Nursing Reflective Journal: Analysis of Clinical Issues & Experiences

This reflective journal assignment delves into various clinical issues encountered in nursing practice. It utilizes Gibbs' reflective model to analyze experiences related to communication breakdowns between healthcare staff and patients, particularly in a mental health setting with dementia patients. The journal also reflects on the impact of insufficient staffing levels on patient care and the author's practice, highlighting the importance of adequate staff ratios for optimal patient outcomes. Furthermore, it addresses medication errors stemming from poor documentation, emphasizing the critical role of accurate record-keeping in patient safety. The reflections conclude with action plans for improving communication skills, advocating for better staffing, and ensuring meticulous documentation to enhance the quality of patient care. Desklib offers a wealth of similar solved assignments and past papers for students.

Running head: REFLECTIVE JOURNAL ASSESMENT
REFLECTIVE JOURNAL ASSESMENT
Name of the student:
Name of the university:
Author note:

1REFLECTIVE JOURNAL ASSESMENT
Communication issue between nurse, patients and other staffs
Introduction
The nurses are positioned to be the important companion of the health care facilities; they
must build an effective communication between themselves and the other professionals in
order to deliver appropriate care to the patients. The healthcare professionals require active
communication with one another and with the patient so that they can share information and
data linked to the patient and the treatment process (André et al., 2016). This assignment will
have a reflective account of the experience I had in a clinic due to lack of communication
between the health care facilities. It will focus on Gibbs reflective writing (Smith & Roberts,
2015).
Description
I was transferred to a mental health centre, where patients where suffering from various
mental issues. And during my placement I was in charge of a patient who was suffering from
dementia and I encountered with various issues that was effecting treatment process and
patient’s recovery. The major reason behind this issues was lack of communication between
the healthcare facilities and the patients. The communication issue was creating a major gap
and due to which we were not able to understand the problem the patient was facing
(Clements et al., 2015).

2REFLECTIVE JOURNAL ASSESMENT
Feeling
As I noticed that there as a huge communication gap between the patient and the rest of the
health care facilities, I started feeling helpless. As it is known that a patient suffering from
dementia losses its ability to remember things, the patient I was working with was facing the
same issue. And it was creating a huge problem in the treatment as he was forgetting things.
And as I was new so there was less communication taking place between me and other nurses
which was very disturbing.
Evaluation
According to NMBA 2016, standard 2, the nurses should have a better professional
relationship with each other in order to provide better care to the patient. As I completed few
days in the centre, I started interacting with the patient and the other nurses, and I came to
know that they don’t have proper knowledge about the patient suffering from dementia, and
as he hacks the ability to remember things, it was observed that he has shared half of his
details with one nurse and rest with the other, so the treatment process was not planed in
proper way.
Analysis
After I completed my session in the clinic, I was able to understand that there is a huge gap of
communication between administration and the basic level in the health care centre due to
which the treatment of the patient is lacking behind. And this gap can only be filled by better
communication skills between the patients and the health care facilities, so that they can
understand better the requirements of a better treatment process (Clements et al., 2015).

3REFLECTIVE JOURNAL ASSESMENT
Conclusion
To conclude, I would say that after working with my patient in the health care service, I
gained a better understanding about the importance of communication with in the facilities
and the patient. And communication makes the treatment process much easier and effective.
Action plan
Focusing on my strengths and weaknesses I identified while working with the patient, I intent
to work on my communication skills and would like to induce a plan for rest of the facilities
in order to improve their communication skill. So that the chances of errors in the treatment
reduces and a better care is provided.

4REFLECTIVE JOURNAL ASSESMENT
Less staff ratio in clinical and its effect on my practice, environment and
patients.
Introduction
There is a strong connection between the number of staffs in a health care centre and its
patient outcomes. Shortage of healthcare staffs in a clinic creates a lot of stress on the staff
and it effects the patient treatment process (Lasala, 2017). In this portion of the assignment, I
will use the Gibbs reflective model to reflect my experience and knowledge about the
situation I faced due to lack of staff. And it will also focus on its effect on my practice and
the care provided to the patients (Smith & Roberts, 2015).
Description
I was posted to a health care centre in a rural area and after I reached their I found that there
was some serious issue going on with the health of the people there. The population there was
suffering from some kind of flue and every day about 4,5 individuals were getting admitted.
And the number of staffs were very less, around 15 members were present because the centre
was located at a very backward area. It was getting very tough for us to operate with such less
number of staffs. And we were not able to help the patient and their condition was not
improving.
Feeling
It was really frustrating as there was less number of staffs and the number of patients were
increasing day by day. At it ended up into a situation where each nurses were handling 10
patients alone. It becomes near to impossible for a single nurse to handle 10 patients, and due
to which I was not able to give proper care and treatment to the patients as per their
requirement. And it was ultimately effecting their health.

