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reflective essay

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reflective essay
Introduction
This assignment will be a piece of reflection based on a clinical decision I have assisted in during my placement. This reflection will relate to a situation that occurred in my clinical work where I felt that I have learnt something that is of value to my practice. The clinical decision was based on wound dressing. I will identify what I have learned from the experience and how this relates to theory that has been researched. To help me with this reflection I will use Gibbs (1988) model of reflection. For the purpose of confidentiality I will call the patient Mrs H. The description of events will be in the appendix.
Feelings
I remember that when we found out about Mrs H’s new wound I was feeling a mixture of confusion, surprise, anger, impotence and sympathy. I was confused because I didn’t know what kind of wound to expect. When we found the wound the nurse was unsure herself which made me unsure so I couldn’t offer a second opinion, couldn’t suggest an idea that might help support the patient, moisture lesions and pressure sores are sometimes mistaken with each other and I didn’t want to make that mistake. I was surprised at how quickly she developed this moisture lesion as she was seen recently.
My feelings of impotence were related to my lack of clinical experience. No matter how many placements I go to, I keep meeting situations where I am unsure on what’s going to happen next. I feel younger, less knowledgeable than I should be in this stage of my training. I want to be able to reassure patients in their own homes, support colleagues and give good advice without second guessing, but I did not have enough confidence to do that.
I felt angry towards her daughter as she had been advised before about pressure area care and skin checks and to keep an eye on Mrs H’s skin and to keep her clean and dry when her incontinence reassessment was completed. Lastly I felt sympathetic towards Mrs H because she already had previous wounds and she was



References: Bianchi J (2012) Causes and strategies for moisture lesions. Nursing Times ;108: 5, 20-22. Cooper P, Gray D (2001) Comparison of two skin care regimes for incontinence. Br J Nurs (Supplement) 10(6): 6–20 Gray M, Bliss D, Doughty D, Ermer-Seltum J, Kennedy-Evans K, Palmer M (2007) Incontinence-associated dermatitis: a consensus Gustafson D, Arora N, Nelson E, Boberg E.. (2001). Increasing understanding of patient needs during and after hospitalization.. Jt Comm J Qual Improv. 27 (2), 81-82. Kray, J. (2013). Moisture lesions. Available: http://www.disabledliving.co.uk/DISLIV/media/publicationpdf/Symposium%20Presentations%202013/Elderley/moisture-lesions.pdf. Last accessed 17/11/10. NHS. (2012). Clinical Decision Making.. Available: http://www.effectivepractitioner.nes.scot.nhs.uk/media/254840/clinical%20decision%20making.pdf. Last accessed 17/11/13. NHS Posnett, J., Franks, P.J. (2007) The costs of skin breakdown and ulceration in the UK. In: Pownall, M. (ed) Skin Breakdown: The Silent Epidemic. Hull: Smith & Nephew Foundation. Thomas, S. (2008). The role of dressings in the treatment of moisture-related skin damage. Available: http://www.worldwidewounds.com/2008/march/Thomas/Maceration-and-the-role-of-dressings.html. Last accessed 17/11/13. Thompson, C. (2002). The value of research in clinical decision-making. Nursing Times. 98 (42), 30. World Union Wound Healing Societies (2007) Principles of best practice: Wound exudate and the role of dressings. A consensus document. London MEP Ltd Appendix

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