Reflective essay of personal and professional development

Reflective essay of personal and professional development This assignment is a critical analysis and reflection of my continuing personal and professional development (CPPD) needs in practice. This account will identify practical needs that I must improve with supportive evidence based research, and evaluate the impact of this need for my personal development as a future qualified nurse. My learning need was with assertiveness in communication when working with a staff nurse during admission. To meet the need and demonstrate the ability to engage in advancing my care, Gibbs (1988) framework model of reflection will be used. To maintain confidentiality as emphasised by the Nursing and Midwifery Council (NMC 2008), a pseudonym Tommy will be used to protect the patient’s anonymity. In addition, I will be using the post-registration education and practice (PREP) guidelines (NMC 2011) to maintain up to date knowledge and skills as well as empowering a lifelong learning in my nursing career. (NMC 2012) My skills in communication have improved in all contact and this has been acknowledged in every practice. However, I thought of this learning need, when I recognised my weakness was with assertiveness in communication when working with a staff nurse, faced with a difficult patient during admission. I took part in this learning activity in November, 2014 during my placement in hospital. I identified this need during the second week of placement, as I was able to perform patient admissions under the supervision of my mentor. The need to improve this skill was established from my mentor’s feedback and I agreed that it must be developed in order to help avoiding errors in future practice, improving my decision-making skills and professional satisfaction. I have spent a good amount of time to research and critically analyse this learning need However I felt this could be an ongoing process of improvement as Webb (2011) identified, supported by the Department of Health’s (201 3) ongoing process of improvement in the NHS to be more efficient and less bureaucratic. I again felt this was important for me to work on because it had an impact on the patient and me as a future qualified nurse (Fowler, 2008). Tommy is a 50 year old who suffers from right leg cellulitis and lives alone with his cat. I felt my first meeting with Tommy was challenging as I found it difficult to present myself as a self-assured, assertive and empathetic student nurse due to the impression that the situation was out of my comfort zone. I observed from the beginning of the visit that this gentleman was unable to cope; however I felt that I could not make a direct statement without coming across as patronising or a dominant student nurse. On the positive side, I chose to improve this learning need so that I would learn to be prepared with the knowledge and set of skills I must have in managing complex patient care in future placements (Fowler, 2008). Having encountered patients who have refused requests from other student nurses and staff nurses alike by expressing their dislikes, disagreements and sometimes even anger when offered treatment, I have observed that patients sense how the student nurses present themselves and could base their decision on the student nurses’ abilities to communicate assertively (Fowler, 2008). This also made me think about my self-awareness and empathetic skills. As I listened to Tommy’s emotional concerns, he opened up about being terrified of not having anyone in his house to feed his cat while he was in hospital because he had no close relatives. I responded calmly and confidently, using clear language that my intention was to obtain his permission to allow health professionals offer long term support to him (Fischhoff et al, 2011). As student nurses, our main role involves patient interaction and several studies have indicated that student nurses lack assertive skills evidenced by Bekkum and Hilton (2013) McCabe and Timmins (2005) qualitative study in two schools (n=30). It highlighted that most student nurses were assertive but chose not to display this skill to maintain positive interpersonal relations and avoid conflict. However, quantitative study (n=72) by Almost (2006) deemed it important to measure nursing students’ level of assertiveness prior to, and near completion of their pre-registration programme and to offer help throughout their programme to develop their assertiveness. Almost also considered the conflicts mainly developed from the multi-professional roles that student nurses have and that the basic nursing functions of caring and controlling can result in tension. Many researchers have challenged these such as Iglesias and Vallejo (2012) qualitative study identified that work have established that conflict resolution techniques can be achieved through compromise and collaboration which the nurses can use for their specific work environments. However all the previously mentioned approaches suffered from serious limitations as Tommy’s safety could have been compromised when nurses failed to speak up or be heard, identified by Page’s (2004) qualitative study. I found Almost (2013) very appropriate when giving personal care because this technique would have enhanced my learning need earlier in my nursing programme to improve patient care. Bekkum Hilton, (2013) qualitative study support and acknowledgement on these account findings imply that, education programs ought to be taken into account. The perceptions of the participants risks involved in not being assertive and the focal point must be on changing these perceptions rather tha n attempting to change student nurses’ values or focusing solely on specific