Reflection on Nursing Practice and NMBA Standards in Clinical Setting

This report is a reflection on a nursing student's clinical experience in an orthopedic department. The student recounts an interaction with a patient suffering from a knee fracture, detailing their initial approach to patient care, which involved focusing on medical treatments and, at times, aggressive communication due to the patient's frustration. The report critically analyzes the student's actions in light of the Nursing and Midwifery Board of Australia (NMBA) standards, specifically Standard 2 on therapeutic relationships and Standard 6 on providing safe and responsive care. The student acknowledges shortcomings in developing a therapeutic relationship and failing to be responsive to the patient's emotional needs. The reflection highlights the importance of empathy, effective communication, and a patient-centered approach in nursing practice. The student concludes with a commitment to adopting a more empathetic and responsive approach in future practice, emphasizing the need for both physical and mental well-being of patients, as well as adherence to professional conduct and standards. The report also includes a comprehensive list of references to support the analysis.

Running Head: NURSING 0
BACHELOR OF NURSING

NURSING 2
Contents
Introduction......................................................................................................................................3
Description of my experience..........................................................................................................3
Evaluation........................................................................................................................................4
Application of Standard 2 of nursing...........................................................................................4
Application of standard sixth of nursing.....................................................................................5
Analysis...........................................................................................................................................6
Conclusion.......................................................................................................................................6
Action..............................................................................................................................................6

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Introduction
Nursing and Midwifery board of Australia contains the nursing standards that guide the
practice of nurses (Ramezani & Kazemnejad, 2014). The proper application of these standards
led to ethical nursing practice. For a nurse, to deliver her best practices, it is important that she
adheres to the guidelines and standards set for nursing. In a practice of a nurse, she comes across
at a point where the decision-making becomes tough various instances. In such difficulty
situations, the standards guide the way of nurse (Childs, 2015). The following essay will be
discussing the one of the events that I came across during my nursing practice and the critical
analysis of application of NMBA standards in it.
Description of my experience
During the days, when I was doing my bachelors of nursing. I had a nursing experience in
one of the orthopedic departments of the hospital. There was a patient who was in his thirties and
had suffered from the knee fracture. Although, the injury was not that severe but he was advised
bed rest for a period. To build my practical knowledge, I was instructed by my head to provide
for medicines and injections in case of increased pain and other uncomfortable symptoms
(Wiechula, 2016). The next day, it was 11 am, when I found the patient acting aggressively with
staff. I understood with his behavior that he might be feeling uncomfortable with the increased
pain in his left knee. The increased pain had made him act aggressive then I rushed to my work
station and got the allocated injection of the patient to inject him. When I reached there, I tried
calming him so that I could inject the medicine peacefully in his body but I could not calm him.
Then I got frustrated and harshly spoke few words to him. On that, the patient felt helpless and
lied on his bed and then I performed my medication therapy. As the days passed, I reimbursed
my duties as a nurse giving him all kind of medical therapies to cure the fracture on his left knee.
Whenever he used to get frustrated, I used to calm him by acting aggressively with him. I
became indifferent towards him. Although I used to provide him with effective, medical
therapies but there were little improvements in the movement of his left leg (Godi, 2013).
Observing no improvements in the patient’s health, the nursing charge of the patient was shifted
to my colleague. A watershed moment in my life arrived when I saw my colleague calming the

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patient with a warm hug. I could see her doing so every time the patient was emotionally
weakened, as days passed the patient could walk properly. When finally, the doctors reported
him to be physically fit for the discharge. Considering the contribution of my colleague to the
patient, my colleague was rewarded with the best performer of the month and I could sense her
achievement because of her positive response to the patient.
Feelings
During my learning experience with the patient, initially I used to feel the pressure of the
duties reimbursed on me. As I never used to associate the duties with the positive responsibility
of serving the patient. As a student of bachelor of nursing, to improve upon my learning
experience of practical knowledge, I was given responsibility of the patient with the knee
fracture. With the feeling of simply curing him with the medical therapies, I used to attend him
daily. Sometimes the aggressive behavior of the patient due to his inability to walk used to
frustrate me which I used to deal with aggression. The day when the responsibility of the patient
was taken away from me, I felt like a failure and was quite depressed for a week. After
sometime, seeing the nursing practice of my colleague. I recognized mistakes and did the
commitment of doing it again (Arnold & Boggs, 2019).
Evaluation
Application of Standard 2 of nursing
After going through my past nursing practices, I understood the importance of adhering
to the standards of nursing. The experiences, I had in the nursing practice gave me some good
and bad experiences (Melnyk, 2014). After sometime, when I reflected upon the event, I realized
many mistakes that I committed as a nurse patient with knee fracture. According to the standard
2 of NMBA standards 2016 that states importance of therapeutic relations with the patient, I did
not develop the good relations with the patient (Fisher, 2017). My focus was to only provide the
medical therapies for the cure. The therapeutic relation states developing good emotional bond
with the patient for the improved recovery rate of the patient. The therapeutic relation has five
important components that include Trust, positivity, empathy, acceptance, and genuine interest
(Zhang, 2017). These components lead to the development of the therapeutic relation with the
patient. I never focused on building trust and empathetic relation as my only focus was to simply

