Reflective Report on Gastroenterology Clinical Experiences

This report presents a comprehensive reflective analysis of gastroenterology, focusing on clinical practices, patient experiences, and ethical considerations. It begins with an overview of key clinical practices such as doctor-patient communication, empathy, and medical ethics, highlighting their importance in healthcare. The report then delves into reflective experiences, including the author's personal experience as a patient, analyzed through Gibbs' reflective cycle, and reflections on experiences as a practitioner. The author discusses challenges in integrating these practices, such as workload pressures and linguistic differences. The report concludes with actionable insights for healthcare professionals to improve patient care and ethical considerations. The author emphasizes the importance of effective communication, empathy, and ethical principles in fostering positive patient outcomes and building trust in the doctor-patient relationship.

Gastroentrology

Table of Contents
1. Reflective Report.........................................................................................................................1
2. Reflective experiences.................................................................................................................4
2.1 Reflection on my experience as a patient..............................................................................4
2.2 First experience as a practitioner...........................................................................................5
2.3 Second experience as a practitioner.......................................................................................7
3. Conclusion...................................................................................................................................9
4. References..................................................................................................................................10

1. Reflective Report
Clinical practices are considered as one of the important part for health care providers, that
provides them a roadmap for making better decisions for patients’ well-being. It includes good
communication skills, patient-doctor relationship, way of influencing patients to get a treatment
etc. that aid practitioners to become professionally develop in the respective field (Hunt,
Denieffe and Gooney, 2017). Reviewing over such practices like “Doctor patient
communication”, it has been evaluated that it is one of the integral part of clinical experience,
on which whole procedure for well-being of suffering people depends. When done well, good
communication gives a therapeutic effect for the patient, which has been validated in the whole
treatment. The way in which a health care provider communicates information to sick people is
as highly important as the information which is being communicated (Han and Pappas, 2018).
People who understand their consultants are more likely to acknowledge about their health
problems, apprehend their treatment procedures, modify behaviour accordingly, by following the
prescribed medication schedules. In fact, through engagement in clinical practices, I have
recognised as a health practitioner that effective physician-patient communication will provide
better health outcomes. Communication is important to deliver top quality patient care, where
any breakdowns in the same can lead to cause serious problems, such as complications,
difficulties in getting consent form from patients if they do not fully understand what care
providers are saying, medical errors etc. (Grace, 2017). Along with this, poor communication
often misleads to arise dissatisfaction among patients with increasing illness severity. In this
regard, whatever tactic facility chosen by health practitioners, it needs to make sure that all forms
of communication including clinicians are top-notch. In addition to this, developing and
enhancing the written and oral communication skills of healthcare providers can aid to prevent
big medication errors, that both hurt patients as well as bring negative attention to hospital.
Another main factor which is crucial is “Empathy in clinical practice”, which defines as an
ability to place oneself in a situation face of another person, to look at condition of them via their
emotions, perspectives, actions and reactions (Dunn and Hope, 2018). This practice helps care
providers in building a trusting connection with patients and associated staffs by focusing on
different point of views. It strengthens the communication among physicians and patients to
understand how they are surviving including their experiencing and what they are feeling. As a
healthcare provider, I have personally recognised that when suffering people undergo treatment
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then they feel anxious, overwhelmed or even terrified about what will go with them
(Kangasniemi, Pakkanen and Korhonen, 2015). In some cases, prognosis or poor communication
is grim, that might affect negatively on mentally and emotionally stages of patients. Medical
practitioners in this regard, must understand that empathetic care can help the alleviate suffering
when a patient fight with chronic disease and goes through a complicated surgery and endures a
long recovery. Therefore, empathy is essential for promoting a dialogue with suffer people about
their anxiety, discomfort and preferences. If empathy is neglected in clinic practices by
practitioners, then it may arise a number of issues like feeling of discrimination, overt aggression
and more, among patients, which often impact negatively on desired health outcomes (Virdun
and et. al., 2015). Therefore, from analysing the concept of empathy as a main clinical practice, I
have evaluated that under this practice, if health practitioners keep themselves in place of patient
then they will better understand what they feel under medical process. So, this would help
practitioners in behaving more effectively with patients and offer better treatment options to
them, for health recovery (Pye, 2015).