assertive behaviours to improve student emotional intelligence. Based on the findings, I realised that my practice was out of date therefore would cost the National Health Service (NHS) and impact negatively on patients’ care. As identified by Smith’s (2012) phenomenological study, 75 per cent (n=20) of student nurses felt unable to verbally express their concerns when working with qualified nurses. Yet Jones’ (2013) qualitative study identified that 60 per cent (n=30) of student nurses felt confident by the end of their training. However, there is little consensus in the research available although I feel my experience reflects Smith’s (2013) findings. My inability to be assertive during patient admission was because I was working with an experienced qualified nurse and hiding behind my mentor limited my development in skill. This impacted on my clinical ability when I failed to be an assertive student nurse. It also shows in these research studies I was not using up to date practice. White’s (2009) phenomenological study identified that 75 per cent (n=28) nursing students in clinical placements suffer from self-doubt, have anxiety about their clinical performance and do not possess the characteristics of strong self-confidence. A qualitative study conducted for student nurses by Jones, Mccoy and Pitt (2013) have indicated that majority of student and staff relationships highlight that a sense of belonging was central for student nurses for a good clinical experience. A students sense of belonging and feeling a part of the team were essential before students could learn. This is reflected in Lathlean and Levett-Jones’ (2009) quantitative study (n=200) of student findings on third year student nurses who participated in the study as they had been on a number of clinical placements. This explanation, however, seemed to overlook the fact that many students feel compelled to work hard in order to fit in the nursing team rather than become motivated to le arn. This has made me realise that although being in a good nursing team, I would still prioritise looking after my patients by paying more attention to the patient needs and expectations. A qualitative study conducted by Lyndon (2006) mentioned that student nurses’ ability to make a clinical decision could be influenced by patient situation, availability of resources and interpersonal relationships. Student nurses, however, on a variety of situations, can experience moral distress as Ganske, Iseminger, Lachman and Murray (2012) have identified in their phenomenological study. These two articles revealed that the ability to communicate with patients should not cause moral distress as student nurses would neither be aggressive nor patronising, nonetheless the interaction would achieve the patient’s best interest. This is reinforced by Grumbach and Bodenheimer, (2004) qualitative study which identified (n=18) of student nurse, who noted that greater disability may be as a result of anxiety in some cases and loss of self-confidence. However, Begley (2010) phenomenological study (n=20) identified and argues, little has been investigated to explain the reasons why assertive behaviour occurs in one situation and not in another. Results suggest that, student nurses’ standard measures of assertiveness and of anxiety are irrespective of their scores p=00.1 chances. One should consider the consequences of student practitioners being assertive, while making a decision regarding how to behave I felt this was helpful in reminding me how important self- confident skills can aid improved patient care. Although, their underlying theories of subjectivity are very different, there are some important affinities between the researches that correlate which I believe would help me care better in future pla cement. In addition, Begley’s (2010) qualitative study established that patients were to be considered as partners in their health care delivery. Trust does not come easily for people and I have since learnt from past experiences that patients need to be included and actively involved in the planning and evaluation of their care. By learning to ask open questions helped promote and encouraged patient expression and enabled patients to enhance trust in a relationship as I have shown my interest and investment in the patient’s care and treatment. This study has an impact in addressing my need and offered help on how to be assertive when dealing with difficult patients. As highlighted by White (2014) qualitative study, majority of student nurse depend on their mentors to be assertive and sometimes adopt it as coping strategies. Even though, this is a small number of student nurses, (n=30) to base a judgement on, it provides statistically relevant data and allows an insight into practical experiences. I also felt this research was significant for me to work on my assertiveness, because it had an effect towards the patient and me as a future qualified nurse. I solely depended on my mentors for assertiveness as a coping strategy. Conversely, these poor coping strategies I adopted were highlighted in a qualitative study by Fischhoff et al, (2011) where common coping strategies utilised by student nurses being assertive in clinical settings are explored. Although this is a small sample size (n=18) which does not provide statistically relevant data, it is qualitative design allows an insight into the student nurses experience of assertiveness coping strategies (Parahoo, 2006). I found these results of the thematic critical analysis linked to my own clinical experience, including the poor coping assertiveness strategy I adopted. This was due to underestimating my capacity from the onset of being self-assured and self-confident without being aggressive (REF). I