Gibb's Reflective Cycle: A COPD Patient Care Case Study and Analysis

Desklib provides past papers and solved assignments for students. This reflective essay details a student's experience with COPD patient care.

REFLECTION ESSAY
Practical Application SSC310
Student Name:
Student Id:

Table of Contents
Introduction:............................................................................................................................................2
Description:..............................................................................................................................................2
Feelings:...................................................................................................................................................3
Evaluation:...............................................................................................................................................3
Analysis:...................................................................................................................................................3
Conclusion:..............................................................................................................................................4
Action Plan:..............................................................................................................................................4
References:..............................................................................................................................................5

Introduction:
The objective of this essay is to present reflection of my work as care worker during my
placement with Heathfield Solutions Limited using an appropriate model of reflection. I
have researched on a number of models to examine and identify the right model that
will be suitable for my refection of work. Relfection as defined by Botten 2012 is a
process of examining and assessing your previous work from the perspective of careful
evaluation and analysis to make sense of things that happened and identify areas of
improvement which can be converted into future action plan. Reflection is a very crucial
element to one’s learning process. Rolfe et al suggested a model of reflection that is
based on the development model of Borton. Pryce, 2012 had defined the model as a
simple one based on 3 simple questions of What? So What? And Now What?. Gibb’s
reflective cycle on the other hand is a model based on staged process of examining the
work and presents a more comprehensive and elemental approach to reflection. For the
purpose of my reflection of work, I therefore, would be using the Gibb’s model in this
essay. Reflection in the clinical field as highlighted by Botten 2012 is important element
in learning about themselves and ways to work in practice.
As per the code of conduct by NMC to maintain the confidentiality the real identity of the
patient would be kept hidden in the essay and thereby the patient will be addresses as
Mr Tom.
Description:
During my place with Heathfield I dealt with a number of clients and situations. I worked
with respiratory team and one such encounter was with Mr Tom, a 71-year-old Man
having problems of COPD – Chronic Obstructive Pulmonary Disease. As per WHO
2013, COPD is a disease of lungs when due to chronic obstruction air flow to the lungs
gets interrupted thereby affecting the regular breathing pattern. I was involved with Mr
Tom during a PRP insights session on exercises and education for COPD patients. The
objective of the session was to teach breathing techniques to the patients primarily
focusing on the PLB technique – Pursed Lip Breathing. I was assisting Mr Tom during
the programme. I have been taking his score from the beginning. As soon as we started
the walking exercise, Tom started feeling breathless and unsaturated. Since morning I

have been encouraging and motivating Tom to use PLB. Tom needed a continuous
reassurance to keep doing so. After spending around 10 minutes with him he gained
some assurance. Immediately he gained his breath and was much more relaxed, calm
and comfortable now. He, however, did not continue the full program that day.
Feelings:
While I was working with the respiratory team I felt confident and was sure enough in
assisting Tom. I was happy to have learned a lot of things from the morning sessions.
While at one hand I was confident and calm at the other hand I felt helplessness as I
was unable to do anything which can help alleviate the symptoms which Tom was
experiencing. All I could do was use my knowledge and learning from morning sessions
to keep help Tom, keep him motivated in participating in exercises and give him
assurance and comfort.
Evaluation:
I believe the morning session on the breathing techniques was very valuable and the
learnings were fresh in my mind. I was able to use those to build a positive nurse-
patient relationship. Tom also had very positive opinion and experience of PRP. Puhan
et al have also supported this by concluding in their research that COPD patients have
noticed positive outcomes of PRP. PRP can help reduce depression and anxiety,
reduce hospital admissions and improve quality of life for COPD patients (NICE, 2010).
From my interactions and observations of Tom and other patients it was clear to me that
patients living with COPD have a common problem of Dysponea. However, I lacked
knowledge and understanding on how Dysponea effects the daily living and anxiety
associated with COPD. I plan to take this as a further research to understand this better.
Along with this I also realized that I need to learn and gain more understanding about
SBOT.
Analysis:
As the program begin, Tom was responding well with the exercise having a moderate
SOB – Shortness of Breath. In order to avoid the risk of patients feeling isolated and
less confident it is very important to keep encouraging them in participating exercises.
(Bellamy & Booker 2014). When Tom started with the walking exercise his anxiety

