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Reflection of an Ethical Issue

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Submitted By kml501
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Reflection on a ethical issue in practice/ Reflection on a therapeutic relationship

Gibbs reflective cycle (1988)

Description No names have been used during this account in order that confidentiality is maintained as required by The Code (NMC, 2008). Gibbs reflective cycle shall be used in order to explain and analyse the incident (Gibbs, 1988).
During a period of placement I was involved with the care of a client who had taken an overdose and attempted to end his life. During that day I had been involved with settling the client onto the ward and filling out his paperwork. The patient was understandably distressed and we had had to ask some quite personal questions about how he had been feeling in the days leading up to the overdose and what had triggered his actions and his current feelings. Later that evening the client absconded from the ward and the team had to call security. The client was eventually found outside of the hospital and it was discovered that he had ripped the cannula from his hand. The patient was later detained under the mental health act as it was felt he was a danger to himself.
Feelings
During this process I felt quite uncomfortable and like I was invading the patient’s privacy. This I believe was due to the fact that I have not had much experience of someone who has just been involved in such a highly emotional and charged situation. I found it difficult to know how to react and what to say in case it was the wrong thing as I did not want to further distress the patient. The fact that the patient felt that they had to run from the ward and then be sectioned made me feel sorry and worried for the patient. I struggled with trying to act ‘normally’ around the patient.

Evaluation
In terms of what was good and bad about the situation I can determine that the good points are that I now know that certain, actions, procedures and questions are necessary to protect a patient who may be at risk from their distress. Also another good point is that now that I have had this experience I am better prepared to improve my practice for the future. The bad points of the experience were my awkwardness around the patient I worry that this may have shown and hope that this did not cause him further distress.
Analysis
During my time so far I have encountered a number of patients in a similar situation. The observance of these has taught me that patients are complex and are presented to the ward for a variety of reasons. I have learnt that attempted harm and suicide are not exclusive to a particular group in society but can be wide and varied in nature due to different stressors (Blows, 2011,DOH, 2011 & WHO, 2011). I have learnt, that it not my place to judge the patient or their actions but give high standard and holistic care, in order that the patient can become medically and psychologically fit again as required by the Code (NMC, 2008). The job of an adult nurse therefore is to treat all patients with unconditional regard and refer to other professionals if it is in the best interests of the patient.
Conclusion
When reflecting on what I could have done better, I would say that I should have relaxed my body language more and not looked awkward as this may have been obvious to the patient. However, I recognise that my limits are born from my lack of experience around such situations and will improve with practice.
Action Plan
Read more on the subject of attempted suicide.
Be more self- aware of body and verbal language.
Continue to treat people with unconditional regard.

Source:
Blows, W. (2011). The biological basis of mental health nursing. 2nd edition. London.Routledge.
DOH (2011) Consultation on preventing suicide in England: a cross-government outcomes strategy to save lives.
NMC (2008) The code: Standards of conduct, performance and ethics for nurses and midwives.
Gibbs, G. (1988), Learning By Doing: a guide to teaching and learning methods, Further Education Unit - Oxford Polytechnic, Oxford.
World Health Organisation (2011). Stress in the workplace. http://www.who.int/occupational_health/topics/stressatwp/en/.Viewed 5/7/2011.

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