found that these researches gave me insight into how unethical and limiting avoidance practices are when dealing with patients, which was seen in a small number of participants in this study (n=3) (Morris Turnball, 2006). I felt this was helpful in remindi ng me how important assertiveness skills can improve patient care (Morris Turnbull, 2006). Besides, Fischhoff et al, (2011), descriptive study postulates assertiveness in student nurses who become attached to their mentors remain as consistent helpers for weeks in their placement during the period from the first till the third year, and it is suggested that this is due to the students underestimating their capacity from the onset of being self-assured. Although this is a small sample size (n=207) which does provide statistically significant relevant data, 60 percent (n=127) were more positive compared to 40 percent (n=83). Its quantitative design allows an insight into the student nurses’ experience of assertiveness skills (Begley, 2010). Nonetheless, Phillips and Simmonds (2012) phenomenological study supported this descriptive study and further on said this is a key concern for some student nurses within practice setting. The concept of assertiveness and understanding concept as student nurses will enable them to consider that the patient’s aggressiveness might be about other issues rather than their care. In a phenomenological study of (n=50) nursing students in London, Monsu (2014) identified that greater disability may be as a result of anxiety and loss of self-confidence dealing with a difficult patient. Findings of these researches do not seek to be generalised but were reliable to me due to the appropriateness of the methodology and the thematic analysis being correctly applied. This will aid me in caring for my patients in future practice. In a questionnaire survey of (n=200) student nurses in London, Smith (2013) identified that 70 per cent (n=49) of university students preferred mentors to do all the assertiveness communication for them due to underestimating their ability. Only 20 per cent (n=4) of students responded and of those who did respond, many of them did not fully complete the questionnaire. The data suggested that 70 per cent of students who preferred a mentor to do all the assertiveness communication do not constitute very strong evidence. Yet Monsu (2013) argues that from his own experience as a student in placement, there was a strong attachment with mentors being assertive in all him / her communication which did help with the assertiveness skills needed for future practice. This cannot be generalised as Monsu (2013) is not referring to a piece of empirical research but to his own experience. Having identified the context of Monsu’s (2013) own experience argument, I found it very relevant to me and it topped my hierarchy of evidence, but does not appear to have been undertaken in a thorough manner to help my caring for patients in future due to their lack of a soundly-based qualitative theory compared to Smith (2013). Having discussed with my mentor what happened during the admission; it felt good to have attempted the interaction with the patient and recognised some of his needs. Even though the patient seemed reluctant, I demonstrated the ability to remain calm although I did struggle with my approach when I spoke to him about offering more support. Instead, I focused to help the client respond to my questions and identify what his concerns were. I believe during that incident, I showed assertive behaviour because I maintained my duty of care to the patient. I have reflected that this would have an effect on my clinical ability if I had failed to be the patient’s advocate. With the DOH (2009) updated work on providing guidelines on consent to treatment and putting these principles of consent into practice, my actions caused me to consider my practice whether obtaining informed consent would be an issue. Tommy fully realised that he should comply with the nurse as she understood the conseq uences if his pains were not treated (Cole, 2012). According to Baldwin, Duffield, Fry and Merrick (2011) the interaction between the decision-making, skill development opportunities, social support and identity comes with the nursing role so as to be prepared for the upcoming nurse population to meet new challenges. When this type of situation happens again, I believe I have the skill to show my assertiveness skills by using compromise as well as recognising the boundaries of my actions. Using clinical decision skills and asking open questions, which I can gain from meeting other patients would enable me to show that I am a self- assured, reliable and trustworthy student nurse. I need to try and achieve leadership skills that could be essential for patient satisfaction and to achieve this, I have learnt to engage in leadership activities such as handovers and undertaking tasks on behalf of my mentor. I recognised that once I fitted into the clinical environment, I needed to be more actively involved in challenging clinical situations such as detecting unpredictable patient deterioration and learning to make quick clinical decisions. Cook Leathard (2004) suggested that good student nursing leadership and good quality nursing care will be effective if nurses go through leadership training program mes during the early stages of their career. This can help me in preparation to become more aware of how I feel, think and act in front of my patients. Reflecting and learning to be assertive can increase my confidence and self-esteem through appreciating what I have done well and maturely, accepting the improvements I must make to become a better nurse in the future. Having said that, I was satisfied that I had