BROADENING PERSPECTIVE NURSING

Paper, Order, or Assignment Requirements

COURSE WORK ONE
Course work one requires student to produce two, one thousand word reflective assignments. Each assignment must address at least one of the areas identified by the NMC e.g. communication, compassion etc. The word limit suggests one area per essay would be best. It may be reasonable to address the same topic in both essays as a comparative study but this must be approved by a lecturer before commencing the work and must demonstrate extensive development of the theme.
Each of these assignments should investigate an area of nursing outside of the domain for which the student is training. Adult nurses may select from mental health nursing, childrens nursing, maternity care, care of the elderly or learning disabilities. Mental health nurses clearly must choose anything other than mental health. Learning disabilities is an option available for mental health students.
A reflective model should be demonstrated and be used to structure the work. Accordingly, these assignments should emphasise the first person singular (‘I’ statements) rather than the detached third person analytical expressions usually associated with academic work in Nursing. Since both assignments will be submitted as one unit of work it is unnecessary to replicate the chosen reflective model in both essays,- indeed marks may be lost for unnecessary repetition. A tip is to offer the reflective model as a precursor to both reflective accounts. Each reflective analysis account thus becomes a derivative of the common descriptive stem (the reflective model).
The reflections, regardless of the model used, should account for the Affective, Cognitive and Behavioural elements of the experience being analysed. Emphasis is on analysis rather than description of the event and the marks will be awarded accordingly. This assignment though is a ‘Pass or Fail’ exercise.
Examples of previous assignments include;-
• Communicating with a learning disabled client relating to their diet,
• Expressing compassion to relatives of a dying child
• Explaining a pre-operative checklist to a non-English speaking patient.
• Administering an injection for the first time
• Undertaking a wound dressing for the first time
• Bathing a member of the opposite gender.
• Communicating with distressed and angry relatives
• Delivering a patient summary at staff shift handover.

THINGS NOT TO DO:-

a) BROADENING PERSPECTIVE EXPERIENCES

DON’T;
• Put yourself into a dangerous situation;- avoid war zones and areas of civil unrest / conflict. Also consult with local supervising personnel about safety issues.
• Depend on the University for expenses or other financial support
• Work in isolation or unsupervised
• Engage with vulnerable service users
• Try to cover all of the NMC requirements in all of the essays / reflections. One subject per assignment will suffice.
DO;
• Respect the needs of all patients, clients, service users and service providers.
• Investigate the organisation NOT the clients
• Provide details of your proposed experience to lecturers BEFORE embarking upon it.
• Produce your posters to demonstrate and validate your activities
• Record your experiences in your portfolio

b) COURSE WORK 1

DON’T;
• Identify individuals or organisations either directly or by implication unless they either agree to it or they are a public body… and even then discuss this with lecturers before writing.
• Try to accommodate all of the areas of nursing in all of the assignments. One per assignment will suffice.
• Offer only superficial description;- you must investigate and analyse deeply in order to pass these essays.
• Be late with your submission

DO;
• Analyse and criticise
• Discuss the work with lecturers as required

First 1000 words essay
Use Gibbs reflective module to reflect how communication is been implemented in maternity service. I have selected the use of an interpreter as a mode of communication with a woman with limited English. Please use Harvard style referencing and UK research

Second 1000 words essay
Use Gibbs reflective module to reflect on how safeguarding is been implement in maternity service. I have selected a woman undergoing domestic abuse. Please adapt every part of it to the uk.

FACULTY OF SOCIETY AND HEALTH

GENERIC ASSESSMENT CRITERIA Society & Health: LEVEL 7

A
(85-100%) (70%-84%) B
(60-69%) C
(50-59%) D
(40-49%) E
(34-39%) F
(33% – 0%)
Level 7 Criteria >8.5 7-8.4 6-6.9 5-5.9 4-4.9 3.4-3.9 12.7 12.6-10.5 9-10.4 7.5-8.9 6-7.4 5.1-5.9 <5.1
2. References