“Medical Ethics” is another crucial clinical practice, which is based mainly on set of values
such as respect for autonomy, beneficence, non-maleficence and justice (Wojda and et. al.,
2017). Universally, these principles deal with respect for all human beings as moral equals,
where practitioners need to make sure that all their medical actions must intend to achieve health
outcomes with less harm, as well as treat patients with fairness and equity. The first two
principles that are beneficence and non-maleficence states for doing good and avoiding the evil
or harm practices respectively. While another one principle i.e. autonomy states that people are
born as the autonomous agents, which gives rights to self-determination and get respected
(Wilson, 2019). Autonomy in clinical practice demands for respecting all individuals with their
dignity. By doing so, healthcare providers can take opinion or willingness of patients to get
involved or not. Practitioners can refer this practice in case of conflicts or any confusion.
Integrating it in medical process, allow care providers or doctors to create effective treatment
plan by involving patients and their family members, for getting desired health outcomes. Along
with this, ethics also look at the moral basis of public health as a guiding support, that put in
place for maximizing welfare, where health is considered as a main component of welfare
(Greenberg and et. al., 2016). This kind of view frames under clinical experience as core moral
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challenge of the public health, in terms of balancing liberties of individuals with advancement of
their good health outcomes.
Considering the above health practices, there are number of factors that creates challenges in
front of health practitioners to integrate the same in their medical procedures (Liu and et. al.,
2017). One of such factor includes population, where benefits to an individual cannot readily be
personalised from those to another, nevertheless its burdens and benefits might often appear to
fall as unevenly on other sub-groups. For an example – if a patient is suffering from chronic
issue like cancer then disclosure of this information to its family members, without concerning to
him, arise ethical issue in front of health practitioners. But if same information will not disclose
then it may raise complications in providing treatment, as well as lead to death of patient also.
Therefore, under such kind of situations, it may difficult for care providers to maintain ethics in
clinical practices. Similarly, factor which leads communication related issues in healthcare
services, includes workload pressure and linguistic differences (Feldman, Lee and Fiore, 2015).
Due to workload issues, where to see number of patients in a single day especially during an
epidemic, arise challenges for care providers to make effective communication and personal
relationship with them. While linguistic problems create issues for both patients and health
practitioners, in making communication with each other and understanding treatment plan, gain
consent form etc. This lead to create poor communications and arise medical errors in treatment
procedure (Spector and et. al., 2015). In context with challenges arise in integrating the empathy
in clinical practice, includes Self-esteem, self-efficacy, major satisfaction, interpersonal
relationships and gender difference. It creates problems and challenges for healthcare
practitioners in understanding what their patients feel during treatment. Therefore, before
implementing clinical practices, it is essential for understanding impact of these factors, so that
professionals can get prior trainings.
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2. Reflective experiences
2.1 Reflection on my experience as a patient
On the basis of my clinical experience as a patient, during consultation I have faced lots of
issues, which I am going to evaluate through Gibbs reflective cycle in following way –
Step 1: Description - Considering this module https://www.youtube.com/watch?v=95Pm-
D2ToS8&feature=youtu.be, which is deliberated example on one of the main issue i.e. bad
consultation. So, as a patient, I have felt that the tablets which were prescribed by my doctors,
are not working well. During my treatment procedure, my doctor hasn’t given me much options
of treatment (Ahmadi, Nilashi and Ibrahim, 2015). In a last meeting, when I went to consult my
doctor about not getting desired result from medicines prescribed by her, then, she behaves
enormously with inappropriate way of communication. She has not even try to listen my problem
properly, not even console me to take the treatment afterward. I was expecting that she would
communicate with me properly, understand my situation which I was facing worst from last few
months and will offer different treatment plans to gain quick recovery and overcome from health
issues. But, on contrast, she has just tried to state that due to my busy working schedule,
treatment is not going well (Perkins and et. al., 2018). So, I got frustrated and disappointed due
to bad consultation with my doctor.
Step 2: Feelings - As communication between doctor and patient plays a main role in
carrying out the treatment procedure appropriately. Therefore, if it won’t be done properly then it
will lead to arise feeling of bad clinical experience. So, facing similar kind of situation, during
last meeting with my doctor, I have felt really disappointed. During discussion, I have tried to
discuss with doctor about my problems, that why I couldn’t take medicines on time due to busy
schedule. I was expecting to change my treatment plan according to my situation and lifestyle,
but instead of that, my doctor hasn’t listen properly (Kangasniemi, Pakkanen and Korhonen,
2015). She not even put herself in my situation to understand what situation I have faced. The
conversation I have made with her was not gone well as I expected. It really disappoints me and I
have left the conversation with doctor after a while, when not getting appropriate outcomes.
