Nursing Reflection: Community Placement, Oral Care, Infection Control

This nursing reflection details a student's experience during a community placement focused on oral care and hygiene. The student reflects on their role in demonstrating proper oral hygiene techniques, emphasizing infection control practices such as hand decontamination and the importance of obtaining informed consent. The reflection follows Gibbs' Reflective Cycle, exploring the student's feelings of anxiety and concern when first tasked with the procedure, particularly given the intimate nature of oral care and the potential for patient distress. The student evaluates the experience, highlighting the significance of patient comfort, communication, and the challenges of providing care to individuals with physical limitations. The analysis focuses on the importance of clear communication, the use of appropriate tools like soft-bristled toothbrushes, and the broader impact of oral hygiene on overall health. The conclusion underscores the crucial role of nurses in promoting oral health and hygiene, the importance of effective communication, and the need for proactive patient education. The action plan outlines the student's commitment to further learning, improved patient interaction, and increased community involvement to enhance their nursing practice.

Running head: NURSING REFLECTION
Nursing Reflection
Name of the Student
Name of the University
Author Note

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Gibbs’ Reflective Cycle
Skill: Oral Care – Infection prevention and control
Description
In this reflection, I am going to reflect on my personal experience
during my community placement as a trainee nurse to demonstrate the
process of infection control in dental care and oral hygiene. The
placement simulation group which I was enrolled went to a multi-skills
laboratory to practise comprehensive oral health and hygiene. The role of
community campaign was to educate the rural people living under poor
hygienic set-up to understand the importance of dental hygiene. My role
was to work under the instructions of the registered nurse or to assist
them in delivering oral hygiene. It was one month long community
placement and during the second week of my placement, I was asked by a
senior registered nurse to demonstrate proper skills for the maintenance
of oral hygiene. I was assigned a colleague and was asked to brush his
teeth with the help of tooth brush and toothpaste. The first thing which I
did was, I put on gloves in order to prevent hand contamination. I also
followed effective hand decontamination even after wearing gloves. As
per the NICE guidelines effective hand decontamination cause significant
reductions in the transmission of potential harmful pathogens present in
hand. This in turn reduces the rate of occurrence of preventable
healthcare-associated infections and thereby reducing rate of mortality
and morbidity (National Institute for Health and Care Excellence 2014). I
initiated my work after taking consent form my colleague. This is because

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as per the ethical norms and code of conduct of Nursing and Midwifery
Council UK, a nurse needs to act in best interest of people in all time (code
4). This code emphasize on taking informed consent from the patient
before the initiation of the treatment Nursing and Midwifery Council UK
2017). After taking informed consent, I undertook a quick visual
assessment of his buccal cavity. 13th code of conduct of Nursing and
Midwifery Board UK (2017), instruct a nurse to accurately access the
normal signs and symptoms or worsening physical condition before the
initiation of the treatment. I then positioned him in such a comfortable
position so that he could tolerate the wash. According to the Nursing &
Midwifery Board UK (2017), special pay and attention must be given in
order to satisfy the physical needs. I that point of time, physical comfort
was one of his prime needs and hence emphasized on it. Thereafter I
brushed his teeth via proper moving the brush through the edges and
corners or each tooth and via carefully side passing the gums and tongue.
I finished off via helping his to rinse his mouth first with water and then
with mouth wash to clean his gums and tongue. I treated my partner in
such a way, pretending that he was physically unable to hold the brush
and perform the oral hygiene all by himself. However, I was allowed to
communicate with my colleague and he was allowed to assist me in terms
of gargling and spitting with water at the end of the procedure.
Feelings
When I was first informed that I will be asked to perform this task, I
felt extremely anxious and concerned. The first thing which came to my

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mind that I haven’t brushed anyone’s teeth apart from myself and since
mouth is a personal and intimate part of the body and is not exposed to
anyone other than a dentist, I felt more conscious. I was concerned about
how my partner about whom I was not personally involved, will react to
my approach of examining his mouth. Moreover, I felt that I am not
competent enough to carry out this role, going against the “preserve
safety” ethics of Nursing & Midwifery Board. I was also concerned that my
own range of anxiety might affect my partner who also passing through
an awkward and embarrassed phase. My share of anxiety increased
further after the initiation of the treatment when I noticed that my partner
suddenly started coughing as an affect of distress. This made me further
hesitant to carry forward the procedure. This is the common response
coming from the carers when they observe that their patient is in distress
(Schultz 2013). I immediately call my senior registered nurse in order help
me out with the situation. This was the part of the informed decision
making process. According to Oshima, Lee and Emanuel (2013), shared
decision making in health care practise helps in procuring improved care
with reduce cost. The registered nurse asked me stop the act for a while
and to resume after his cough subsides. I followed her directions and ask
my partner to spit the entire forth in the basic and then resumed brushing
after he felt conformable. After this act, there was no notable mishaps in
my community placement acts and after the completion of the act, I felt
relieved.
Evaluation

