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In this essay, I will discuss several issues that seem to bind nursing practice with questions of ethics, sociology and management. Reflective practice is an important aspect of nursing management and in this essay we discuss implications of discrimination in nursing care and examine the importance of anti-discriminatory perspectives in nursing. In this paper, the case study I will elaborate is of an elderly woman who was of a non-British ethnic origin and spoke little English. A junior nurse visited her home to provide care but her attitude towards the patient has been discriminatory and abrupt, a situation that calls for serious reflection on the issues of racial discrimination at the clinical setting. The patient was apparently treated with leg ulcer. The questions that have to be considered here are: Where in the observation did discrimination occur and how this could have affected the delivery of care given? And how has discrimination influenced the lady’s care?
The concept of anti-discriminatory practice as a contemporary issue within adult nursing is discussed here considering observational evidence and similar case studies. Reflection in Nursing: Reflective practice in nursing is guided by models of reflection. Reflective practice model serves as a framework within which nursing or other management professions can work. Reflective practice model is also a structural framework or learning model that serves the purposes of a profession and is particularly applicable to health related professions. Any portfolio of practice includes a model of reflection as reflection helps in determining what was positive or negative or a learning experience within the profession.
Reflective practice highlights the importance of learning from experiences after thinking about it and relates the practical experiences to the theoretical learning approaches. CPSU, 2005 In the Gibbs’ model, the event is reflected upon and includes a description of what happened followed by feelings about the situation, and reflection on what the thoughts and feelings were at that time upon being into the situation. The nursing professional then personally evaluates whether the experience has been good or bad for her and analyses whether she can make any sense to the situation. The conclusions are drawn depending on alternative and what else could have been done with the situation and what were the other options available to tackle the situation better or more appropriately. Proposed and future action plan is thought of and how the situation will be acted upon in the future is also determined. Kolb’s model however stresses on the importance of generalizations of concrete experiences testing the implications in similar situations. Whereas John’s model of reflection emphasizes on the stages of description of the event, reflection on what was aimed at, the factors influencing strategies, alternative strategies to what have been used, and learning from the experience, Atkin’s and Murphy’s model of reflection is on analysis and identification of the learning experience and action planned based on awareness and evaluation of this relevance of knowledge.
Considering these models of reflection, we will use only the more popular Gibbs model to evaluate the case study discussed here and the situation of discrimination against the elderly lady Mrs. In this essay I am reflecting on an incident that happened in my earlier years of working as a professional nurse. As per NMC 2002 guidelines, for protecting identify of the patient, names have been replaced with pseudo names. Determinants of the appropriate site of care involve medical, functional, and social aspects of the patient’s illness. The patient’s acute and chronic medical conditions, potential for rehabilitation, and decision-making capacity must be taken into account. Multidisciplinary teams aim to address treatment that is focused on both the physical and psychological needs of the person suffering with the orthopaedic condition or illness. The MDT meeting took place on the ward, and all members of the team were aware of the time the meeting was taking place so avoid any delays and confusion.