Critical Incident Reflection: Nursing Practice and Ethics

This report provides a detailed reflection on a critical incident experienced by a registered nurse, focusing on a spirometry test and subsequent complaint. The nurse describes the situation, her feelings, and the evaluation process, utilizing the Gibbs reflective model to analyze the incident. The report highlights the importance of critical thinking, communication skills, and ethical considerations in healthcare. It discusses the impact of the incident on the nurse's professional and personal life, including the involvement of the Australian Health Practitioner Regulation Agency (AHPRA). The analysis emphasizes the significance of maintaining hygiene, obtaining written consent, and the importance of learning from such experiences to prevent future issues. The conclusion stresses the value of critical evaluation, decision-making, and remaining calm in stressful situations to protect against negative outcomes. The nurse's action plan includes strategies for dealing with allegations, such as effective communication, knowledge of relevant laws, and the importance of presenting evidence. The report underscores the need for nurses to protect themselves against defamation and to utilize their rights within the healthcare system. The nurse's proactive approach, supported by negative medical reports, played a crucial role in demonstrating her innocence.

Nursing Assessment

Table of Contents
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................1
Demonstrating knowledge by reflecting on critical incident.................................................1
Conclusion.......................................................................................................................................5
REFERENCES................................................................................................................................7

INTRODUCTION
A registered nurse requires meeting all requirements outlined by state and authorized licensing
body in order to gain nursing license. This present study is going to show some negative effects
of critical incidence which have on professional and personal life of nurse Butts & Rich, (2019).
Further, it will discuss the whole incidence which will be discussed and shared by nurse with
effective critical and communication skills. It will also show importance of having critical
evaluation skills and also following codes of ethics in health care department. All skills and laws
developed for registered nurses also play an important role in protecting against any lawsuit and
getting justice.
MAIN BODY
Demonstrating knowledge by reflecting on critical incident
In the context of nursing and health care I can say that working in this department is not an easy
task as one of the main responsibility and role of nurses and all health care professionals is to
take care and providing better treatment to patients. Taking care of them, maintaining hygiene,
protecting their rights and performing each and every task in an ethical manner. But still after
following all these, nurses and health care professionals have to face some problems due to
patients aggressive, possessive and other behaviours. Some patients takes undue advantages of
some situations. Critical incidents happen in healthcare department but as nurse we all need to
come out from such incidents in an effective manner. One of the critical incidents i want to share
which I experienced while dealing with one of my patients with the help of Gibbs reflective
model Dressler & et.al., (2018). It can help out in explaining the whole incident and my roles and
skills which I used in an effective manner such as:
Description: I want to describe the whole situation in which I have to attend a patient which
was allocated to me in my patient list for spirometry test. It is a normal test which is being
performed and done in order to access how well lungs are working of patient and also knowing
the normal range of inhaling and exhaling air. This spirometry test is being done for diagnosing
asthma and chronic pulmonary disease. For any type of test and dealing with patient I usually
interact with patient by telling them my personal interview and knowing their conditions in order
to make them feel comfortable and engaging in the process of tests. In this case also I followed
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same steps as calling patient from waiting room, wished her with good morning and explained
the whole process which I was going to use. Before that day or 2 weeks ago I was on sick leave
as I was not feeling well and I had a residue cough and due to this the patient showed concern
about my cough. But for making her sure that i am well I told her that now I am fine and felling
well and I have been sick previously and this cough is just that after effect. For more making her
sure I also told her that I went through from several investigations but all reports were negative
After that the patient became comfortable. After few days that patient lodged a complaint against
me that I have caused her asthma as I was suffering from cough and did not use proper hand
sanitize during the process Tawanwongsri & Phenwan, (2019).
Due to this Australian health practitioner regulation agency sent a notification and requested
me to respond on such allegations. This complaint was made under the Health Practitioner
Regulation National Law which is specially developed for helping out registered practitioners to
seek help for any health issues. If we become fail to prove ourselves against allegations then we
have to pay penalties. This was one of my critical incidents which affected me the most.
Feelings: Initially after getting that notification about complain I overwhelmed and also
burst into tears. I was completely shocked that this is happening to me but after that I made
myself strong and used me critical thinking skills and all options, ways and sources from where i
can get help. So, I thought about insurance to seek help but when I rang my membership then I
notified that I was not insured at that time of providing and dealing with that patient because of
the process of switching to another insurance provider. Again I become hopeless and was
thinking that all doors of hopes have been closed.
Again I stood up and tried to understand the whole situation and by making use of my skills of
critical evaluation, working under pressure, taking decision after evaluating the whole situation
and remaining calm and patient I decided to write a letter to APHARA with the whole incident.
In that letter I wrote down the whole incident which happened that day and how I deal with that
patient even after using hand sanitizer and lack of proper resources in room where such
spirometry test happens Li & et.al. (2020). In my favour I told them as we are not provided hand
basin in that care plan room but still we are taught to maintain hygiene before, during and after
touching any tool, patient and dealing with patient. I already told the whole story about my
sickness to patient and patient agreed and became comfortable in it and agreed on continuing the
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process. In addition, I also wrote about all negative results which I get in investigations from
which I went through when I was sick and I think it was one of my main proof.
Evaluation: After evaluating the whole situation I found both negative and positive aspects of
this situation and from this incident I learned so many new things. When I notified and received
a notification about complaint and wrong allegation I became shocked and hopeless. I came to
know that anyone can take undue advantage of their rights and because of sources and laws of
