NMIH303 Analysis On Therapeutic Use Of Self: Diary Entry On Healthcare Experience Assessment 1 Answer

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Question :

Assessment 1: Critical reflection - 2020



NMIH303: Therapeutic Use of Self

1. Assessment task 1: Critical reflection

Assessment TitleCritical reflection

Task Description
You are required to critically analyse the therapeutic use of self. To achieve this, you will need to write a reflective “diary” entry on a healthcare experience that you have had. This should not be a procedure such as how to perform hand hygiene or administer medications. Rather, it should be a clinical experience where you identified an issue/problem (for example, poor communication led to an incident occurring). The experience may have occurred on a clinical placement, as an employee in a healthcare setting, as a patient or a healthcare experience of a family member or friend in which you were involved. The experience should have an issue or problem that you would like to learn
more about through critical reflection and research so that you arrive at a new understanding about your therapeutic use of self.
Headings should be used to format this assessment. The diary entry describing the experience should
be approximately 250 words. You may write diary entries using the first person “I”. To maintain confidentiality of participants and facilities, you are required to de-identify people and places by using pseudonyms. All diary entries will be treated as private and confidential documents.
Following your diary entry, you are required to complete a Level 1 (What) (approx. 500 words), Level 2 (So What) (approx. 1000 words) and Level 3 (Now What) (approx. 500 words) analysis  Please do not use any other reflection model. Your reflection should provide a conclusion summarising your new understanding about your therapeutic use of self.
Please note that Level 2 of the framework requires you to address how and why the issue/problem occurred and the evidence to guide the practices and knowledge you could now apply. Within this step, you are required to conduct a search of the literature to identify and analyse evidence that will help you develop a new understanding of the experience you are reflecting upon. You will need to demonstrate effective literature searching skills and ability to consolidate, analyse and critique evidence. In this section, you are required to reference appropriate Australian nursing legislation. 
Type of CollaborationIndividual
Length2500 words
DetailsCritical reflection
Style and formatEssay format with heading
References: APA6
Subject Learning
1-3, 5-6

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Answer :

Assessment Task 1


Case Study

Level 1 (What) 

My role in the situation was of the nurse taking care of the patient and was on the routine duty. As I was passing by, recently I saw a buddy nurse was shouting at the top of her voice to the fellow nurses and in front of the patient. Due to this, not only I could see her fellow nurses feeling disappointed, frustrated and even showed the sign of agonized. The fellow nurse not only felt demotivated but also felt disoriented and lacked focus.  As a quick action, I quickly communicated the same to the buddy nurse and told her the importance of proper and clear communication, such as speaking in the closed room, in a subtle voice and also raising concern compassionately. Initially, the buddy nurse reacted awkwardly and didn't accept the consequences or anything (Hughes, 2016). After a brief discussion with the nurse related to having good communication and how to coordinate with the nurses effectively can prove to be better patient care. It has helped the nurse understand the situation at a mature level.  For this even example was given and discussed in a better manner, such as how the message appears in the loud and the high pitch voice and the same message when shared politely, how it creates influence. I even gave her the descriptive personal of how to approach the nurse and how to be ethical in the duty of care for the patient and the other fellow nurses. The same thing was observed by the buddy nurse with the fellow nurse who quickly took corrective measures (Doran, 2016). As I can see initially the nurse felt bad as she was told by me who was practicing alongside with her, but when she got to know the intentions and how the approach should be in such scenarios, she quickly understood her mistake and ensures preventive steps in the future (Kurtz, 2019). The consequences were more support from the fellow nurses who became conscious and always be aware of the good communication talking with the patient and with the fellow nurse (Ready, 2016). Initially, the nurse felt unhappy about pointing out the finding, but as it was a brief open discussion in the closed room, it helped her to understand, she felt embarrassed but again started to check her points. She understood the recent episode of the elderly patient getting undiagnosed due to poor communication and lack of coordination among nurses in such cases. The patient not only suffered a fall, but faced a life-threatening consequences of getting hurt and impairing himself physically.. By noting this example, the buddy nurse was informed of the good and bad communication. Due to the support and gaining good confidence, a good communication campaign was also initiated. It was a learning experience and the nurse felt happy to be supportive of such causes. The response was initially negative which was transitioned into the positive outcomes and reciprocation of the feelings behind it. It was an overall good experience, as with the fellow nurse and everyone could understand allow the Duty of care and the standard codes of the nursing such as beneficence, veracity, and justice was followed by ensuring the rights of the good communication are met (Professional standards, n.d.). The therapeutic care begins with the awareness and feeling the other emotions systematically, but it should be citric with the personal approaches and abidance of the codes of conduct within the professional set up. 


