Driscoll's Model: Reflection on Safeguarding in Adult Nursing

This assignment is a reflective analysis of safeguarding practices within adult nursing, employing Driscoll's reflective model. The student explores various forms of abuse, including medication misuse, inappropriate physical sanctions, and psychological abuse, observed in clinical practice. The reflection describes specific incidents, analyzes their implications for patient safety and well-being, and identifies the need for improved safeguarding measures. Key learning outcomes include the importance of recognizing abuse, adhering to safeguarding principles, and implementing proactive strategies. The student proposes actions such as implementing the eight principles of prevention (empowerment, prevention, proportionality, protection, partnership, accountability, and transparency) and developing robust reporting and inquiry processes. The conclusion emphasizes the value of reflective practice, the identification of safeguarding failures, and the need for nurses to be empowered and accountable for patient safety, highlighting the importance of adopting safeguarding principles in healthcare settings.

SAFEGUARDING IN ADULT
NURSING
Student Name:
Student Number:
Date:
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Introduction
Safeguarding in nursing constitutes an important topic, especially in older adults. The
principle of safeguarding includes two underpinning principles of safeguarding being
everyone's responsibility, for the purpose of services to be rendered in an effective
manner. Hence every professional and organization needs to play their full part in
safeguarding their patient practice. Organizations and professionals need to work in
partnership in order to deliver safeguarding protection of children and adults in need.
There are two safeguarding principles that are provided by the RCN Principles of
Nursing Practice. There are eight principles that instill a proactive and empowering
stance for the purpose of preventing issues that might relate to safeguarding. Being
a nurse, I am responsible for safeguarding older patients in my care and respond to
identify the various issues related to safeguarding. The current scope of reflection
makes use of Driscoll's model in contextualizing the discussion in adult nursing and
to conclude with some of the findings from such reflection.
Analysis
In the context of UK adult is any individual aged 18 years or above and those who
are facing considerable risks from harm, abuse and neglect due to their need for
care and support are not able to safeguard themselves (Howatson-Jones, Standing,
and Roberts, 2015). Applying Discroll’s model of reflection is one of the simplest
models that allows overcoming the challenges faced and impacted patient care. The
model has certain stages for reflecting which will allow establishing key findings in
my current domain of adult nursing.
Having experience in clinical practice
Safeguard remains an integral concept in adult nursing and there are principles that
need to be applied to empower stance for effective prevention of safeguarding
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related issues. However, I have observed in my clinical practice, that the
safeguarding concerns applicable in an individual health practitioner’s practice
application are often ignored in it (Cook). For example, in adult nursing, I have seen
often prevalence of physical abuse related to misuse of medication and inappropriate
restraint in physical sanctions. Apart from physical abuse, I have often noticed
psychological abuse related to blaming and unreasonable withdrawal from services
or supportive networks. For example, older patients at my healthcare center were
removed from spiritual counseling without prior notice (Kalbfuss, and Deanus, 2017,
p 11). So according to my experience in the clinical practice, I have noticed various
forms of physical as well as psychological abuse that patients suffer from. May times
this has raised considerable issues related to safeguarding.
Description of the event
Physical and psychological abuses can be of various types. However, the type of
physical abuse that I have witnesses includes misuse of medication and
inappropriate physical sanctions (Elcock, 2015, p 21). In misuse of medication, I
have noticed that healthcare professionals administering medication without having
prior knowledge regarding it. This especially arises in specific cases when certain
medications are unavailable and substitute medications need to be administered
(Burns, 2018, p 10). This raises serious cases of medication-related safe issues
pertaining to safeguarding in older patients. In inappropriate physical sanctions, I
often found healthcare professionals not restricting or limiting activities of patients
even post their surgery or in cases of injury. They keep their activity schedule for
their patients similar to what it was when they were able to move. This might
increase the risks of further injury or pain in older adults.
In psychological abuse I have noticed during my service, that older patient being
uselessly blamed for their ailment or pain. Older patients often suffer from
withdrawing certain services without being prior informed regarding the same. Older
patients are given services from supported networks such that they are able to
manage their illnesses in a better manner (Young, Godbold, and Wood, 2018, p
172). It also helps them develop mental strength to cope with their illnesses. But in
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this case, several patients did not have any access to these services without being
notified regarding it.
Purposefully reflecting on selected aspects of that experience occurring in
clinical practice
The above incidents described reveals that older patients were subject to physical as
well as psychological abuses (Le May, 2015). Physical abuse and psychological
abuse can take on many forms hence it should not be analyzed in an appropriate
manner. In the above case of physical abuse that has been discussed for older
patients, there can be significant harm caused to the patient. In the case of
medication misuse, there is the harm of life that the patient can suffer from. There
can be allergies or risks from the development of substantial other symptoms
connected to it. Therefore, such physical harm needs in-depth analysis considering
the consequences of the same (James, 2018, p 15). Similarly, in inappropriate
physical sanctions, the patient can suffer from the risk of injury, falls, and other risks.
This will lead to the older patient to need more dedicated care. This can pose
significant complexities and older patients are at risk of developing complexities.
In psychological abuse, older patients can significantly suffer from symptoms that do
not easily improve (Donnelly et al, 2017). Blaming the patient can act in a negative
manner on patient healthcare outcomes as psychological health is inter-related to
physical health. Similarly, older patients who are dependent upon some type of
supported networks or services are at greater risk to have their health being
deteriorated from the same (Tait et al, 2015).