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treat him with the medicines. (Webster, 2013) I never spoke with kindness to him as I thought
that I could treat his mood swings by being aggressive to him. It is also proven by medical
science that a good emotional connection can cure a person better than medicines (Pickles,
2019). In my practice, I used to feel agitated with her aggressive behavior so I started acting with
harshness in order to calm her but my strategy proved negative and led to the worsening for her
state. My behavior with the patient lacked patience and positivity that resulted in worsening of
the situation. If I had acted calmly with her then the patient would have responded more
positively with the treatment (Lowe & Plummer, 2019).
Application of standard sixth of nursing
The other important standard for nursing practice is Standard sixth that is to provide
appropriate, safe, and responsive quality practice of nursing (Attree, 2015). As a newly
registered nurse, I did my best to provide the best quality of nursing practice. I used to take care
of hygiene while providing her the medicines. I always assured that I provide the safe quantity of
medicines as the high dosage could result in bad health. I made sure the area around her remains
cleaned. I always cleaned or washed my hands before giving her medical therapy. I also ensured
that the syringes used for injections are well sterilized to avoid any further infections. As my
patient was physically unfit due to knee fracture to perform basic human activities, I made sure
that the urine bottles are frequently changed. The bed-sheet was also changed once in every three
days.
Although under the NMBA standard sixth, I have provided him with the safe and
appropriate quality of nursing practice but at times, the responsive component was missing from
the practice (Kane, 2015). I stuck around with the basics of the nursing practice but was not
responsive with the specific situations. As, the patient used to get aggressive due to his inability
to walk and situation demanded me to be more medically responsive by being soft-spoken with
him and using various kind of medical therapies to comfort him. I instead of getting more
attentively responsive, used to follow aggressive practice to calm his emotions. There was one
instance in my practice when the situation of my patient demanded me to stay a little longer at
hospital, as there was availability of no other nurse and the patient needed a mental support as he
had just recovered from a minor knee operation. I did not consider the gravity of situation and
walked away (Bromley, 2018).

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Analysis
My interaction with the patient had been a great learning experience of practical
knowledge. It had taught me how to medically cater to the needs of the patient using a patient-
centric approach but at the same time, it taught me the importance of person-centric approach, as
a right application of the person-centric approach could heal the patient mentally and physically.
The bad experiences of not being responsive to the treatment made me more responsive
according to the needs of a patient (Kane, 2015).
Conclusion
As I nurse, I could have been better at my nursing practice. It is important for a nurse to
follow the professional code of conducts and standards to deliver the best nursing care or
practice to the patient. The most important part of being a nurse is to adopt the person-centric
approach towards the patient, as a patient-centric approach makes a nurse empathetic towards the
problems or issues of the patient. The person centric approach helps in the development of the
therapeutic relationship between the patient and the nurse. It develops the element of trust,
empathy, and genuineness in the relation. The other important component to the nursing practice
is responsiveness. The responsiveness means being able to respond to the varying needs of the
patients in an effective and efficient manner (Zhang, 2017). The responsiveness element
develops the feeling in the patient that the hospital staff is caring for her well-being. The
successful incorporation of the elements could lead to better and successful relations of nurses
with their patients (Tremayne, 2014).
Action
The nursing practice during my studies as a student had taught me various ways of rightly
attending to the patient. In my future nursing practice, I would be an empathetic nurse who
would tend to patient with the heart of care. I would ensure that the physical as well as mental
needs of the patients are met effectively. I would be more soft-spoken and will focus on
developing a good therapeutic relation with the patient.

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Bromley, P. (2018). Capability in nursing. Australian Nursing and Midwifery Journal, 42-43.
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Lowe, G., & Plummer, V. (2019). Advanced Practice in Nursing and Midwifery: The
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