuss ONE priority pre-requisite
Relate this to the literature on person-centred practice and outcomes, highlighting its importance as an attribute
for health professionals and how this should be demonstrated with reference to the Registered Nurse Standards
for Practice (2016) (300 words).
It is evident from the description that the role of the nurses in this case did not meet the pre-requisite of the
development of skills”, as the nurses in charge failed to inform the patients about the procedures and the
importance of the tests. An open disclosure about the test procedure and the importance could have reduced the
fear and anxiety in the patient. It has been found in that use of effective interactive communication strategies by
the nurses in a health care settings can be beneficial to reduce the stress and improve the living.
Having a good communication with the patients reduces anxiety in patients and helps to build their confidence
(Bach and Grant 2015).
I could have approached the patient in a more holistic way to inform her about the tests that needs to be done.
Nayebi and Majd Teymouri (2015) have stated that communication is required, not only to transmit information,
but also to associate different individuals around the world in the milieu of the associations, families, societies and
nations. Interactive communication skills is a crucial attribute of nursing as, improper interpersonal
communication may cause chaos, malady, distress, clash, misunderstanding and wastage of the resources (Nayebi
and Majd Teymouri 2015). Communication with elderly patient ensures the patient that she was actually being
cared for and hence can rely on treatment. The standard 2 of the NMBA standards also recommends to
communicate effectively with a person and be respectful to the dignity, culture, beliefs, and rights of that person
(NMBA, 2017). I admit that that the professional standard of the nurse has been breached for not being able to
communicate clearly and establish a curative relationship with the patient. Some of the essential ways of patient
centred communication involves active listening, compassion and empathy towards the patient.
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Discuss what risk/impact there was/could have been
The chosen pre-requisite was not being enacted to its full capacity during the situation/clinical encounter
nominated. What risks/impact did this/could this have/had? Was it eventually corrected? (100 words).
Lack of interpersonal communication skills in nurse would leave the patient in increasing level of anxiety. Anxiety
and fear can lead to symptoms like dizziness, panic attacks, and high blood pressure, racing heart rate, feelings
physically violent or running away from the treatment (Riley 2015). This can delay the treatment. In this case
scenario, kit is evident that the patient did not want to get tested. Her misconception can cause delay in her
treatment.
However, later on, I explained to the patients about the rationale behind the test assessments that needs to be
conducted. However, this incident jeopardised and questioned my competency skills.
Consider your own nursing practice
Reflect on what you have learnt and what you will now do to ensure your future practice is able to consistently
apply the pre-requisite discussed (250 words).
Analysing the incident, I have understood that, I should develop my inter-professional skills. I have understood
that developing interpersonal skill does not only reduces anxiety in patients but is an essential element of a
person centred care. Development of interpersonal skills has been found to reduce the rate of clinical error and
aims towards a shared decision making (Riley 2015). Nowadays patient autonomy has become an important issue
related to person centred care, due to the fact that increasing number of incidents have been reported where
there had been deliberate breaching of the professional standards. Communication with the patient is the
ultimate way to patient empowerment (American Geriatrics Society Expert Panel on Person Centered Care)‐ .
Kolanowski et al. (2015) have suggested that in order to meet the required pre-requisites, a nurse should indulge
in active listening, in order to understand the grievances of the patient. While reporting a medical condition, a
non-medical person might not have enough vocabulary to describe what is wrong with the patient. Hence a nurse
should have an excellent listening skills to identify the cues used by the patient.
The nurse is always in the frontline to describe incidents to the doctor and accuracy is necessary for the
determination of immediate action. Hence, proper verbal and nonverbal communication skills should be present
when it comes to taking in of the information and passing on to the doctor (Riley 2015). Nurses should also have
good sense of humour as it is the one outlet to relive tension. Had I explained the patient about the tests or had
introduced her to other patients who had gone through the same procedure could have alleviated her anxiety to
an extent.
References
American Geriatrics Society Expert Panel on Person Centered Care, Brummel Smith, K., Butler, D., Frieder, M.,‐ ‐
Gibbs, N., Henry, M., Koons, E., Loggers, E., Porock, D., Reuben, D.B. and Saliba, D., 2016. Person centered‐
care: A definition and essential elements. Journal of the American Geriatrics Society, 64(1), pp.15-18.
Bach, S. and Grant, A., 2015. Communication and interpersonal skills in nursing. Learning Matters.
Kolanowski, A., Van Haitsma, K., Penrod, J., Hill, N. and Yevchak, A., 2015. “Wish we would have known that!”
Communication breakdown impedes person-centered care. The Gerontologist, 55(Suppl_1), pp.S50-S60.
Nayebi, N. and Majd Teymouri, R., 2015. Communication skills and related factors within patient by nursing
student. Journal of Holistic Nursing and Midwifery, 25(2), pp.93-101.
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NMBA, 2017.Professional standards. Access date: 6.9.2019. Retrieved from:
https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx
Norouzinia, R., Aghabarari, M., Shiri, M., Karimi, M. and Samami, E., 2016. Communication barriers perceived by
nurses and patients. Global journal of health science, 8(6), p.65.
Riley, J.B., 2015. Communication in nursing. Elsevier Health Sciences.
Vertino, K.A., 2014. Effective interpersonal communication: A practical guide to improve your life. OJIN: The
Online Journal of Issues in Nursing, 19(3), pp.1-6.
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