levels increased significantly, he started having severe SOB and saturation levels fell
from 90% to 76%. It is suggested to have a saturation levels of 88% to 92% for COPD
patients.
Dysponea is a common symptom observed in many COP patients. As per Karent et al
2011, many COPD patients have withdrawal symptoms from hobbies and day to day
activities due to Dyspnea.
As per Currie et al 2011, depression and anxiety are directly related to the severity of air
obstruction in COPD patients. These two are often underestimated in COPD patients
and there is a need to have a strong focus on interventions in these areas.
Conclusion:
Relfection as defined is a process of examining and assessing your previous work from
the perspective of careful evaluation and analysis to make sense of things that
happened and identify areas of improvement which can be converted into future action
plan. Reflection is a very crucial element to one’s learning process. Gibb’s reflective
cycle on the is a model based on staged process of examining the work and presents a
more comprehensive and elemental approach to reflection and hence been considered
for reflection here.
Having analyzed the episode, I would conclude that COPD has a social, physical,
psychological and emotional impact and distress on the patients effecting their day to
day lives. Dyspnoea is a common symptopn with majority COPD patients. PRP can help
reduce depression and anxiety, reduce hospital admissions and improve quality of life
for COPD patients. Depression and anxiety are directly related to the severity of air
obstruction in COPD patients. These two are often underestimated in COPD patients
and there is a need to have a strong focus on interventions in these areas. I would also
like to acknowledge that prior to this episode I had a misconception that SBOT will help
reduce Tom’s symptoms. But having experienced the difference and doing further
research I identified that SBOT is asked to be discontinued until there is a confirmed
evidence of it benefitting the patients.

Action Plan:
In order to be efficient in the caregiver work space for COPD patients it is important to
understand more about day to day activates of the COPD patients. It also requires to
have more understanding, training and knowledge about various techniques of
breathing and care packages for COPD Patients. It is also important to listen and
communicate efficiently that will help building a strong nurse-patient relationship.
Patients are already under depression and anxiety and it is important to stay confident
and calm and give them assurance and motivate them to participate in exercises. I plan
to in-corporate these learnings in my future endeavors. Dysponea is a common
symptom observed in many COP patients. Many COPD patients have withdrawal
symptoms from hobbies and day to day activities due to Dyspnea.
I also acknowledge lack of understanding on how Dysponea effects the daily living and
anxiety associated with COPD. I plan to take this as a further research to understand
this better. Along with this I also recognize the need to learn and gain more
understanding about SBOT.

References:
 Beard, C., & Wilson, J. P. 2014. Experiential learning: a handbook for education,
training and coaching. London, Kogan Page.
 Bellamy, D & Booker R 2014. Pulmonary Rehabilitation. In: Clarke, G Chronic
Obstructive Pulmonary Disease In primary Care. 3rd edition. London. Class
Publisshing, p.113
 Botten Emma, 2013. How to use reflection as a learning tool.British Journal of
Nursing VOL. 21, NO. 6
 Currie, G.P and Douglas G. 2011. Non pharmacological management. ABC of
COPD 2nd edition. Oxford, Blackwell pp 27-30
 Johns, C. (2013) Becoming a reflective practitioner. 4th edn. Oxford: Wiley-
Blackwell.
 NICE 2010. Chornic obstructuve pulmonary disease: Management of chonic
obstrcutive pulmonary disease in adults in priary and secondary care. [online]
Available at: http://www.nice.org.uk. Accessed on 14th March 2019.
 Pryce, A. 2012. Refracting experience: Reflection, postmodernity and
transformations. NT Research, 7(4), 298–310.
 WHO 2013. Chronic respiratory disease. [online]. Available at:
http://www.who.int/respiratory/copd. Accessed on 12th March 2019