The importance of “improving good communication among the health care workers (HCWs) and it is important to oblige and understand the necessary intervention. For example, the elderly patient who was fallen could have been protected through a better coordination and collaboration in between the nurses. The incident was a result of the poor communication and direction. Such as in the incident, buddy nurse directed to support the elderly patient from the left, but the fellow nurse just supported the patient through the legs, which eventually lead to the fall from the bed, due to the imbalance. The theory of Planned Behavior” thinks in line to bring effectiveness and also relate with the most effective intervention that can help to reduce healthcare-associated miss communication or the lost in translation messages within the hospitals. As per the theory, it is important to be in sync to the cognitive belief-base framework and also approach the matter with the delicate, normative and also in a brief controlled manner (Maiden, 2016). Through the theory, the approach is to understand the relation and how the underpinning nurses’ can formulate the decisions and how to have good communication. It has to be done following the recently applied national guidelines. The factors and the determinants of good communication decisions for the healthcare workers are one of the greatest assets for the patient-nurse who can work effectively to improve the compliance. Depending on this theory of the planned behavior provided it would be important to streamline and be in sync to the strategy to place in accordance with the beliefs of nurses. The importance of good communication decisions should be in line with the 5 critical moments, which are listen, discuss, interrupt, receptive and responsive. It would help to ascertain the importance of good communications and the importance of the required theories should be in accordance with the guided studies. The importance of the improved nurses’  and the respective care for the good communication practice should be inline to the 5 moments and it has to follow the individual strategies which can also help to experience and work over the distraction that can result in abiding by the duties and it should be consistent to follow the peer-based initiatives. Through this, it would help to foster a sense and develop a shared responsibility along with approaching the management-driven solutions which can help to tackle the staffing and the resource issues. Through good communication, it is important to touch the patient with therapeutic care and with the proper good communication manner (McConville, 2016). It would help to overcome any infectious or the related neglected opportunity of not being able to follow the compliance. With the theory of the planned behavior, not only the goal of improving good communication is the prime focus but also for the health care workers (HCWs) the main motive is to work coordinately in setting up an effective intervention. The goal is also to be in line with reduced risk and also work collaboratively to overcome healthcare-associated miscommunication and the lack of coordination in the hospital setups. It can also be helpful to collaborate and work over the detrimental effects which can be observed in the patient health outcomes and how it has resulted in the impacts on the health systems. As per the World Health Organization (WHO) (2009), it is important to adopt the new global guidelines which are related to good communication. The organization states that there should be effective, integrated and coordinated communications that can help to provide a better whose goal and aim for a healthier future and also be inline to promote health, keep the world safe and serve the vulnerable. With this the role of good communication would help to overcome any unnecessarily overlapping roles, confusion caused in miscommunication, the problem of collaboration and coordination can be overcome. It is important to follow a proper methodology to have better communication. There is always a scope of improvement while abiding by the compliance. The nurses have to ensure the physical contact in line with the patients. The goal is also to understand the importance of good communication and how to work over the collaborative practices that can help to mitigate the occurrence of the confusion, any sort of risky compliance, mismanagement and adhering to the related compliance.

The problem and the challenge are to have an intervention plan and sync with the required framework of following the good communication in sync to the portals and the compliance. As per the Theory of Planned Behavior (TPB), in my view, it is necessary to have a validated decision-making model and also ensure it has been well implemented as the strict portals within the hospital. The main importance of the theory, in my understanding, can help to influence the determinant of behavior and also create a better intervention that can be influenced due to the three factors which are to have a proper attitude, to create a subjective norm almond with abiding by the perceived behavioral control (Odell, 2018). 

Alternative action solutions to the problems identified are forming the attitude which would be referred to as the positive or the negative evaluations of the behavior (Mahinroosta 2018). It is important to perform better good communication and it should be good. The subjective norm needs to be in line with the perceptions based pressures and it can help to perform the behavior. Another is through the set examples and influencing the health workers to have the perceived behavioral control and addressing how to have better ways to perform the behavior of interest.

The broader issues arising out it, is better ways of prevention, having an adequate controlled strategy and also understanding the importance of good communication (Porter, 2018).

 Level 3 (Now what) 

In my view, from the theory and the incidence, it has helped me to understand how to make a good habit of using good, precise and effective communication and be in line with the compliance rule. In the incident, if the elderly patient was supported through a  proper communication and direction, it would have prevented injury and helped the elderly patient to get a better support from the medical staff and nurses. As per the therapeutic use of the self, it is important to reflect on the actions and the importance of suggesting the ways to improve it. In my view, often we can see that while complying with the standard proposes, it is important to identify the stages and also formulate the steadies which would make it a habit. The habit of proper good communication can be followed through the positive attitude of the acceptance and the changed behavior. The guidelines directed per the WHO should be followed from the inner conscious and compliance. It would help to prevent miscommunication and any sort of overlapping roles that can lead to lost in the transition message and bad quality care for the patient. The patient concerns should be duly noted verbally and in a written manner, to avoid any mishaps. The coordination between the nurses and the medical practitioners can be enhanced by having precise, concise and better communication support. It is important to be mentally conscious and approach the matter ethically. The changes to be made are the adaptation and integrating of the good communication and adopting the effective, efficient communication which can be followed in between the multi-disciplinary and from the top to bottom approach.  As the first step through awareness programs, campaigning about maintaining good communication should be maintained. Regular in coordinating and monitoring the peers while maintaining good communication should be watched. Any signs of the breach or violation should be closely watched and it should be guided with proper compliance. Often the problem can be a lack of acceptance and also in the attitude, it can result in the breaches and the resultant compliance breaches (Young, 2020). The sign of violation in maintaining good communication can cause conflicts and confusion. As a concluding statement, training and the imparting of proper good communication should be educated and detailed to the people, the importance of knowledge sharing and how to constantly comply with good communication and the prevention of it (Skinner, 2016). The main goal is to ensure the importance of overcoming the problems of poor communication and how to handle it delicately and ethically manner. The changes should be in attitude and behavior. The rationality to maintain good communication needs to be adopted and maintained.   Good communication can ease the situation, where there is an overlapping of the role and there can be mis- communication, due to the language barriers or message. To provide an adequate care it is necessary, nurses coordinate with each other and have a better communication strategy.  It is important to have the effective and the efficient communication that can help to avoid any confusion and have the better clarity of the roles. Communication can avoid any medical negligence and can help to overcome any language barriers or issues.