Healthcare Reflection: Reflective Analysis of a Nursing Incident

This assignment presents a reflective analysis of a nursing incident, structured around the 'What? So what? Now what?' framework. The student, during their internship, recounts a situation involving miscommunication with an elderly patient and her son, highlighting the importance of accurate patient history, effective communication, and ethical conduct in healthcare. The reflection delves into the consequences of the student's actions, including the emotional impact on the patient and her family, and the damage to the hospital's reputation. The analysis explores the theoretical underpinnings of nursing practice, emphasizing the role of nurses in providing psychological support and the critical need for patience, sensitivity, and ethical decision-making. The student identifies key failures, such as the mishandling of patient information, inappropriate communication styles, and lack of anger management, and relates these to the impact on patient care and the overall professional conduct. The assignment concludes with a discussion on the need for continuous self-assessment, ethical awareness, and the importance of learning from mistakes to improve patient outcomes and uphold professional standards.

HEALTHCARE

Analysis of Journal
Health care service is among those services which requires sensitivity and accuracy in the
execution. Health is the primary concern for human beings and any insensitive or careless
action taken in this regard could actually cost in a high way. Taking nursing as a profession
has been one of the decisions which has helped me in gaining the qualities of being sensitive
and active in each and every action that I take or execute. Nursing is one of the professions
which demands that the person has to be accurate and attentive in nature. The responsibility
of nurse is quite critical as she is the one who needs to follow the instructions of the doctor in
the most specific manner and has to deal with multiple patients at a time, keeping in mind the
medical history of each patient. This specifies that the nurse has to be specific in her
approach and her decisions in the emergency situations should be accurate too (Allen, 2019).
A nurse is the one who has to act as a doctor in his absence and thus, the medical knowledge
along with the mental management or psychological management of the patient is to be
handled by the nurse.
WHAT?
During my internship I remember an incident where I realized the significance and sensitive
score that needs to be maintained by a nurse. I was dealing with an old lady who had a
fracture in her right leg, was 86 years old, had diabetes and was eager to visit her husband’s
home after his death, seven months ago. She was living with her son, after her husband’s
death and was going through mental stress more than physical. She has been missing her
husband’s home and wanted to spend rest of her life. But due to her health issues and
psychological pressure, her son has brought her with him. She slipped in the bathroom due to
which her right leg was fractured and she was brought to hospital where I was doing my
internship. While servicing her one morning, she managed her morning activities with little
help due to which I appreciated her and she took me wrong that if she does her activities on
her way, she could visit her husband’s home. This impacted her mentally in a positive
manner and she expressed her joy to her son when he visited her in the evening. His son was
really annoyed and agitated and he immediately called me and asked if I have given her false
hope for reacting positively to her treatment. He spoke in a loud voice to me which created
pressure on me and I asked the old lady if I have said her any such words in the morning as
her son was stating. I talked to the old lady through reaching her face and speaking loudly so
that I am audible to her as I carried a perspective that she has hearing problem. This made her
son angrier and he asked me to talk to her in a proper manner and not shout at the patient as