15
The Harvard system must be used consistently and accurately throughout the work.
It is expected that students will demonstrate a range of reading appropriate to the topic and the academic level. Although difficult to prescribe, it is anticipated that students will draw on a range of literature, and other forms of evidence, using this to extend perspectives and elaborate on current thinking. The Harvard system must be used consistently and accurately throughout the work.
It is expected that students will demonstrate a range of reading appropriate to the topic and the academic level. Although difficult to prescribe, it is anticipated that students will draw on a range of literature, and other forms of evidence, using this to extend perspectives and elaborate on current thinking. Able to extrapolate from a diverse range of evidence. Harvard System used consistently and accurately.
Wide range of reading evident and utilised appropriately throughout the work. Harvard System used consistently and accurately.
Wide range of reading evident and utilised appropriately for the majority of the work. Harvard System used consistently and accurately in the majority of the work. Some evidence of wide reading within the work. Harvard System used with minimal errors in referencing evident.
Some evidence of wide reading to support parts of the discussion.
Harvard System used but referencing incomplete and multiple errors evident. References not always utilised appropriately to support the work.
Limited evidence of wide reading to support discussion.

Using Gibbs: Example of reflective writing in a healthcare assignment
• Description
In a placement during my second year when I was working on a surgical ward, I was working under the supervision of my mentor, caring for a seventy-two year old gentleman, Mr Khan (pseudonym), who had undergone abdominal surgery. I had been asked to remove his wound dressing so that the doctor could assess it on the ward round.
I removed the dressing under my mentor’s supervision, using a non-touch procedure, and cleaned the wound, as requested by the doctor. My mentor was called to another patient at this point, so at her request I stayed with Mr Khan while we waited for the doctor to come to see him.

The doctor had been with another patient, examining their wound, and I noticed that she came straight to Mr Khan to examine his wound, without either washing her hands or using alcohol gel first. I also noticed that she was wearing a long-sleeved shirt, and I was concerned that the cuffs could be contaminated. I thought for a moment about what to do or say, but by the time I had summoned enough courage to say something, I thought it was too late as she was already examining Mr Khan.

Feelings
I was alarmed by this, as I had expected the doctor to wash her hands or use alcohol gel before examining Mr Khan. However, I felt intimidated because I felt that the doctor was more experienced than me as a second year nursing student; and I didn’t want to embarrass her. Also, I didn’t want to make Mr Khan concerned by confronting the doctor in front of him.

Later, I spoke to my mentor about the incident. She suggested that we speak to the doctor together about it. My mentor took the doctor aside, and asked her whether she had washed her hands before examining Mr Khan. She looked quite shocked. She said that she had been very busy and hadn’t thought about it. My mentor discussed the importance of hand hygiene with her, and the doctor assured her that she would wash her hands before examining every patient in the future.

Evaluation
The incident was extremely challenging for me. I regret that I did not act to challenge the doctor’s practice before she examined Mr Khan. However, I am pleased that the doctor responded so positively to the feedback of my mentor, and I have observed that she has now changed her practice as a result of this incident. I too have learned from the incident, as it has taught me the importance of acting assertively with colleagues, in a sensitive manner, in order to safeguard patients’ well-being.

Analysis
The Royal College of Nursing (2005) states that hand hygiene is the single most important activity for reducing cross-infection, and points out that many health care professionals do not decontaminate their hands as often
as they should. Recent guidance published by the Department of Health (2007) highlights the possibility of staff transmitting infections via uniforms, and the need to review policies on staff dress. The Nursing and Midwifery Council Code of Professional Conduct (2004, section 8) states that as a nurse ‘you must act to identify and minimise the risk to patients and clients’. As the student nurse caring for Mr Khan under my mentor’s supervision, this also applies to my own practice as a student nurse.

Conclusion
Looking back on this incident, I can see that I should have acted sooner, and that I should have ensured that the doctor washed her hands before examining Mr Khan. I can now see that my inaction in this incident put Mr Khan’s well-being at risk. After discussion with my mentor, I recognise that I need to develop the confidence to challenge the practice of colleagues, putting the well-being of clients at the forefront of my mind. I realise that I need to be supportive to colleagues, understanding the pressures that they may be under, but ensuring that their practice does not put clients at risk.