Reflection On Person Centred Care

The purpose of this assignment is to explore the importance of reflection within a workplace setting. Also draw a contrast on the different models of reflection, explain an understanding of my own role and key aspects of professional accountability and person-centred care . All names have been changed in order to protect individuals privacy (Data protection Act 1998).

Schön, D. (1983) Describes reflective practice as; “The capacity to reflect on action so as to engage in a process of continuous learning”

The model of reflection I will be using in this assignment will be Driscoll (2007).
Although this model has three simple questions; These lead onto trigger questions which allow the practitioner to reflect, learn and improve past experiences.
The questions are divided into three main sections each with subsequent follow on prompts;

What
Is the purpose of returning to this situation?
Exactly occurred in your words?
Did you see? did you do?
Was your reaction?
Did other people do? eg. colleague, patient, visitor
Do you see as key aspects of this situation?

So What
Were your feelings at the time?
Are your feelings now? are there any differences? why?
Were the effects of what you did (or did not do)?
“Good” emerged from the situation, eg. for self/others?
Troubles you, if anything?
Were your experiences in comparison to your colleagues, etc?
Are the main reasons for feeling differently from your colleagues etc?

Now What
Are the implications for you, your colleagues, the patient etc.?
Needs to happen to alter the situation?
Are you going to do about the situation?
Happens if you decide not to alter anything?
Might you do differently if faced with a similar situation again?
Information do you need to face a similar situation again?
Are your best ways of getting further information about the situation should it arise again?(Driscoll, 2007)

What…
The purpose of returning to a situation is to reflect on my past decisions and consider how I would react if faced with a similar situation again. The event in question happened during my first week at a new job, working with people who have learning difficulties. My client was a gentleman who had severe learning difficulties, autism, epilepsy and a condition called Pica. Pica refers to eating objects which are not suitable to be eaten. These can include stones, faeces and clothing (The Challenging behaviour Foundation, 2014). Due to his complex needs I was very anxious of how to deal with this client. On my first week working with my client I shadowed other more experienced support workers, the purpose of this was to gain a better insight on how to put my training into practice.

As Mr Jones has such complex needs it takes him time to form meaningful and trusting relationships with people as he finds it very hard to communicate with his support workers.
This was very daunting knowing that I was going into his home and his personal space, however I was reassured by my line manager that although I felt nervous now, in the next few weeks I would become more confident. I was invited to join a meeting with the Mr Jones his advocate and support workers, they were putting together a care plan using MAPS (Making Action Plans) Developed by Judith Snow, Jack Pearpoint and Marsha Forest, this is a very visual and graphic plan that focuses on the clients past and their aspirations for the future. MAPS is an 8 step process which gathers information from the client then uses that information to create a plan of action (Favley et al, 2003). There is now a new emphasis on person centred care due to recommendations of the governments white paper, valuing people now (The Department of Health,
2009).

This was my first experience and as I was only observing I felt completely comfortable to sit back and allow my colleagues to take the lead. My supervisor and two other support workers began to speak to Mr Jones’s about his hobbies, these were noted down and added to the care plan. They showed such patience and understanding, it was amazing to see how a shy and reserved man opened up and really enjoyed the experience. MAPS is visual and allowed Mr Jones to see his care plan in a way he could understand. The care plan uses the clients interests, aspirations and goals to allow them to have better control of their own care and allows for self-advocacy.

“Person-centred planning begins when people decide to listen carefully.
And in ways that can strengthen the voice of people who have been or are at risk of being silenced.”
(O’Brien and O’Brien, 2000)

So What…
At the time I enjoyed seeing how inclusive of Mr Jones needs and wishes the company were. According to Begley (2010) there are four A’s of professionalism in health care;

Advocacy
Accountability
Assertiveness
Autonomy

I feel these were upheld by everyone at the meeting and the client was always put first. On a personal level I understood my own accountability knowing I lacked the proper training to be competent in my role, so was completely comfortable taking a passive position to Mr Jone’s care. After reflection I still feel the same, this was a mainly positive experience for myself, the client and my colleagues. After the meeting I was praised by my supervisor for my patience and willingness to undertake further
training.

Now What…
The outcome for Mr Jones was that he received the best possible care, his needs were met and I was involved in the decision making, planning and care without putting Mr Jones at risk.

I feel that further training is still needed and as my confidence grows and I build a better relationship with Mr Jones I can take a more direct role in his care, work with him more closely and be a better and more understanding support worker. After reflection nothing needs to be changed because the experience was a very pleasant one, I felt supported and valued by my colleagues and supervisor.

Fowler, M. D. M. (2008) states that;
“Collaboration is not just cooperation, but it is the concerted Effort of individuals and groups to attain a shared goal. In health care, that goal is to address the health needs of the patient and the public. By its very nature, collaboration requires mutual trust, recognition, and respect among the health care team, shared discussion-making about patient care, and open dialogue among all parties who have an interest and a concern for health outcomes“

As it is company policy for all employees to undertake intensive training courses in learning disabilities care and personal care I feel I do not need to raise anything with my supervisor. I was directed to further training on autism which will benefit me and the company. Communication within the company is very open and honest, we all work together as a team to ensure the very best outcomes for colleagues and clients.

Conclusion
When looking at our own practice within a healthcare environment it is of the upmost importance to be reflective. Using a model of reflection prompts the practitioner to ask the correct questions that allow them to improve their practice and develop as an individual. The model of reflection used for this assignment was Driscoll (2007) this differs from models such as Gibbs’ (1988). Although Gibbs’ has prompting questions they can be quite short and do not allow for further development.