that may impact her mental condition. When he stated that his mother doesn’t have any
hearing issue and why and how can I talk to my patient in this manner which is unethical n
my profession, that moment I realized that I have mixed up the report of my other patient
with her. This lady doesn’t have any hearing issue and the way I talked to her my body
language, expressions, volume of voice all has been unethical. The moment I realized my
mistake I apologised to the old lady and to her son from the bottom of my heart and made
them comfortable. The old lady has also been impacted psychologically and this would have
impacted her physical health too. The willingness of going to her husband’s place has been
enhanced and this could have an intense negative impact when she doesn’t get over there.
The lack of communication, lack in anger management, lack of clarity in the patients’
medical history, mismatching the medical history, all took place in this incident and in the
career of a nurse all these actions are considered to be unethical. The incident took place in a
ward of four which impacted the other patients too and this, also impacted the outlook of the
nurses working in that organisation or hospital. The way I communicated with the patient and
the patient’s family member all were inaccurate and this, made the incident a lesson for me or
my profession.
Reflection (SO WHAT?)
The experience which I gained through this incident has been quite productive for me and it
actually was the best lesson which I learned during my internship at the hospital. Dealing
with elderly patients requires immense patience and handling them is a bit difficult. Though
the incident has been marked with my multiple faults and absence of mind which created the
issue or the scenario. The son of that old lady was completely furious because of my
unexpected reaction and this impacted the old lady too. Being a nurse to an elderly person,
the foremost requirement is to manage anger and express and explain every bit of the word
uttered in the simplest manner. In technical words, communication is one of the major and
the significant considerations in the profile. It was observed that my communication was not
appropriate and specific in words. The old lady mistook my words of appreciation and this
gave her the hope of visiting to her husband’s place which was no way possible from her
son’s end. Had I appreciated her just for her activities and not provided her with the hopeless
hope, the scenario wouldn’t have taken place (Rogers & Bush, 2015). The second issue that
was created cause of my fault was that I reacted to her son’s statements and questions in a
wild manner. A nurse could or should never be wild in her approach no matter, what her
patient is going through (hearing issue) or how worse the situation is. The reaction to the

son’s behaviour could have been calmly handled through explaining the matter to him. The
way I approached my patient, my body language, my way of expression, words that I used
and other considerations all were unprofessional and unethical.
The messing up of the medical history of the two patients is something which a nurse could
never afford to practice as this could cost a human life. The details of the patient should be
clear on the nurse or any health care service provider as this is the criteria where the accuracy
and the specification of the profession comes in. I miss-matched the hearing issue of another
patient with the old lay due to which the situation was worsen and the impact on the patient
as well on the patient’s family along with the organisation’s reputation all was messed up.
Even if a confusion was there in my mind whether the lady has a hearing issue or not, I
should have checked her medical log which would have made the things clear to me and my
reaction would have been accordingly. Approaching the patient in a furious and wrong body
language carries a hard core impact on the patient and due to this, the patient could lapse in
some situations too. I would have appeared to be more sensible if my reactions were as per
the ethics of nursing and health care services. During my training sessions I remember one of
my trainer used to say that a nurse is a part time doctor as she is the one to treat the patient in
the absence of the doctor. During emergency if the doctor is not reachable then the decision
of the nurse could either save the patient or worsen his or her situation. I even argued with the
old lady’s son which was again unethical as a nurse should always provide all the information
about the patient to her family in the most accurate manner (Squires et al. 2017). A nurse is
the one who could actually heal the patient’s family’s mental illness or worry. The family of
the patient should be convinced and should have faith on the organisation and on the nurse
servicing their family member. The faith is actually the best remedy for the patient’s family
and this completely depends on the nurse capability to provide this. The way I reacted to the
situation made the patient as well as the family unsecured and sicker though it was
psychological but it impacted quite aggressively to them. The situation could have been
handled in a very simple and professional way if I would have kept myself calm and the
biggest is that of mismatching the reports of the patients would not have taken place. As a
nurse I carried a big responsibility and a mistake which appeared to be minor but had major
consequences, was committed by me. If I would have been much attentive in my course and
in my profession this scenario would not have taken place and I would have been holding a
good position. I have been quite guilty on acknowledging my mistake and had no option of
correcting it in anyway because the old lady has been disturbed by the contradicting