An analysis of the event
Safeguarding for older patients is a major concern for all healthcare professionals
and especially nurses. Thus, analyzing the event reveals that nursing professionals
need to be competent so as to identify and recognize issues related to safeguarding
such that they can protect their patients from the same (Bhandari, and Baral, 2017, p
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6) Nurses have the role to identify instances of physical and psychological abuses
such that they can empower and prevent such instances from taking place.
In the event of physical abuse, healthcare professionals including nurses failed to
realize and identify the potential harm that their action regarding medication or
physical sanctions could have caused (Fields, and Brett, 2015, p 10). In the second
instance, nurses failed to recognize the benefits provided by the supported networks
and without considering the patient's point of view simply decided to withdraw from
its practice. Therefore, nurses and other healthcare staff simply ignored the concerns
related to safeguarding the patient, exposing the patient to considerable amounts of
risks (Flynn, and Mercer, 2018, p 50).
Figure 1: Driscoll Model of Reflection
Source: (Driscoll, 2007)
Discovering what learning arises from the process of reflection
The key learning arising from this reflection experience includes analysis of relevant
safeguarding issues that arise in older adults’ practices. Though I have been able to
capably identify relevant issues related to safeguarding practice, yet there might be
prevalent a number of other safeguarding issues in the healthcare system (Ochieng,
and Ward, 2018, p 28). There was no procedure for identification of issues related to
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safeguarding connected to the healthcare system. Nurses and other healthcare
professionals were ignorant of the relevant legislation that can be applied to the
safeguarding of older patient healthcare. Though nurses are recruited based on their
competencies, they failed to identify specific issues that are related to safeguarding
and which might lead to issues related to abuse for their patients (Stevens, and
Cook, 2015). The nurses did not abide by the safeguarding principles or practices
that can enable arriving at suitable outcomes related to their patients. The principles
related to safeguarding were completely ignored and there was seen no particular
efforts that could enable a personalized approach connected with safeguarding.
Proposed actions following the event
As in the issues diagnosed above, there have been various issues related to
safeguarding connected with physical and psychological abuse, the proposed action
following the event has to be the implementation of principles (Moore, 2016, p 2).
The eight principles of prevention are empowerment, prevention, proportionality,
protection, partnership, and accountability. The application of these principles in
safeguarding in the adult healthcare setting will allow informing ways in which
professionals would work with people at risk from abuse, neglect or harm.
Empowerment will allow presuming on the basis of person-led decisions and
undertaking informed consent. This implies that before withdrawing any support
services, relevant stakeholder groups, especially the patient will be informed.
According to prevention, there will be action undertaken to prevent before the harm
takes place. In proportionality, healthcare professionals will be encouraged to
accommodate appropriate response system to the potential risks presented
(Northway, and Jenkins, 2017, p 25). In protection, there will be support as well as
representation for the people with need. Hence nurses will need to identify the
people in need and then develop a support framework for their protection. While
partnership aims at partnering with services and working with communities to deliver
appropriate care for patients. Accountability and principle of transparency will all
deliver appropriate safeguarding roles to nurses and other healthcare professionals
(Yoeli et al., 2016).
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Once these principles have been applied in the healthcare settings, there will be
stages undertaken to identify the safeguarding concerns, report them and then
participate in inquiries for developing a suitable protection plan. Identifying concerns
connected with older patients will enable resolving the problem to some extent. As
with this step, nurses will be able to develop skills relevant to identify patient cases
who face safeguarding related issues (McGarry et al, 2015). Reporting concerns are
essential as for most nurses and healthcare professionals this will be in inclusion
with organizational policies and practices. Reports will allow maintaining of records
and avoiding such cases of abuse in the future time period. While participating in
inquiries relevant protection plan will be developed, then the entire process will be
reflected upon. This will allow understanding the outcomes and learnings from the
event in a better manner.
Actioning the new learning from that experience in clinical practice
Actioning the new learning from the experience is essential in clinical practice to
attain significant outcomes in the future. Most importantly I will adopt and also
encourage my colleagues to accommodate the principles in their practice of
safeguarding patients (Ousey et al, 2015, p 14). Another concern is the development
of reports as per organizational standards and practices is essential, as this will allow
compliance to rules and regulations as set out. Then I will also instill a reflective
experience practice which will enable reflecting upon the key values and strategies
learned in the process of developing the practice of safeguarding.
Conclusion and summary of findings
In conclusion, this reflective experience has allowed learning of several important
areas that are crucial to the practice of nursing. In summary, there are several
learnings that I have gained from this entire experience. Firstly, through this
reflective experience, I was able to analyses the importance of reflective experience
in practice. With my skills, I was able to successfully identify the safeguarding
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aspects that were not being followed at the healthcare practice. There are prevalent
a number of types of abuses that older patient suffers in the healthcare settings and
only a few of them are reported. Then connect and differentiate between the various
abuses that are presented. Most importantly, it is relevant to diagnose and analyze
the implications of such practices and avoiding safeguarding principles for older
patients needs to be undertaken. This categorization and identification of the
safeguarding practices enabled recognizing relevant areas of functioning that
requires improvisation. Then I browsed through the several safeguarding principles
that are applied to the UK health care staff and practices regarding patients.
Learnings from this reflection include identification of the relevant course of action as
suggested through steps that can allow incorporation of safeguarding principles at
the workplace. Hence for a functioning workplace and healthcare setting, it is crucial
that relevant practice in regards to safeguarding is adopted. Nurses and other
healthcare professionals need to be empowered such that they can take up health-
oriented decisions to safeguard the patients within their workplace. Nurses also need
to be professionally accountable and transparent while delivering services to their
clients. As nurses, we need to value old patients and protect their interests such that
they feel secure and get appropriate supporting within the healthcare setting.
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