the opportunity to practice nursing handover, as it is one of the vital roles of a qualified nurse and one aspect of nursing care that is required of me when I am qualified.Loseby, Hudson Lyon (2013) wrote, handovers are information that can influence the delivery of care. In the process of this learning experience I felt well supported by my mentor giving me several opportunities to practice my handover until I felt more confident and less anxious because she created quality time for me and necessary feedback that helped my learning need as well as other aspects ofnursing. McCloughen, O’Brien Jackson (2010) defines a mentor as someone that helps others grow by teaching them, encouraging them and being interested in their success. This is also further supported byHamric, B.A., Hanson, M.C., Tracy, F.M., OGrady, T.E.,(2013) who indicated that a good mentor is one who spends quality time to foster growth, committed to the developme nt of their learning need, willing to share and feedback on any rough spot in their career development. In conclusion, I have critically analysed and reflected on clinical learning needs, which are essential for my continuing professional development. As a student, critical analysis and reflection helped to facilitate good learning outcomes so that I can relate and apply concepts to clinically orientated situations as well as explore and evaluate evidence. Also my clinical learning need was acknowledged through mentor feedback by showing assertive skills in communication with difficult patients. This need is an on-going process of development for me. However; I recognised that attempting interactions with patients and collaborating with nursing staff will help in my development to be a more self-assured nurse. Participating and engaging in leadership activities such as handovers and task delegation would be beneficial at this stage of my learning. Through the reflection and recognition of these learning needs, I could only move forward and continue to develop my learning proficiency as a student nurse towards professional competency as a qualified nurse. 1 | Page

The Act of Sacrifice from Achilles and Gilgamesh Essay -- The Iliad Gr

The Act of Sacrifice from Achilles and Gilgamesh The act of sacrifice is a very important event in literature. Often, it can define and shape a character’s life and personality. The ancient texts discussed in class contain many diverse, yet equally meaningful examples of sacrifice. Even though these acts of sacrifice can occur for different reasons, each one has a similar purpose. The characters that perform such sacrifices are required to give up something they love, cherish or own in order to serve a greater purpose. Achilles from The Iliad must sacrifice his physical possessions to appease his gods. Gilgamesh is unwillingly forced to sacrifice his beloved brother. Cain from The Bible also forfeits material possessions, but he also gives up his own integrity, as well as eternal life in his Heaven. These sacrifices appear to differ in the severity of what is given up, but they are actually alike in the way each is used to accomplish certain goals. Achilles is an excellent example of one who performs sacrifice. In The Iliad, Achilles is a supreme and god-like warrior, but his many character flaws hold him from achieving his full potential. His rampant pride and unharnessed rage overtakes his other good qualities and causes him many hardships. Achilles hopes to reduce these flaws by sacrificing numerous possessions to the gods. He believes, as did most other Greeks of the time, that thee gifts would urge the gods to look favorably upon the givers. Objects, such as cows, pigs, and wine, were cooked in an extremely orderly manner. Any deviations from the proper method of offering the gifts would be seen as a sign of disrespect. Sacrifices are made to obtain or achieve something in the future. In the case of Achilles, his sacrifice was made in hope that the gods would control and possibly eliminate his rage and pride. Achilles’ gifts of animals and drink to the gods were viewed by the Ancient Greek public as normal, hon orable, and religious. Most citizens made some kind of offering to the gods, but the gifts were definitely not as lavish and extravagant as the offerings made by Achilles. Regardless of the sacrifice, the importance was found in how much the gift meant to the giver, and how often the gifts came to the gods. Like Achilles, Gilgamesh also made an extreme sacrifice in order to better himself and those around him. In Gilgamesh, the tit... ...necessary arrogance that stirred unrest in his people. After his sacrifice, he had known the joys of brotherhood, become wiser and humbler, and gained the respect of his people. The complete opposite of Gilgamesh’s case is Cain’s. He begins as a humble, faithful servant of God, and he is given a good job. But he makes inadequate sacrifices and compounds the problem by murdering his brother. At the end, he does not have his job, he has lost his loyal brother by his own hand, and most walk aimlessly across the earth for eternity. As can be seen, sacrifices take on many different shapes and forms. These sacrifices can be alike and different in many aspects, but they all are important in literature. Sacrifice molds the integrity and reputation of those making them, not only to the society in which they live, but also with the higher power that they worship. The sacrifices of Achilles, Gilgamesh, and Cain were all important in their respective cultures and were very influential in how these three will be looked upon throughout history. It is obvious that any sacrifice to be made must be carefully picked over and analyzed before it is enacted. Otherwise, one may wonder forever.