5REFLECTIVE JOURNAL ASSESMENT
Evaluation
Working there for a week and I was already aware of the importance of a complete staff in a
health care centre. I evaluated that the patients condition was not improving, they were not
getting proper attention and treatment. the environment of the health centre was very
disturbing, the nurses were getting tired and losing hope as they were not able to handle so
many patients at a time.
Analysis
From the experience I was able to analyse the importance of a full staff clinic in a region like
this. I was not able to perform under a pressure where I had to take care of 10 patients on my
own. And a proper team is required to help the patients and maintain a healthy environment
in the clinic which is also important for the patient’s health (Hill et al., 2015).
Conclusion
In order to conclude, I would state that from my experience I came to understand the
relationship between the staff ratio and the patient outcome. I understood the importance of a
complete nursing staff in a health care centre and it also has an effect on your performance.
No nurse can work or handle its patient alone and needs support from the other staffs to
provide a better service to the patients.
Action plan
Based on the experience, I identified that, the clinic would need a proper number to staffs to
provide better service. And to do so recruitments are needs to be done, so that the health care
centre and its patients does not suffer and get better care. They should always keep count of
the shortage of their staffs and take proper action towards it (World Health Organization.
2016).

6REFLECTIVE JOURNAL ASSESMENT
Medication error happen because of poor documentation
Introduction
It has been seen that medication error is a leading cause of most of the deaths in health care
centres. Medication administration is a very complex process that consist of prescribing,
dispensing, transcribing, and administering medication and monitoring the person suffering
(Jember et al., 2018). Due to the lack of proper documenttion, proper treatment and
medication is not provided and sometime medication error occurs that causes harm to the
patient. By using Gibbs reflective method, I will highlight the issue of medication error which
is caused due to poor documentation (Smith & Roberts, 2015).
Description
I got a patient to work with who was suffering from dementia and he was at the age of 70.
He was observed to be getting worse, no improvement was seen in his behaviour. Then after
few days when I got his file of documentation, I observed that he was getting medicated
properly, he was provided with wrong treatments. The whole documentation was wrong for a
person who age 70.
Feeling
I felt very disappointed and careless in myself, I was angry at the other staffs, because, due to
our casual attitude a patient was suffering. He could have recovered, but because our staff’s
error in documentation he is still in the same position.
Evaluation
After I observed his case, I observed that it was not only in this case where the documentation
was done wrong. There were several other cases where the patient was provided with wrong
medication and due to which his condition was getting worse. And as a new intern there I did

7REFLECTIVE JOURNAL ASSESMENT
not check the documentation file earlier and was proceeding with whatever treatment the
staffs were providing.
Analysis
I was able to analyse my fault and others as well. I observed that how a single mistake can
harm a person’s life, and may be if the fault was not observed, it would have ended in a much
worse way.
Conclusion
Coming to the conclusion, I can say that, situations would not have ended in a bad way if the
documentation of the patient was done more carefully. It should have been made by focusing
on the patient’s case history and keeping in mind all the medication he has been taking.
Action plan
While preparing a prescription and documenting a patient detail, medications, treatment
procedure, I will not rush, and I required I will again go through the whole case study and
interact with the patient to prepare a proper and correct documentation. I will not carryout
instructions from others until I check it myself to avoid any circumstance that would lead to a
harmful outcome.

8REFLECTIVE JOURNAL ASSESMENT
Reference
André, B., Frigstad, S. A., Nøst, T. H., & Sjøvold, E. (2016). Exploring nursing staffs
communication in stressful and non‐stressful situations. Journal of nursing
management, 24(2), E175-E182.
Clements, A., Curtis, K., Horvat, L., & Shaban, R. Z. (2015). The effect of a nurse team
leader on communication and leadership in major trauma resuscitations. International
emergency nursing, 23(1), 3-7.
Hill, A. M., McPhail, S. M., Waldron, N., Etherton-Beer, C., Ingram, K., Flicker, L., ... &
Haines, T. P. (2015). Fall rates in hospital rehabilitation units after individualised
patient and staff education programmes: a pragmatic, stepped-wedge, cluster-
randomised controlled trial. The Lancet, 385(9987), 2592-2599.
Jember, A., Hailu, M., Messele, A., Demeke, T., & Hassen, M. (2018). Proportion of
medication error reporting and associated factors among nurses: a cross sectional
study. BMC nursing, 17(1), 9.
Lasala, K. (2017). Nursing workforce issues in rural and urban settings: Looking at the
difference in recruitment, retention and distribution. Online Journal of Rural Nursing
and Health Care, 1(1), 8-24.
Smith, J., & Roberts, R. (2015). Reflective practice. Vital Signs for Nurses: An Introduction
to Clinical Observations, 222-230.
World Health Organization. (2016). Consultative meeting planning for the global patient
safety challenge: medication safety, 19-20 April 2016, WHO Headquarters Geneva,
Switzerland: meeting report (No. WHO/HIS/SDS/2016.20). World Health
Organization.