Step 3: Evaluation – From all over the situation, I have evaluated that before taking
treatment, the first main thing that enhance clinical experience for a person is relationship and
trust bond between doctor and his/her patient, which would can be made only with appropriate
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communications. When a patient consults physician then he/she expects to get positive response
from them where medical practitioners make treatment plan as per their situations. But in my
case, it hasn’t gone well due to lack of effective communication, my doctor hasn’t offered me
better options to overcome from health issues and the way through I get quick recovery (Dunn
and Hope, 2018). My doctor has failed to console and influence me to take prescribed medicines
or any new further treatment. After last visiting at clinic of my doctor, it has also been evaluated
by me that if she was not good in influencing patients for taking her prescriptions.
Step 6: Analysis – Through all over the incidence that I have recently come across when I
consult with my doctor about not get satisfied result from the medicines prescribed, it has been
analysed that in such case it is responsibility of doctors to offer new treatment plan and
understand patient’ situation. If physicians fail to do so, then it will create bring negative
attention to doctor and health association where he/she works.
Step 5: Conclusion – From my last clinical experience, it has been concluded that the
thing that goes well in a treatment is the trust of patient on his/her doctor. In this case, from
starting of treatment procedure, I was not feeling satisfied from my doctor and couldn’t make
trust with her (Grace, 2017). The medication discussions were also often not so extensive that
creates difficulties for me to understand what medications are being and why it should be taking,
when it is not working well. Since shared decision making between health practitioners and
patient is hailed for future medical consultation, by in my case, such process hasn’t gone due to
insufficient exchange of information. Therefore, all such situations really disappointed me
because of failure in getting engagement with my physicians.
Step 6: Action – After bad clinical experience, I have decided to change my doctor and
will consult a new one, who has ability to understand my working and busy life situation and
prescribe treatment plan accordingly (Han and Pappas, 2018). Before that, I will consult with my
friends and on social sites who have faced similar kind of situations, to explore to whom they
have consulted for achievement of desire health outcomes.
2.2 First experience as a practitioner
As a health practitioner, I have observed that delivering services for well-being of patient
is much difficult job. Growing population and increasing number of patients on regular basis,
arise difficulties for doctors to make trust and personal bond with each individual (Hunt,
Denieffe and Gooney, 2017). Dealing with numerous of different cases of public health, gain a
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higher clinical experience to medical practitioners both in negative and positive manner.
Therefore, being a health care provider I have also gone through a number of cases, that enhance
my clinical experience. One of such cases, I am described here, to demonstrate the critical
situation and how I have managed the same, by using Gibb’s reflective model in following way –
Step 1: Discussion – The incident I will be reflecting here, on occurred whilst I was placed
first time on the nursing ward, after completion of proper clinical training (Virdun and et. al.,
2015). There was an elderly service user who had been admitted due to psychiatric issues
(somatization disorder and depression) on the ward. Upon the arrival of this patient, me and my
team has read his notes properly to analyse his mental health condition. This report highlighted
that respective person had significant learning difficulties, which reflects that to make verbal
communication with him will create difficulties. So, concerning on his case study, as it was my
first experience with an elder service user, creates problem for me to make effective
communication with him, especially to calm him and show compassion (Perkins and et. al.,
2018). Along with this, understanding and addressing the individual needs of this mentally ill
person, without verbal conversation is much critical job for me and associated team of health
professionals. When I try to make conversation with this service user to inform what type of
treatment we are going to provide, then, without being hearing properly, he has become overtly
distressed and meanwhile began to cry and try to harm himself. Under this situation, to calm him
down and gain his consent for treatment, arise problems for me and my medical team.
Step 2: Feelings – Prior to occurrence of this critical incident, as it was my duty to
integrate different clinical practices like empathy, effective communication skills and more, so, I
have used the same. At the time of this situation, I had kept myself on the position to understand
what he feels and use non-verbal communication tactics like facial expression and body gestures
to engage the elder service user in given treatment (Ahmadi, Nilashi and Ibrahim, 2015).
However, initially I did not feel confident due to less experience to deal with such situation
independently, so, it has increased my anxiety level. Afterward, my seniors have handled the
case where, to deal effectively with him by using therapeutic communication techniques.