help, people can complain easily about anyone. But on the positive side I found myself positive
as I was having critical thinking and evaluation skill and my effective communication skills
helped me out to explain the whole incident to APHPRA in an effective manner. I also came to
know that before providing treatment and dealing with patient we need to take written concern of
patient for protecting ourselves against wrong allegations and any law suit and penalties as well
Contreras & et.al., (2020). By making use of skill of explaining things, memorizing I also told to
health practitioner regulation law after using hand sanitizer only I touched all tools and
instruments used in spirometry test like disposable spacer and spirette and these was all new and
opened from a sterile pack. So, there is no chance of passing infection on to her. I also learned
from this that as a professional we all require to meet our responsibilities and following all
guidelines. It plays an important role and help all of us in accomplishing our goals and having
positive effects of all thing. Following all things in an ethical manner also protect us in
preventing against wrong allegations, negative effects of critical incidences and lawsuits
Analysis: Health practitioner regulation law (national law) is mainly committed to provide an
accessible complaint handling mechanism in order to make sure that the national registration
scheme for health practitioner is responsive. Before making any decision they held investigation
and evaluate the situation in an effective manner. As there were no proof against me except some
post effects of sickness Dressler & et.al., (2018). But still as per the normal ethics we often
maintain hygiene as it is our responsibility to treat patient. So, I Can analyse that after knowing
all facts only APHPRA will take decision and there may be chances of getting affected of patient
by touching chairs inside the waiting rooms, at her own workplace and any other place. Overall
it can also be evaluated from the whole situation that putting allegation is easy but for proving
them there is requirement of having proof. I can also be said that patient came for spirette test
and it is being mainly done for diagnosing asthma and any other associated problem. People
often came for getting this test done but most of them come when they have some symptoms and
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face problems in breathing. So, there may be chances of having asthma in that patient before
results of test. So, it proves that there is no strong proof against me. I also stated that as I was not
feeling well so I was in sick leave for 2 weeks and when I felt better then only I came back as all
reports were negative. So, it can also be analysed that there is no strong proof which can show
that as a nurse I caused and passed infection on to that patient Johns, (2017).
Conclusion: From the above overall situation or critical incident I experience and went through
it can be summarized that critical evaluation, decision making and ability to remain calm in any
situation played an important role in healthcare department. All these skills help registered
nurses and other health care professionals in evaluating situation, taking better decision which
can protect them against all negative effects which critical incidents can have. It has also been
concluded that following ethics and maintaining hygiene while dealing with patients is also
important as it helps both patients and health care providers against getting infected. Taking
written concern from people or patient is also important for protecting against penalties and
lawsuit and also from negative effects of such incidence on personal and professional life
Patterson & et.al., (2016). It can also be concluded that ability of learning from all situation
makes an individual able to protect themselves and work under any kind of situations without
becoming frustrated and aggressive.
Action plan: There are several ways and strategies of dealing with wrong or false
allegations. One of the most important ways and technique is using all skills and remaining calm
and evaluating the whole situation before taking any action. Dealing with sensitive and critical
cases is an important task so, after accusing of any crime it is important to have knowledge about
appropriate sources and actions which people can take. Other main strategy and skill which can
help in such cases and I used is using an effective oral as well as written communication skills,
speaking with attorney before making any statement. I believe that when an individual lies then
he fumbled while talking and speaking and sharing feelings with confidence shows about the
truth Teng, (2016). Following codes of ethics, speaking in an effective manner, not becoming
aggressive and frustrated are all effective ways which can help anyone in taking out them from
critical situations. All these skills also helped me out and increased my confidence that I can also
prevent myself against negative effects of critical incidences.
We all have rights to be protected from defamation and using appropriate laws. All people
have some rights and by making use of that rights and laws, we can prove ourselves if we are
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right, I did the same and by making use of my own skills, rights which are given to registered
nurses I tried to prove myself innocent. As an evidence I also represented all negative reports of
investigations. So, it can be said that all skills played an important role in proving right things
Hains, Turner & Strand, (2017).
Conclusion
From the above study it has been summarized that critical skills and ability to take decision
skills under critical incidents played an important role. These skills help out to people in taking
better decision and also protecting against negative effects which some emergencies and critical
incidents have. Further, this study has also discussed importance and effectiveness of using
Gibbs model as how it helps people or nurses in sharing or explaining their feelings about any
critical situation and problem which they experience along with action plan used for solving
them.
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REFERENCES
Books & Journals
Butts, J.B. & Rich, K.L. (2019). Nursing ethics. Jones & Bartlett Learning.
Contreras, J.A. & et.al., (2020). Effects of Reflective Practice on Baccalaureate Nursing
Students’ Stress, Anxiety and Competency: An Integrative Review. Worldviews on
Evidence‐Based Nursing.
Dressler, R. & et.al., (2018). The cross-cultural reflective model for post-sojourn
debriefing. Reflective Practice. 19(4). pp.490-504.
Dressler, R. & et.al., (2018). The cross-cultural reflective model for post-sojourn
debriefing. Reflective Practice, 19(4), 490-504.
Hains, T., Turner, C., & Strand, H. (2017). The non-medical surgical assistant in Australia: who
should contribute to governance?. Australian Journal of Advanced Nursing, The, 35(2),
51.
Johns, C. ed. (2017). Becoming a reflective practitioner. John Wiley & Sons.
Li, Y. & et.al. (2020). Nurses’ Psychological Feelings About the Application of Gibbs Reflective
Cycle of Adverse Events. American Journal of Nursing. 9(2). pp.74-78.
Patterson, C. & et.al., (2016). Nursing students' reflections on the learning experience of a unique
mental health clinical placement. Nurse education today, 46, 94-98.
Tawanwongsri, W. & Phenwan, T. (2019). Reflective and feedback performances on Thai
medical students’ patient history-taking skills. BMC medical education, 19(1), p.141.
Teng, J. (2016). AHPRA-Notifications, investigations, processes and outcomes. Australian
Nursing and Midwifery Journal. 23(7). p.24.
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