Description For my first clinical attachment

Description
For my first clinical attachment, I was posted to Peacehaven Nursing Home. I arrived at the ward at 8am sharp. My partner and I were in charge of bathing a 63-year-old gentleman named Mr Yew. Mr Yew has been staying at Peacehaven for approximately 10 years and he is one of the residents in Peacehaven that requires more assistance as he suffers from Parkinson Disease and Dementia. This disease affects the nerve cells in the brain that produce dopamine and the syndrome causes gradual progressive cognitive decline that causes the patient to suffer from confusion and memory loss. We were tasked in assisting Mr Yew with bathing and when we were about to finish up with bathing Mr Yew, we asked if he was ready to get out of the toilet, however, Mr Yew refused and began reacting aggressively and got really agitated. He started speaking Hokkien to cuss and demanded to see his wife. I was fully aware that Mr Yew and his wife had divorced 7 years ago as I was able to take a look at his case study notes. In the moment, I was panicking on the inside but I tried to stay composed and told Mr Yew that he could stay in the toilet a little longer if he wanted to. After Mr Yew calmed down, my buddy and I helped to manoeuvre Mr Yew from the bathroom to the bed without much problems on both our end.

Feelings
After the whole incident, I was having mixed feelings as I felt that it may be because of what I said that had affected Mr Yew which resulted in him reacting the way he was. It was really heart rending as from the incident, I was able to establish that Mr Yew is still holding onto the good memories from the past and as a result, such reminiscences have become a reality for him. I am also sad that Mr yew has to depend on someone else to carry on with his daily routine for the rest of his life which spurs me further to help these elderly people who are really in need. On the other hand, even though I was traumatized by the whole situation, I am glad that I was able to adapt when needed and handled the situation efficiently and effectively. It was my first experience in helping out someone with Parkinson and Dementia but I do feel that I have learnt a lot from it as it has helped me grow in many ways which will be very useful to me in the future. I am also contented with myself for having the patience to help out Mr yew until the very end despite facing multiple setbacks during the entire procedure.

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Evaluation
The incident that has occurred will be one of the many milestones in my education as a healthcare student as I am still a novice in this healthcare setting with no working experience. What I have gained from this learning experience is that years of experience is required so as to be able to predict and evaluate a situation and that we have to be confident in ourselves so that we are able to handle such situations efficiently and effectively. In order to be able to know what I should do when I face this kind situation in the near future, I have to figure out how the patients are and their current way of life in order to be able to communicate with them without any conflicts. I feel that it is important to read up on the patient’s profile before I talk and help them. Not only knowing my patient’s background is important, I feel that improving my confidence level is also important as it will allow me to understand and react appropriately in the event that a similar situation should arise again in future. Confidence in both my partner and I is the key as it would allow both of us to think rationally and logically instead of acting on impulse.
Patience is also another key factor as we must know that most of these patients are old and it takes some time for them to settle down and willing to open up to us. Experience is also necessary as it trains us to communicate with the patients and also help them to ease their pain. It takes time for us to be able to have great patience and communication. Due to my lack of experience, I started to panic when Mr yew became grumpy and angry which is not right for me to react this way in front of him. With more experience and trainings, I will be able to access the situation calmly and find the best possible route I would need to take to care and comfort the patient. Being flustered and stressed out during such incidents will not help in solving the problem or help in calming the patient in anyway.

Analysis
I feel that I could have handled the situation in a better and more appropriate manner by seeking help from the senior nurses as I am still a student nurse. Things may have gotten out of hand and due to the lack of experience and knowledge, I would not know how to approach the situation tactfully and readily. Also, by staying composed at the start instead of panicking would have enable me to resolve the problem more quickly and efficiently. My experience at the nursing home has taught me to be more proactive in the future practice. For example, I should have looked at the problem in a more positive light and come up with possible solutions to solve the problem in a strategic and calm manner. In addition, it has made me realised the fact that I have got to improve on my communication skills with patients of different religious backgrounds, by increasing my exposure to different patients from different backgrounds, starting from interacting with patients from different native languages and those who are not fluent in speaking English. I myself should be able to at least understand where they are coming from and apply appropriate practices when it comes to caring for patients of different ethnic backgrounds so that they will not feel neglected or biased against if I do not understand what they need. I feel that it is also important to be able to know some simple dialects and languages such as Hokkien and Malay respectively since most of the patients are old and the chances of them not knowing simple English is high. This would further help in my communication skills with the patients I may attend to in the future. This will also further help me to bond with my future patients more effectively and by having a good relationship with helps me to deal with the rough situations less painfully too.

Conclusion
This clinical attachment has really been an rewarding experience as it has helped to maximized my learning experience as a student nurse. This is my first time seeing how it is it like in a nursing home and how devoted and dedicated the nurses are towards their own patients. It has also enabled me to gain more exposure and insights to what I will be dealing with in future and learn new skills that the school has not been able to touch on. I am glad to be able to experiment this kind of hands on practical skills which are useful when I come out to work as a nurse in the future. At the same time, this clinical attachment has made me realise how important and how enormous the effect that communication can have on the patients. On the other hand, it also made me realise that as each of us adopt different sets of values which may differ from the one another – between both my partner and the patients, we would need to be able to adapt fast and understand from their perspective and position as well. Me and my partners must also have good teamwork to be able to deal with sudden situation fast and effectively. By having great teamwork with my partners, we will all have a much more pleasant time at work. Therefore, by understanding that every patient has their very own way of thinking and beliefs, it has helped me to gain better insight into their reasoning and their behaviours, and hence has enabled me to grow as a healthcare student.

Action Plan
This experience has enabled me to realise my shortcomings and the areas I have got to improve on so that if such incidents were to arise again, I will be able to solve the situation in the most rational and effective manner. For example, I can come up with better strategies to effectively overcome such problems and improve on my communication skills. During instances when a patient becomes aggressive and refuses to cooperate with me and my partner, there are better techniques to get the patient to calm down and listen instead of forcing them, which could further affect their emotions. I could also try to divert their attention to other activities or try to understand the source of their feelings by responding in a firm but caring way in both verbal & body language while maintaining a safe distance. Other activities such as letting them listen to their favourite music or tell them an interesting story may help them brighten their mood and will change their mind to corporate with us.
On the other hand, I will also try to deviate from sensitive topics such as their past incidents they have experienced or their families which will further make them upset. In future clinical attachments, I would want to expose myself to different religions and age groups by attending physiotherapy sessions to gain a better understanding towards such patients. Similarly, signing up for dialect classes would also benefit me as patients may not be fluent in speaking English, and thus, it will enable me to communicate and accommodate to the patient’s needs better.