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That major learning outcome after the completion of this act was a
sense of satisfaction that I was successful in providing the care in a
comprehensive manner. I also after completion of the act, I also realized
that patients value supportive and caring dentist. The feeling of having a
supportive, dedicated and caring dentist can help the patients to take the
supreme control of their own oral health (Sbaraini et al. 2012). The
experience also helped me to understand that proper oral hygiene is
important for avoiding unnecessary infections. It also helped me to
understand that it is difficult for the people with physical disability to
observed comprehensive oral hygiene. Inadequate oral hygiene may be
made worse via systemic diseases and medication that may eventually
produce rapid decline in oral health. This decline in oral health and
hygiene affects both the quality of life and general health of the patients
along with their carers (Zuluaga et al. 2012). Despite my initial discomfort,
my experience under this process highlighted the complex problems that I
might have solved in advanced under the provision of care to the patients
with whom I might not have previous contact This task also helped me
work on my communication skills and I understood the importance of
proper communication skills in delivering comprehensive care to the
patients. Proper nursing communication helps in ascertaining patient
satisfaction and thereby modifying the therapy plan accordingly (Radtke
2013).
Analysis

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After the completion of the dental care activity, I analysed that
communication at the personal level before the initiation of the care plan
might have help me and my partner in proper understanding about each
other and this will in turn will help to achieve a standard level of co-
ordination. According to Kourkouta and Papathanasiou (2014), proper
communication between the patient and n nurse is an important factor
behind the successful outcome of an individualized nursing care plan. In
order to achieve this, the nurses are required to understand and
simultaneously help their patients via demonstrating kindness, courtesy
and sincerity. I also analysed that selection of soft bristled toothbrush is
appropriate towards the prevention of dental trauma or trauma to the
gums. Dental decay is the most chronic diseases that is prevalent
worldwide. Several factors like microbial, immunological, genetics,
environmental contribute to onset of dental caries. However, proper
maintenance of dental hygiene can help to reduce the predisposition at
significant rate (Peterson et al. 2013; Andreasen et al. 2012).
Conclusion
Maintenance of oral care and hygiene is crucial or dental health and
nurses play a crucial role in assisting the patients in maintenance the
same. This task identified the role of the nurse in encouraging patient for
the maintenance of proper dental hygiene (Alfano 2012). Oral hygiene in
nursing homes are required to be improved. The resistant behaviour
coming from the patient is the major barrier towards providing optimal
dental care (Willumsen et al. 2012). Proper communication is another

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important role in nursing profession. Quality of communication in
interactions between health care professionals and patients has an
important impact on patient outcomes. This influence is pivotal in domains
like patient health, adherence to hygiene, education towards health and
well being and satisfaction with care. As the nurses have the principal role
in satisfying the communication needs of the patients, effective
communication skills in nursing is regarded as one of the critical element
of patient care (O'hagan et al. 2014).
Action Plan
My next plan of action is to read m ore books in relation to dental
health and hygiene and effective nursing communication. My aim will be
to provide proactive care to my patients in future. I will also make sure
that I access all the dental history of the patients before initiation of the
therapy. I will also try educating the patients about the importance of
dental health in maintenance of proper health and hygiene. I will also try
to remember that in the first attempt the patient might feel awkward in
sharing his or her dental hygiene data with me or might feel embarrassed
while allowing me to access his or her buccal cavity. In such scenarios, I
will take help of effective communication to side-pass the sense of
awkwardness. Since I love to interact with people, I think my approach of
effective communication will act as my strength in providing quality care. I
will also participate in more community nursing campaign. Further access
towards community care procurement will provide me more exposure to

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different dental health complications and steps required to overcome such
health scenarios.

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References
Alfano, M.C., 2012. Connecting dental education to other health
professions. Journal of dental education, 76(1), pp.46-50.
Andreasen, J.O., Lauridsen, E., Gerds, T.A. and Ahrensburg, S.S., 2012.
Dental Trauma Guide: A source of evidence‐based treatment guidelines
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Kourkouta, L. and Papathanasiou, I.V., 2014. Communication in nursing
practice. Materia socio-medica, 26(1), p.65.
National Institute for Health and Care Excellence, 2014, Infection
prevention and control: Hand decontamination.National Institute for
Health and Care Excellence, England.
Nursing and Midwifery Council, 2017, The Code for nurses and
midwives.Nursing and Midwifery Council, UK.
O'hagan, S., Manias, E., Elder, C., Pill, J., Woodward‐Kron, R., McNamara,
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