NRSG139 Assessment: Reflection on Clinical Assessment Challenges

This essay is a reflection on the challenges encountered in healthcare, utilizing Gibb's reflective framework. It analyzes a TPR assessment video, focusing on the nurse's application of the fourth standard of practice, which involves comprehensively conducting assessments. The reflection covers the assessment process, feelings about the process, an evaluation of the experience, and an analysis of patient engagement. The author identifies the importance of communication skills and documentation in improving clinical outcomes and proposes an action plan to enhance these skills for future practice. The reflection emphasizes the need to internalize the Registered Nurse Standards for Practice and integrate them into clinical practice to improve data gathering and patient outcomes. The essay also acknowledges the challenges that can arise from overly open patients and the importance of maintaining professional boundaries while fostering communication.

Running head: REFLECTION WITH GIBB’S FRAMEWORK
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Reflection with Gibb’s Framework
Student’s Name
University

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Reflection with Gibb’s Framework
The registered nurse standards for practice offers standards that nurses are required to use when
dealing with patient-related issues. The TPR assessment video offers a case of how the nurse
applies the fourth standard of comprehensively conducts assessments to meet the needs of the
practitioner (Nursing&MidwiferyBoardofAustralia, 2016). This essay is a reflection of the
challenges in healthcare using the Gibb’s reflective framework.
Description
The video is an assessment process of a practitioner evaluation the progress of the patient by
analysis the health of the patient following the requirements of the fourth principle (Burston,
2018). The practitioner used clinical tools to measure vital signs of the patient to understand the
progress that the patient has achieved in healthcare progress after treatment. To test the progress
of the patient, the practitioner used questioning skills to engage with the patient and gather
required information from the patient. Further, Middleton (2016) clinical assessment tools were
also used to measure the exact value of clinical signs like the pulse rate that cannot be narrated
by the patient. From this I understood that the nurse had to use both methods to collectively
collect required information for informed decision making. Since clinical decision making needs
to be based on proper information, then the practitioner has to use appropriate data collection
methods.
Feelings
The healthcare process captured the right data as per the methods used by I feel it did not meet
the required information. From my view, I thought the practitioner is supposed to engage more
with the patient in collecting holistic data for the assessment. However, the time was limited

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since the practitioner only gathered the clinical sighs and recorded them but failed to verbally
engage the patient more (Maier, Barnes, Aiken, & Busse, 2016). This is due to limited time
which made it difficult for the practitioner to trace the history of the patient from the time he left
the healthcare institution up to the time he came back for a checkup. This information is missing
in the assessment and is useful in making clinical decisions.
Evaluation
One good thing with the experience is the cooperation of the patient towards the whole
assessment process. The patient was participative in the process and asked a few follow-up
questions which made the whole process easy. Participative patients make clinical processes
easier since they seek to understand the whole process making it easy for the practitioner to ask
follow-up questions that relate to the assessments (Clarke, 2014). Further, engaging in the
clinical process makes the patient to understand the assessments thus following up easily when
there is another similar checkup.
Analysis
From the process, engaging with patients in clinical care yields more results since it satisfies both
the needs of practitioner and the patient. when the practitioner requests to carry out a few tests on
the patient and the he is more accommodative than expected, then the whole process becomes
easy since the barrier of communication have been broken down by the patient. However, open
patients can be challenging since they tend to ask questions about the whole care process and
easily refuse some tests since they have built rapport with the practitioner (Douglas, et al., 2016).
Once the practitioner respect have been simplified to common understanding, the patient can sue

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this to his advantage by frustrating the care process and pushing for any processes that benefit
them more rather than yield more outcomes.
Conclusion
The care process was easy and good since the patient was open to the practitioner. This made it
easy for the practitioner to address the patient since the communication barriers had been broken
down. This is the reason why the assessments process was easy and took the shortest time
possible (Clarke, 2014). Both the practitioner and the patient enjoyed the whole process with the
patient suggesting that he was feeling better every day. This is a way of appreciating the care
received from the practitioner. However, I discovered that clinical communication skills are
important in improving clinical outcomes since they allow collection of more clinical
information.
Action plan
The need to improve clinical outcomes is based on applying the required standards of the
Registered nurse standards for practice and at the same time applying communication skills. This
is through internalizing the standards and working on ways of integrating all of them in clinical
practice. This will lead to improved clinical processes and proper data gathering of patient
outcomes. However, documentation of clinical data is critical since it ensures that patient
information is recorded well to make it easy for analysis of the outcomes (Douglas, et al., 2016).
Therefore, as a practitioner, I need to focus on improving my communication skills to improve
interaction with the patient and at the same time allow gathering of more data for the whole
process. I will, work on communication and documentation skills as a way of ensuring that my
clinical abilities have improved for future practice.

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References
Burston, A. (Producer). (2018). NRSG139 Ax3 TPRVignette [Motion Picture].
Clarke, C. (2014). Promoting the 6Cs of nursing in patient assessment. Nursing Standard,
28(44), 52-59.
Douglas, C., Booker, C., Fox, R., Windsor, C., Osborne, S., & Gardner, G. (2016). Nursing
physical assessment for patient safety in general wards: reaching consensus on core skills
. Journal of Clinical Nursing.
Maier, C., Barnes, H., Aiken, L., & Busse, R. (2016). Descriptive, cross-country analysis of the
nurse practitioner workforce in six countries: size, growth, physician substitution
potential. BMJ Open, 6(9).
Middleton, J. (2016, February). The impact of accurate patient assessment on quality of care.
Nursing Times.
Nursing & Midwifery Board of Australia. (2016). Registered nurse standards for practice. .
Nursing & Midwifery Board of Australia.