REFLECTIVE PRACTICE

Reflective Practice



Reflective Practice

Introduction

The experience of reflection as a implement for understanding in workplace education, can allow the student to problem solve in practice. (Holloway Whyte 1994). This reflective case study has been written using the Gibbs (1998) model of reflective writing. Confidentiality has been preserved throughout in accordance with the Health Professions Council (HPC) Code of Professional Conduct (Health Professions Council 2003)and I have chosen the pseudonym of Joyce Charles for my patient.

Although this was the first week of my second placement in general practice this was the first time that we had met, therefore, I introduced myself and made clear at the practice and explaining that I was a Paramedic undergoing further training to become an Emergency Care Practitioner (ECP) (as described by Silverman et al 1999). Joyce gave me verbal consent (Department of Health 2001) to take part in her consultation and treatment.

Description

The rationale for reflection in relation in to this topic is to understand the difference in today's standards and how important the Health Care Professionals role will impact in providing care for patients suffering chronic disease.

Joyce had returned to the surgery following a glucose tolerance test, for diabetes, she was a 43 year old clinically obese female. The previous week she was seen by the Doctor as she had some sores that were not healing properly. Joyce was asked to return to see the diabetic nurse at the surgery clinic to obtain her results and ask any questions, that arose.

Feelings

Joyce was going to be given the news that she had Type 2 diabetes and after a few minutes she asked a number of questions and as she did so, her voice started to waiver and she clearly was quite shocked at this news. She had tears welling up in her eyes, then burst into tears. This outburst of emotion overwhelmed and surprised me, however the nurse was also a trained counsellor and was very supportive and sympathetic in her manner. I was now quite worried that I would become too focused in this one area of her emotion. I always seem to lose my confidence and train of thought as a result of being watched, probably fear of being criticised in a non conducive manner. Baile et al (2000 1597-1599)note that as long as the beginner is following the rules, his/him performance will be halting, rigid and mediocre.

Whist I was attending one of my first lectures, I was advised to use the acronym LEAPS which is a way of effectively conducting a consultation by listening, empathizing, asking questions, paraphrasing and summarizing. Techniques like this enables practitioners who are at the beginning of their new roles, a foundation on which to build the consultation, leading to confidence, which I hoped would be communicated to Joyce.

I did feel a degree of consternation when I started talking about diet, as Joyce had a body mass index of 39, which is just one below the morbid obese level (Simon et al 2002) and she appeared embarrassed and visibly ...