Discrimination Against Females in Sport

Discrimination against Females in Sports Gender difference has always been an issue in many shapes and forms and throughout many circumstances in the past, present and still will be in the future. This paper focuses on the issue of discrimination against women in sports. Either being an athlete or a coach, women have always been looked upon as not as talented sports wise as men, even though in reality, they are. This issue is articulated in many ways.The news paper Green Leaf Weekly reports from the past that sports editors and journalists think that women’s sport is not â€Å"newsworthy† (Brown, 1993). Just that quote says a whole lot about the lack of respect people have for women who play sports who work just as hard as men to contend in their sport. Research by Eileen McDonagh and Laura Pappana demonstrates that sex segregation in sports does not simply reflect biology, but it actively constructs and reinforces social ideas of female inferiority (McDonagh & Pappana, 2010).For example, it has been a known fact that women have better physiological endurance compared to men, but yet in the Olympics some of the racing events are actually shorter compared to the men because the women are perceived as not being able to handle the same distance men run. In May of 2004 the sports world was flipped upside down when Title IX was put in place. This title should have been put in place a long time ago, but with all the discriminatory gender issues, it took this long to come to be. Title IX prohibits discrimination against girls and women in federally funded education and athletic programs.The law states that schools who do not follow Title IX, will lose their federal funding. This was a huge step in the beginning of discriminatory actions towards females in sport to be diminished. There are many resources available for exploring this subject area. Finding data and charts is hard to find, but there are many news paper articles on discrimination against wome n in sports. Also a few websites as well to help you get informed on how and why there is discrimination towards women in sports in the first place. There is a website called Women’s Sports Foundation that has a lot of information about women in sports.The good thing about this website is that though it focuses on the negative aspects like discrimination, it also focuses on the positive aspects and what women have achieved in sport and what future goals for women’s sports are. A fact the website states that by 2010, 53 athletic opportunities were offered to every 100 high school boys, and 41 athletic opportunities were offered to every hundred high school girls. Though the number is lower than that of the males, it still is much better than 20 years before this time when it was seldom that 7 athletic opportunities were offered to every 100 high school girl.This statistical research shows that discrimination in sports towards women is improving, slowly, but surely. Wome n are the most affected by this issue because they are being discriminated against in sports. More so than just women, younger women have an even harder time as when you are a young girl there are no girl’s leagues, just mixed leagues with boys. When females play with males, a lot of people say discriminatory things about girls and how they are incapable of playing with males.Likely problems that could come out of this for Canadian society would be that the discrimination problem against women will never be fixed, or it could also get worse. Women need to realize their worth and do something about the issues that are being brought towards them in sports. They have the right to play sports and enjoy them just as much as males do, and they are just as talented as males are. There are many solutions to this problem. A few solutions have already been created in order to better the sports world for women.The Title IX was definitely an important time in history when the document wa s put in place that discrimination against women is strictly prohibited in federally funded sports (Steven, 2004). Women’s sports being in the Olympics also play a very important part in helping this problem. Over the years as more women’s sports were added into the Olympics, it got more media coverage and more attention. With this attention, more young females joined the sports world and the female sports world vastly grew. I feel more women’s sports need to be added into the Olympics, and maybe even create a professional women’s sports league, like the NHL or NBA.Creating a professional women’s sports league would definitely capture enough attention to possibly make the discrimination simmer down. Another option is to possibly create women’s sports centers all over the