Ellis (2010) defines professional development as the process of learning to get professional credentials or to be at par with the rapidly changing skills and opportunities within the practice. In respect to nursing, as well as the field of healthcare in general, some of the most prominent changes that have arisen include constant evaluation as well as reflection. Reflection or self-evaluation is important in nursing because it provides an opportunity for the nurse to think about various healthcare aspects, plan, and eventually provide the best possible care to the patients or people in need of healthcare services (Jasper et al., 2013). In this analytical reflection, I focus on my professional development as a student nurse using diverse experiences in child nursing, mental health, learning disability, as well as midwifery as pieces of evidence of my development. Although these four experiences were different, the approach of compassionate, patient-centered care was used in all these aspects. Therefore, the theme of compassionate patient-centered care is used in this analytical reflection. The Nursing and Midwifery Council (NMC, 2019) requires that patient confidentiality needs to be maintained at all times, and in line with that, I have referred to patients with pseudonyms in this analytical reflection.
To provide a background or a snippet of my diverse experiences in various practice areas, some of the patients I encountered included the following: The first was Mercy, who suffered from a mental health disorder as it was portrayed by her low mood after diagnosis. The second was Martin, a child, who seemingly was experiencing excruciating pain because of a wound on his leg. Thirdly, Curtis was suffering from autism and was subsequently disoriented. Lastly, Helen was pregnant and appeared too unsettled during her labor; she did not know what to expect, was anxious, worried, and easily agitated. I demonstrated a compassionate, patient-centered care in various ways, and in accordance with the uniqueness of each situation.
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According to the NMC (2019), nurses have the obligation to conduct their practice in line with the standards of ethics and conduct for nurses and midwives whereby compassion and care are listed as some of the most critical values. Although it may seem obvious that nurses automatically implement and apply these values, some may lack vital attitudes such as compassion (Health Research Authority, 2019). The consequences of the lack of such core and fundamental values and attitudes include patient suffering or inadequate addressing of the needs of the patients (Robert Francis Report). Nurses are vital links between patients and physicians and at the same time, crucial to the recovery of the patients. Since nurses spend a lot of time with the patients, the healing or recovery process of patients may be in limbo if they do not demonstrate the best of attitudes and care to the people in need of their services.
Charlton (2015) defines compassion as the act of promoting respect and empathy while at the same time enhancing a therapeutic relationship between the patient and the nurse. While the nurse may gain more knowledge from the interaction, the patient’s emotional needs may be addressed in the process. Jeffrey (2016) posits that compassion can be perceived to be some sort of intelligent kindness, which is central to the recovery of patients. To reflect on my experiences, I demonstrated compassionate patient-centered care while caring for Mercy and Helen. I demonstrated this approach by providing reassurance in accordance with their specific feelings and emotions at specific times as opposed to generally assuring them that everything would be fine (Baughan and Smith, 2013). I deeply empathized with Mercy, offered her a cup of warm tea and sought permission to sit close to her. By sitting next to Mercy, I got the chance to maintain eye contact, and I think I must have gained her trust because she began to discuss her worries with me. Gorawara-Bhat and Cook (2011) suggest that eye contact may seem a benign action but overall, it covertly helps in a patient-centered care strategy because it makes the patient feel the nurse cares and has a keen interest in their problems. When I realized that Mercy trusted me because of the attention I was giving her, I took the opportunity to lift her mood with positive and encouraging comments in an attempt to persuade her to avoid the risk of self-harm (Doyle, Keogh and Morrissey, 2015). I had already checked her medical history and discovered she had the risk of self-harm.
One of the guiding studies that I took into consideration while dealing with Mercy’s situation is that conducted by Chartrand et al. (2016) that concludes that not all self-harm patients harbor suicidal intentions. Karman et al. (2015) also suggest that nurses often lack compassion and have a judgmental attitude while attending to patients who engage in self-harm. Therefore, I did not assume that Mercy’s condition would likely make her contemplate suicide. I, therefore, empathized with Mercy’s situation and even held her shoulder gently to provide support and reassurance. While reflecting on this experience, I feel my compassionate and care approach was effective because the outcome was positive. Mercy would always anticipate my arrival, and we consequently established a very good relationship. My presence encouraged her to talk, I learned a lot about her and the good rapport made it easier for me to advise and teach her about the best intervention strategies.