Step 3: Evaluation – This experience includes both good and bad elements that has led me
to increase my understanding of mentally ill patient needs and my responsibility as a nurse
practitioner within nursing ward (Spector and et. al., 2015). My role was to physically examined
and analyse health condition of service user then prescribe and administer the medication, then
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recommend for diagnostic or laboratory tests, read the report and more. But after this critical
case of elder patient, I feel that I had not fulfil all latter responsibilities effectively, due to lack of
communication techniques and experience to deal with elder patients.
Step 4: Analysis – One of the most common problems that I have analysed in the
discussed case of elder patient with mental issues, is accessing healthcare for them, especially
when they are suffering from learning disabilities (Feldman, Lee and Fiore, 2015). Therefore,
this situation aids me in analysing the importance of communication in clinical practice that must
be abided with professional standards, including way to prioritise people, preserve safety,
practise effectively, promote professionalism and building trust. In context with present incident,
due to failure in recognising how to respond with patient anxiety and respond compassionately, I
have now focused more on paying attention to promote the wellbeing of such patient by making
use of many verbal and non-verbal communication techniques.
Step 5: Conclusion – It has been concluded after handling this case that now I am more
mindful about importance of being positively respond and exert professionalism within clinical
practice (Liu and et. al., 2017). If similar kind of situation will arise in future, then insight I have
gained from such experience aid me take courage and confidence to handle effectively. The
strong working relationships within healthcare professionals team also have a greater emphasis
within psychiatric ward, for increasing levels of group cohesiveness.
Step 6: Action Plan – After getting engaged in such a situation, I have evaluated my
weakness points which is lack of communication skills. Therefore, I have then focused to work
on strengthening this ability and get training for more than three months under my seniors, for
analysing way to integrate different communication techniques in treatment plan (Greenberg and
et. al., 2016).
2.3 Second experience as a practitioner
The skill which I am going to reflect on further part includes supervision of an intramuscular
Injection (IM). It is an injection that give deep into the muscle of patient due to quick absorption
rate. The reason behind made reflection on this skill is the opportunities that I have gained during
injecting the drug at my current practice placement (Wilson, 2019). However, it is the most
commonly used drug administration method. However, being a nurse I have undertaken many
intramuscular injections but I am going to discuss one of such case, where I have given the
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responsibility of administrating the Papaverine drug to a lady who is suffering from high BP
(blood pressure) issues.
Step 1: Discussion – It was morning, when I was asked to administer an intermuscular
injection to a lady of 45 years old, who has been suffering from blood pressure issue, due to
hypertension (Wojda and et. al., 2017). So, I was agreed immediately as it was not my first case,
then I called that patient to come into room and take her seat. When the lady has come then I
start chatted to her about how she felts, if she had any problem or concerns., then I gained
consent by asking her whether it was to administer IM under guidance of superiors. When she
was comfortable then I prepared equipment having two needles, a piece of gauze, a sharps box
and rest of medication (Pye, 2015). After checking entire prescription with senior nurse and
ampoule against it, then I drew up drug with one needle to dispose it in sharps box then attached
the other needle for further process and injected it well. But when this lady has left, my seniors
has explained to me that all process has been done correctly, but still I have made a mistake. As I
had put the needle into her body too far in case, if it was broken inside then it would not be
possible to get it out easily.
Step 2: Feelings – Afterward, when I was asked to take another case of administration the
IM then, I felt much anxious and less confident because I have never put my concern in deep
manner. Along with this, for next few months, I haven’t take this duty due to anxiety, where
concerning on my situation, senior staff told me and enabled to learn how to administer IM in
appropriate way, including way to get relieve over my anxiety (Kangasniemi, Pakkanen and
Korhonen, 2015). In this regard, after three months, I have taken this duty again and the first case
was patient who roughly of my age and has cardiac issues. It again arises feeling of nervous
because before that, I have never taken case of younger person. But with cooperation and
guidance of senior nurse, I have fulfilled my duty and get back my enthusiasm.
Step 3: Evaluation – From overall experience, it has been evaluated that although clinical
skill gone well but if instruction won’t be taken well, then it will lead to raise serious health
issues for an individual, sometime could be death (Dunn and Hope, 2018). Therefore,
recognising this situation, I have felt that followed the instructions given from mentor might
bring nervous in service providers, but help them to perform with more confidence and correctly.
It has been evaluated that during nursing training, I have given my focus only on learning skills
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about clinical practices, instead of consequences that might create from the same, if not done
properly.