world for women to come together who play sports and possibly make a change and realize there are a lot of other females all around the world who feel just as they feel. Mak ing people aware of the problems of discrimination in sports could open the eyes of a lot of people to see that it actually is a huge problem. In conclusion, sports are meant to be an activity to demonstrate teamwork, hard work, pain, courage and most of all belief.Belief is hard to achieve when you are being discriminated against, and a lot of people turn to sports to gain confidence. Gender in sports shouldn’t matter, sports teach to you the lessons no matter what gender you are. Many people use sports as a getaway from the crazy world now days and they should feel comfortable. Females need to realize their worth to the sports world, and if more people become aware of the problem and try and solve it, many younger females will be inspired in the future society to take sports to a whole new level, without discrimination against females.The problem will never be completely solved, but with determination anything is possible. References Brown, C. , (1993). Green Leaf Weekly. A rticle, 121. Retrieved from http://web. ebscohost. com. library. smu. ca:2048/ehost/detail? vid=3&hid=11&sid=66b0d127-bc37-4ca5-a903-ef2cab3580af%40sessionmgr11&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=fyh&AN=MRB-WRI0271980 McDonagh, E. , Pappana, K. , (2010). In Brief. Women’s Studies, 39(1), 67. Retrieved from http://web. bscohost. com. library. smu. ca:2048/ehost/detail? vid=3&hid=11&sid=66b0d127-bc37-4ca5-a903-ef2cab3580af%40sessionmgr11&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=fyh&AN=46837840 Steven, L. Y. , (2004). The Sport Of Numbers: Manipulating Title IX To Rationalize Discrimination Against Women. Brigham Young University Education & Law Journal, 1, 155. Retrieved from http://web. ebscohost. com. library. smu. ca:2048/ehost/detail? vid=3&hid=

Nature Vs Nurture - 1774 Words

The nature nurture issue is a long controversial issue that explains the significance of nature and nurture in several parts of individual development, such as personality, and intelligence. Nature inheritance is genetic behaviors passed from your parents. For example, some people have family genes that enable them to become successful in subjects such as mathematics and science, as well as verbal intelligence. Nurture experiences and learning takes effect after birth. This is what causes psychological characteristics to be established. For instance, if a child grows up in an abusive and dysfunctional home, they are more likely to look for stable and loving care outside the family. Our president Barack Obama was born in Honolulu,†¦show more content†¦Ignorance and arrogance was not accepted in her book. Ever since Obama was child, he was known to be respectful and kind. Obamas mother wanted him to be as open-minded as possible. She would encourage him to try new things, joi n sports, clubs, and more. Obama quoted, â€Å"Like most of my values, I learned about empathy from my mother,† Empathy means to understand what others are feeling. It is important for a mother to teach her child to have empathy because it makes them more kind-hearted and compassionate to others. By teaching Obama these values, she makes him a considerate man. As the president of the United States, it is important for a president to have sympathy for others. For example, there are 44 million American citizens living in the united states that do not have health insurance. Obama knows that having health insurance can be expensive, but he cares about people’s health. That’s why he just recently came out with Obama care. Obama care motivates lots of Americans with the ability to have health care that they can manage to pay for without struggling. As the president, Obama hears thousands of heartbreaking stories of families who struggle financially, emotionally, and m entally. It is necessary to have empathy when listening to these stories because it really shows that he cares and will have a solution to these issues he is being faced with. Americans want a president to be compassionate becauseShow MoreRelatedNature Vs Nurture : Is The Nature Or Nurture?1300 Words   |  6 PagesAoS 3: Student Directed Research Investigation Unit 1 Psychology - Megan Rodrigues RESEARCH QUESTION How is the nature vs nurture debate related to a consideration of the mental disorder, schizophrenia? INTRODUCTION Schizophrenia is categorized by thoughts or experiences that seem abnormal with reality, disorganized speech or behaviour and decreased participation in regular daily activities. Difficulty with memory and concentration are sometimes also present. 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