statements of her son and which I gave in the morning. On the other hand, her son has been
disappointed with his choice of organisation where irresponsible nursing is provided (though
it was only me who has been so irresponsible in the organisation).
Linking to Theory
According to Fischer et al. (2018), nursing is a critical job where the responsibility carries an
over sensitive position and a single or minor wrong step or decision could lead to major
results. The nursing job holders need to be sensitive enough to acknowledge the mind set of
their patients and respond accordigly. This is a necessary and a significant consideration or
characteristic of nursing. Though nurses appear to be only the care takers of the patients in
the absence of doctors but they are the ones who actually have to deal with the psychological
factor of the patient. The doctor is the one who cures the disease while nurse is the one who
provides mental support and strength to the patient and to the patient’s family. This conveys
that nurses carries a significant position and place in the medical treatment. The
psychological factor is a vital factor as a patient could never recover without winning the
game over his mind. Medicines helps in physical cure while the strength and the capability of
dealing with the pain and situation requires the psychological factor to be strong. A nurse
needs to have immense patience and her sensitivity should be quite accurate in nature to
sense the requirement or the mind-set of the patient. This provides her with the solution as
what and how the min- set could be made strong of the patient. The family of the patient is
another patient with whom the nurse has to deal with. The nurse needs to make them satisfied
and develop a faith in the treatment that is being provided to the patient. As per Jensen et al.
(2016), nursing needs to be considered a far more critical and supportive service of the
hospitals as they are the ones who creates the goodwill of the organisation through providing
best service to the patients. Attentive, alert, sensitive, patience, calm, responsible and many
others are the required characteristics of the nurse, in the absence of any of them the service
of the nurse could not be accurate or productive. A nurse needs to deal with the patient along
with his family and this is where the patience needs to be worked on. As per Bakon et al.
(2018), the patient’s family members needs to be provided with a balanced information as
this helps in keeping the situation under control. The communication skills of the nurse has to
be specific in nature and accurate in her words, as the words she speaks can either build hope
in the patient and his family or lose it. Thus, the balance between the two needs to be
maintained as any of the two if misbalances, then a chaos could be created. The application of
SOAP and other models helps in maintaining or transfering the patient which should be

utilised by the nurse. These models specifies the ingredients or considerations for the transfer
or keeping the record and thus, the activity of the nurse gets simplified.
As stated by Alghamdi (2016), nursing is more of management activity then it is for servicing
the patient. A nurse needs to manage the patient, his family, doctor and the records of the
patient. All these activities needs to be performed in exact way as any of the activity if not
performed in an accurate way, it could lead to some hazardous situation or consequences.
Other than these management, self-reaction management is another activity which she has to
perform which includes, anger management, reaction management, words management, etc.
The personal life of the nurse is not to be considered while she is servicing any patient as
while servicing she has to consider only the patient’s condition and what could be done to
make his condition better. Nursing is just about having the degree or educational qualification
but the practical knowledge and the intensity of the position being held should be well
understood by her.
Suggestion (NOW WHAT?)
On acknowledging the position and the mistakes that took place there are few suggestions
which could have made the situation under control and the impact of the reactions could have
been lightened. The moment I reacted in a furious manner to my patient, I could have been
stopped by her son and he would have calmly asked me the reason for such reaction. This
would have made it clear to me that I am miss matching the reports of the patients. Though
this suggestion is not realistic as no family member would accept such a treatment. The next
suggestion is that I should have not reacted to the old lady’s son’s reaction as he was not
incorrect at his position, I should have realized or questioned myself as why he is reacting
aggressively and cross checked myself. This would have made the situation much more
pleasant and under control. Had I realized my mistake before reacting to the son, I would
have carried a place of apologising to the patient as well as to her son. A nurse needs to have
immense patience and her sensitivity should be quite accurate in nature to sense the
requirement or the mind-set of the patient. This provides her with the solution as what and
how the min- set could be made strong of the patient (Fischer, 2016). The family of the
patient is another patient with whom the nurse has to deal with. The nurse needs to make
them satisfied and develop a faith in the treatment that is being provided to the patient. The
messing up of the medical history of the two patients is something which a nurse could never
afford to practice as this could cost a human life. The details of the patient should be clear on
the nurse or any health care service provider as this is the criteria where the accuracy and the

specification of the profession comes in. I miss-matched the hearing issue of another patient
with the old lay due to which the situation was worsen and the impact on the patient as well
on the patient’s family along with the organisation’s reputation all was messed up. The entire
situation arose because of my fault and I didn’t made a single mistake but I kept on adding it
which worsen the situation. This experience has provided me with some practical and
important factors to be considered in nursing and beyond this situation till date I have not
made such mistakes and intend in future also no such mistakes would take place.

References
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