Magoosh GRE

A Reflection: Application to Practice

| February 6, 2017

Introduction

This reflective brief aims to discuss how and why I will apply my new learning to my routine practice; in particular, focusing on how this learning experience will enable me to show and promote care, compassion, commitment, courage, communication, and competence (6 Cs) within my everyday practice. Although the discussion revolves around these issues, it is consistently supported by literature and evidence.

Reflective Discussion

My most important features of learning within the module

For me, the most important features of learning within the module are the inculcation of evidence-based practice of care through communities of learning, and the positive contribution that healthcare-related lifelong learning can extend to an empowering and person-centred care. According to Houser and Oman (2011), evidence-based practice necessitates the incorporation of scientific evidence in the process of clinical decisions rather than sole reliance on experience or intuition. It is also a problem-solving approach to the practice of care, integrating the utilisation of current best evidence from well-designed researches, the expertise of the care professional, and care users’ values and preferences. The concept has several useful implications for my personal practice.

In the field where I am currently engaged, the evidence-based practice allows me to carry out my profession to promote and deliver care, utilising the supportive backdrop of theory and practice. At the heart of this backdrop is the way in which evidence-based interventions can help deliver positive outcomes to the practice of care. In other words, such learning is not simply cognitive or knowledge-based, but also affective and psychomotor (i.e. applying knowledge into practice). These are also embodied in Utley (2011) and Rice (2006). By offering a way for theory to support practice, evidence-based healthcare seems to allow the practitioners to incorporate affective and psychomotor aspects with a more rational, research-based approach.

I have fully grasped the module’s goal of providing the opportunity to engage with the service users and their carers – their experiences and outlook – and integrating this goal to my professional values. I have thoroughly recognised the importance of this integration, as working with service users and their carers in a healthcare domain necessitates soaking my whole perspective into the care practice. The health practice has become a way of life where I provide care, compassion, courage, etc. which are required of me as a health care professional. This is because it has been a part of my daily routine and concerns. From this, I have come to understand that the care practice is more than a field or profession. Leininger’s Theory of Culture Care informs us of care as the central, dominant, and unifying focus of nursing (De Chesnay and Anderson, 2008).

The 6 Cs

Care is first and foremost the primary duty of a health professional, and on which evidence-based practice must be focused. This idea is also embraced in Brooker and Waugh (2013) and Olsen, Goolsby, and McGinnis (2009). Care requires me to have an interest in the condition of service users, their aspirations, uncertainties, hopes and so on. It is not merely working with service users and seeing the work as an objective component of the care practice; but that the care practice requires traits and values beyond these, such as applying an ethical code and seeing the care user with dignity and respect.

I would like to note that compassion is a concept that cannot be objectively measured. Rather, it is something that I can extend to a care user only if I have sufficient knowledge of their condition, the problems that bother them, their emotional state vis-à-vis their existing health condition (e.g. Department of Health, 2012). This is where we would find the value of clinical assessment, which must be efficiently carried out (Abbott, Braithwaite, and Ranson, 2014). This is also the reason why I need to communicate with them regularly or as needed, since only through constant interaction can I have adequate knowledge of their present condition; from which I can grow compassion towards them.  Commitment hence results from this engagement to the care practice, which I believe is not an overnight process, but definitely requires routine. Watson (1999) describes commitment as a moral ideal aimed to preserve humanity.

Courage takes place from such commitment, which enables the health professional to support and even campaign for the welfare of the service users and their carers;  certainly a result of his care, compassion, communication, and commitment to the care practice in general. I would say that competence is a product of knowledge and practice of care being put together; it is an expression of evidence-based practice on which the module is focused. My important learning in this aspect is that these values are linked to ethical and moral code governing the care practice (Kelly and Tazbir, 2014).

Has the new learning helped me reevaluate issues of dignity and respect?

My new learning helped me reevaluate and better understand issues such as dignity and respect. This is by valuing the human person on a higher scale, viewing the care service as a channel for a person to regain his health and live normally again. This is also by looking at their ultimate recuperation as a foremost goal, including their mental, physical, emotional, and even spiritual well-being. This way, the care user is afforded dignity and respect, of which he is certainly worthy and which the health care professional must provide to him/her at all times and by all means. Treating the service user this way is concretely demonstrated in making him well-informed about his overall condition, the kind/nature of care he needs, and the like (Nolan, Hanson, and Grant, et al., 2007).