Step 4: Analysis – I have analysed the importance of on-going learning where working
under guidance of seniors has given me advantage to understand how single mistake lead to
cause medication errors. This situation where I didn’t make any mistake but still have taken my
concern about serious consequences that may create by a simple duty of injection (Grace, 2017).
It brings my attention towards more skilful practices of administration of IM, including
communication ways to take consent from patient for the same.
Step 5: Conclusion – By thoroughly analysing this event which is not concerned about any
critical case, but allowed me to give attention on minute steps of way to injecting an individual,
without any harm or serious consequences (Han and Pappas, 2018). I have recognised from such
as evidence about importance of working in collaboration and keeping the knowledge as up to
date for being professionally developed in clinical practices.
Step 6: Action Plan – After facing this situation, I have then aimed to be more proactive to
deal with a situation and perform more professionally, regardless of my role within nursing team.
It includes way to come from own anxiety and fear to make mistake, as well as how to keep
ready for taking challenging role in clinical field (Hunt, Denieffe and Gooney, 2017). For this
purpose, I have made planned to work more effectively in cooperation with team-members. I
have made mind to follow each and every instruction given my mentors, for performing my
duties in best way.
3. Conclusion
From all over the report and reflection on number of events as patient and care providers’
perspective, it has been analysed that any clinical case whether it is critical or quite looking
simple like injecting drug, it is foremost duty of staff or associate people to have knowledge of
healthcare practices. By integrating each and every practice like effective communications,
empathy, respect and treat patients with dignity, moral wholeness of every individual without
conditions or limitation, aid practitioners to deliver best services. To affirm uniqueness as well as
differences of each people, respecting their ideas, values or ethnicities, will help in getting better
health outcomes. Before giving any treatment to patient, it is foremost duty of medical
professionals to must inform which medication is being provided to them, and taken their
perspectives for preparing effective treatment plan.
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4. References
Books and References
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studies identifying the elements of end-of-life care that patients and their families rank as
being most important. Palliative medicine. 29(9). pp.774-796.
Perkins, G. D. and et. al., 2018. A randomized trial of epinephrine in out-of-hospital cardiac
arrest. New England Journal of Medicine. 379(8). pp.711-721.
Ahmadi, H., Nilashi, M. and Ibrahim, O., 2015. Organizational decision to adopt hospital
information system: An empirical investigation in the case of Malaysian public
hospitals. International journal of medical informatics. 84(3). pp.166-188.
Spector, N. and et. al., 2015. Transition to practice study in hospital settings. Journal of Nursing
Regulation. 5(4). pp.24-38.
Feldman, L. S., Lee, L. and Fiore, J., 2015. What outcomes are important in the assessment of
Enhanced Recovery After Surgery (ERAS) pathways?. Canadian Journal of
Anesthesia/Journal canadien d'anesthésie. 62(2). pp.120-130.
Liu, V. X. and et. al., 2017. The timing of early antibiotics and hospital mortality in
sepsis. American journal of respiratory and critical care medicine. 196(7). pp.856-863.
Greenberg, J. A. and et. al., 2016. Clinical practice guideline: management of acute
pancreatitis. Canadian Journal of Surgery. 59(2). p.128.
Wilson, J., 2019. Infection Control in Clinical Practice Updated Edition. Elsevier Health
Sciences.
Wojda, T. R. and et. al., 2017. Keys to successful organ procurement: An experience-based
review of clinical practices at a high-performing health-care organization. International
journal of critical illness and injury science. 7(2). p.91.
Pye, L. W., 2015. Communications and Political Development.(SPD-1). Princeton University
Press.
Kangasniemi, M., Pakkanen, P. and Korhonen, A., 2015. Professional ethics in nursing: an
integrative review. Journal of advanced nursing. 71(8). pp.1744-1757.
Dunn, M. and Hope, T., 2018. Medical ethics: a very short introduction. Oxford University
Press.
Grace, P. J. ed., 2017. Nursing ethics and professional responsibility in advanced practice. Jones
& Bartlett Learning.
Han, J. L. and Pappas, T. N., 2018. A review of empathy, its importance, and its teaching in
surgical training. Journal of surgical education. 75(1). pp.88-94.
Hunt, P. A., Denieffe, S. and Gooney, M., 2017. Burnout and its relationship to empathy in
nursing: a review of the literature. Journal of Research in Nursing. 22(1-2). pp.7-22.
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