Regarding my experience with Martin, I used somehow a different approach that I used on Mercy. Part of the vital skills stated in the NMC standards required of pre-registered nursing education is the ability to apply adequate knowledge and equipment to provide care for all people regardless of their mental health, age or physical needs. When I saw Martin in agony because of the pain that he was feeling, I empathized with him and reflected on his inability to express in words the intensity of the pain he was feeling (Carter et al., 2014). I tried to imagine myself in his situation and at the same time maintain eye contact because it had been effective in Mercy’s situation. I also wore a smile throughout my interaction with Martin as well as when I was with his parents. According to Dos Santos et al. (2019), children’s perception of a good nurse is a person who is kind, friendly, and patient, and therefore, I demonstrated these traits. However, my desire to reduce worry from Martin’s parents drove me into assuring the parents that Martin was going to be fine. I later realized that it was a poor practice to predict the health status of the patient because if anything undesirable eventually happened, the parents would likely blame me for giving them false hope. I, therefore, recognized the importance of restraint and working within the confines of my competence (NMC, 2019), and which I have to consider in my future practice. When Martin eventually brightened up, I offered him toys to play with. The National Association of Hospital Play Staff (2019) postulate that playing among children is vital because it helps them express their fears, and consequently makes them develop coping strategies to deal with their illness. Playing must have certainly helped Martin not to think of his pain, and ultimately helped him to recover (Scrambler, 2009).
During my initial interaction with Curtis, I lacked compassionate care. Quite often, interacting with autistic patients or individuals with learning disorders can be a grueling task (Rowe and Nevin, 2014). When the doctor eventually discharged Curtis and asked that his catheter be removed, I thought I got the best opportunity to practice a novel skill. I tried to explain to Curtis using hand gestures that his catheter needed to be removed so that he could go home, but when I got close to him, he felt irksome and anxious. I realized that the cause was because of the noise from the ongoing bell calls, and loud visitors. Stiegler and Davis (2011) identified in their study that sound hypersensitivity was one of the main symptoms of autism. The authors also suggest that excessive avoidance of the reactions portrayed by patients suffering from autism is one of the ways to regulate emotionally the issues by applying learned behaviors such as fear and anxiety.
While interacting with Helen, my approach was almost similar to what I applied during my interaction with Mercy and Martin. Helen appeared to be very unsettled because she kept inquiring about whether her partner had arrived as her contractions persisted. Helen expected her partner to be present while she delivered, and when the midwife informed her that her partner was held up in traffic, she felt helpless. I also realized unconsciously that my facial expression discouraged her when the midwife answered Helen, and I acknowledge that this was a poor performance according to nursing practice and professionalism (NMC, 2019). I realize that in my future practice, I will need to be diligent and conscious of my body language whenever around people who need my services.
Patients usually look up to healthcare givers as their sources of hope in the alleviation of their situations. Karlstrom, Neystedt, and Hildingsson (2015) in their study suggested that childbirth experiences may have long-term effects on the wellbeing of their mothers. When I became aware of my performance and body language, an idea quickly came up on my mind. I asked Helen if I could hold her hand until her partner arrived, and she consented to it immediately. However, I realized that the prompt consent could potentially demonstrate how vulnerable she was. Although research proves that holding hands during labor may provide reassurance and ease pain (Goldstein, Weissman-Fogel and Shamay-Tsoory, 2017), the study of Montgomery and Rogers (2015) suggested that in such a case, a compassionate touch could trigger past memories for women who had been sexually abused. Helen’s partner could have been the only and most appropriate partner to provide comfort and make her feel at ease. Although my action and offer could have been out of positive intentions, I think I performed poorly because I was not aware of Helen’s full history. I would have been blamed if Helen experienced any undesirable past feelings and emotions.
In conclusion, I achieved a gradual but positive professional and interpersonal growth during my experiences with the various patients. I provided reassurance by talking to the patients or just by my physical presence. I empathized with their situations in addition to striving to be open to their needs depending on the uniqueness of their situations and then consequently responding in the most appropriate way. In most of these experiences, I demonstrated confidence and it increased with every progress. In this analytical reflection, I have identified my strengths and weaknesses, which is the basis of my professional progress. I will use my strengths to provide the best care and improve on my weaknesses to provide the best quality care.