My strengths for applying this learning to my practice

The strengths I have for applying this learning to my practice are my sympathetic nature, my interactive character, and my ability to recognise accountability for issues involving the welfare of others. I believe that my being sympathetic will enable me to develop care and compassion (two of the 6 Cs) more easily.  My interactive character connotes my propensity towards good communication (also one of the 6 Cs), which is definitely necessary in the care delivery. My ability to recognise accountability, on the other hand, will motivate me to pursue my goals (as a health care provider) with careful implementation of the care practice so that the care user will receive the most adequate level of necessary care (Barrick, 2009). The Intuitive-Humanist Model explains the link of intuition to the relationship between the nursing experience, the knowledge thus obtained from this relationship, and how it enhances the clinical decision-making process (Banning, 2007).

Enabling me to demonstrate and promote the 6 Cs would require my knowledge of the care practice as the initial and necessary first step; and the next would be immersing in the health profession and knowing the issues/problems related to care users’ health condition or those affecting the delivery of care, as well as the issues/problems faced by their carers. The idea of the whole point is that the care practice must be evidence-based, since if not, our potential to harm the service users will rise accordingly (e.g. Newell and Burnard, 2011).

Opportunities and threats to applying my new learning

An opportunity in applying my new learning to my routine practice is the acquired knowledge of evidence-based care practice and its incorporation into the 6 Cs: care, compassion, commitment, courage, communication, and competence. This is why the 6 Cs are involved/patched to the care practice, as the care practice is not merely a professional domain where one obtains a care service and where the care providers get paid for providing the needed care.

There are also threats that may hinder the application of the 6 Cs in my health practice. These are inadequate care facilities and circumvented processes within the care units, which can both delay care delivery. According to Malloch and Porter-O’Grady (2010), evidence-based processes require the development of attitude and facilities in order to obtain real-time information that must be assessed, applied, and translated within the framework of the care circumstance.  In this regard, inadequate care facilities can be overcome by pointing out the needed areas to be changed and/or resources to be supplied. Circumvented processes can be resolved by applying efficient methods, such as the Lean management method. It has been proved that Lean adoption produces viable results for the care organisation (Lighter, 2013; Zidel, 2006).

A need to share my learning with others

From completing this module, there is a need to share my learning with others. Such sharing will enable the care practice to develop further, especially if it is shared with colleagues. It can also improve health setting when shared within the job, since it can be evaluated this way.  I may pass learning formally through health seminars where I am a speaker. There might also be a case that I would be invited to talk to a group of people about the care practice, in which I can share my learning about the module. The value of sharing one’s experiences about the care practice is in fact exemplified in Hinchliff, Norman, and Schober (2008) where the authors state that the care provider must facilitate the mutual knowledge sharing to others by contributing to their personal and professional learning experiences and development. Capossela and Warnock (2004) even discuss ‘share to care,’ which describes how a group may be organised to care for someone who is seriously ill. It only demonstrates the importance of sharing the care experience to allow others to benefit for their own circumstances.

 

The relationship between my routine practice, continuing professional development, and safe and effective care

These concepts are interlinked and cannot be done without, and dismemberment of any will result in flawed care implementation. If safe and effective care could be achieved by simply doing what one has always done (caring for clients adequately), then it could quite easily be ensured.  Furthermore, such relationship is also understood as one that leads to evidence-based practice. This is because it is through routine practice (from which the care provider gains learning and training everyday) (Gordon and Watts, 2011) that empirical evidence is established. Yammel and O’Reilly (2013) even posit that routine practice is an essential part of a continuing professional development programme.

From continuing professional development, the care professional is able to pursue lifelong learning and develop expertise about the field (Cleary, 2011). Safe and effective care, on the other hand, is the goal of the care user. On the point of view of evidence-based practice (Brooker and Waugh, 2013), it is crucial to ensure that service users get the most effective treatments and services and receive the best health  outcomes. Together with available and adequate funding, cost-effective care services form the provision of clinically effective care.

Conclusion

This reflective discussion presents my learning experience from the module, supported by a range of literature. The evidence-based practice of care provides a basis for promoting and delivering an empowering and person-centred care. It is a field where I have necessarily obtained cognitive knowledge as well as affective learning and psychomotor application.

