The care of a patient’s mouth forms an important component of assisting hygiene needs and yet is an aspect of practice which is not always afforded the attention it fully deserves. It is also a role which too often delegated to health care assistants.
Research shows that, in the United States, nosocomial pneumonia ranks second in morbidity and first in mortality among nosocomial infections. The treatment of nosocomial pneumonia adds 5 to 7 days to the hospital stay of surviving patients and billions of dollars to healthcare costs.
There are different models of reflection one of which is Gibbs (1988). Reflection is the process of reviewing an experience in order to describe, analyses, evaluate and so inform learning about practice (Reid1993).
I will use this reflection model in guiding me because it has helped focusing on different aspects of an experience, and exploiting their full potential for learning will be more appreciated.
Reflection in professional practice, however, gives back not what it is, but what might be, an improvement on the original (Moon 1999).
As part of placement simulation, I was part of a group introduced to oral hygiene care. It is one of the core requirements in maintaining the hygiene needs of a patient. When we were told to bring in a towel and tooth brush, I was taken aback as to what was the need for them?
I went to the multi-skills laboratory not knowing what will befall me. My lecturer introduced us to a range of chemicals for oral hygiene. I had used some before but on this occasion, there was one I had not tried and used before. I was assigned a colleague to have the opportunity of experiencing the giving and receiving of oral hygiene by cleaning his teeth with toothbrush and pepsodent and vice versa.We performed as instructed.
Upon commencement of activity, my views of healthy oral care were not very clear to me. Generally I perceived cleaning your teeth as being much like washing a face. I felt very embarrassed and inadequate and consequently, felt very uncomfortable as I have not done this to anyone outside of my family. On his part, it was obvious from his reaction that he had no confidence in me, thinking I was going to brush his teeth hard. It highlighted the complex problems I have to solve in practice and the provision of care needs to patients for whom I may not have had contact with before. I thought my pride and dignity had been taken away from me but later felt comfortable having understood what it was generally.
Helping patients/service users to meet their hygiene needs is a fundamental component of nursing care. Again, helping patients to meet their personal hygiene needs provides any nurse with an ideal opportunity to undertake a thorough physical, emotional and cognitive assessment of the patient.
Although it seemed difficult at the beginning, by the time we performed on each other for the third time with encouragement we had developed a good working relationship.
Encouraging students to acknowledge their intuitive capacity helps them to appreciate their strengths and weaknesses (SWOT). Jasper (2003) regards SWOT analysis as getting to know yourself. The understanding of our skills and abilities and the awareness of where our limits lie is seen as crucial to being able to act as a professional practitioner. After identifying and analyzing of my own strengths, weaknesses, opportunities and threats, I showed no more discomfort and shown more interest in the activity as our lecturer continued talked us through. Jackson and Mannix (2001) note that amount of interest the nurse shows in the learning needs of the student and the key role he or she plays in their achievement are essential to the student’s development.
It is strange that sometimes you do things or know what things are without ever really stopping and analysing it. Most students and many professionals note that learning acquired from placement experience is much more meaningful and relevant than that acquired in the lecture room (Quinn 2000).
Boud et al 1985 argue: “it is common for reflection to be treated as if it were an intellectual exercise – a simple matter of thinking rigorously. However, reflection is not solely a cognitive process; emotions are central to all learning.”
Caring for a patient requires a relationship and empathy. By developing collaborative relationship with patients, I can provide prompt and focused interventions which can limit illness.
My aim is to be proactive in the future by promptly opening up. I aim to develop the skill of emotional resilience to be able to deliver and receive any care.
Like many others on the group, I thought that students were there through choice, they wanted to learn. As a result of this I expected the group to be mature and behaved. Due to my lack of experience in care and the job title of student nurse, I perceived that most sessions would run in a lecture format. This was probably a very naive move on my part, however following my first two sessions, I realised that if I was to be a successful student nurse, I had to adapt my approach. I needed to focus more upon my involvement and participation, getting the group involved in sessions would help to improve my learning process.
However as I develop my nursing skills and also my ability to reflect, I have begun to realise that the process of reflection is more complex than Gibbs (1988) suggests. Whilst Gibbs highlights key areas of the process, I feel that reflection is not as cyclical as this model implies. As my reflective skills develop, I am finding myself jumping some stages of the cycle, revisiting others and in some instances digressing in different directions.
I feel that this represents my views of reflection as I have a start point (the experience) and an end point (the outcomes/actions), but how I get there is down to my trail of thought. Whilst at this stage of my development I would not class myself as a ‘successful,’ I believe I am working to develop the skills required to be successful.