This reflective discussion has presented what I consider the most important features of learning within the module. The new learning has helped me re-evaluate/better understand certain issues relating to the care user, such as dignity and respect of the human person. My strengths to applying this learning to my practice are my sympathetic nature, my interactive character, and my ability to recognise accountability.

The 6 Cs provide opportunities for applying my new learning and humanising the care profession. There are however threats that may hinder effective care delivery from taking place, such as inadequate care facilities and circumvented processes within the care units. Measures to address them are also identified.

I also see a need to share my learning with others, which the extant literature also supports. The relationship between my routine practice, continuing professional development, and safe and effective care is inter-connected, from which a flawed care practice might occur if such interconnectedness is lost. It is therefore my realisation to ensure the link between them.

References

Abbott, H., Braithwaite, W., and Ranson, M. (2014) Clinical Examination Skills for Healthcare Professionals. United States: M&K Update Ltd.

Banning, M. (2007) A Review of Clinical Decision Making: Models and Current Research. Journal of Clinical Nursing, 2007 February 28.

Barrick, I. (2009) Transforming Health Care Management: Integrating Technology Strategies.  London: Jones & Bartlett Learning International.

Brooker, C. and Waugh, A. (2013) Foundations of Nursing Practice: Fundamentals of Holistic Care. St. Louis, MO: MOSBY Elsevier.

Capossela, C. and Warnock, S. (2004) Share to Care: How to Organize a Group to Care for Someone Who is Seriously Ill. New York: Fireside Rockefeller Center.

Cleary, M, et al. (2011) The Views of Mental health Nurses on Continuing Professional Development. Journal of Clinical Nursing, 20 (1): 3561-3566.

De Chesnay, M.  and Anderson, B. A. (2008) Caring For the Vulnerable: Perspectives in Nursing Theory, Practice and Research. Second Edition.  London: Jones & Bartlett Learning International.

Department of Health  (2012) Compassion in Practice. Nursing, Midwifery and care Staff: Our Vision and Strategy. London: DOH.

Gordon, J. and Watts, C. (2011) Applying Skills and Knowledge: Principles of Nursing Practice. Nursing Standard, 25 (33): 35-37.

Hinchliff, S., Norman, S., and Schober, J. (2008) Nursing Practice and Health Care 5E: A Foundation Text. NW: CRC Press.

Houser, J.  and Oman, K. S. (2011) Evidence-based Practice: An Implementation Guide for Healthcare Organizations. London: Jones & Bartlett Learning International.

Kelly, P. and Tazbir, J. (2014) Essentials of Nursing Leadership and Management. Mason, OH: Cengage Learning.

Lighter, D. RE. (2013) Basics of Health Care Performance Improvement: A Lean Six Sigma Approach. London: Jones & Bartlett Learning International.

Malloch, K.  and Porter-O’Grady, T. (2010) Introduction to Evidence-Based Practice in Nursing and Health Care. London: Jones & Bartlett Learning International.

Newell, R. and Burnard, P. (2011) Research for Evidence-Based Practice in Healthcare. Second Edition. West Sussex: John Wiley & Sons.

Nolan, M., Hanson, E., Grant, G., and Keady, J. (2007)  User participation in Health and Social Care Social Research: Voices, Values, and Evaluation. England: Open University Press.

Olsen, L., Goolsby, W. A., and McGinnis, J. M. (2009) Leadership Commitments to Improve Value in Health Care: Finding Common Ground. Washington, DC: The National Academies Press.

Rice, R. (2006) Home Care Nursing Practice: Concepts and Application. St. Louis, MO: MOSBY Elsevier.

Utley, R. (2011) Theory and Research for Academic Nurse Educators: Application to Practice. London: Jones & Bartlett Learning International.

Watson, J. (1999) Nursing – Human Science and Human Care: A Theory of Nursing. London: Jones & Bartlett Learning International.

Yammel, J.  and O’Reilly, D. (2013) Epidemiology and Disease Prevention: A Global Approach. Second Edition. Oxford: Oxford University Press.

Zidel, T. G. (2006) A Lean Guide to Transforming Healthcare: How to Implement Lean Principles in Hospitals, Medical Offices, Clinics and Other Healthcare Organizations. Milwaukee: American Society for Quality, Quality Press.

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