Reflection has been defined as an active, persistent and careful consideration of any belief or supposed form of knowledge (Dewey, 1933. Dawn, 2007). Reflective practice is a process to improve quality of performance in the workplace, skills up to date throughout workplace and leads to understanding the field of care. Reflection requires self-awareness and analysis (Schutz et al, 2004). To reflect the incident, I have used Gibbs (1988) reflective cycle because it easy to follow, well structured and it allows reflection on feelings as well as actions (Pat, L. 2008). Besides that, it helps to recognize what we do well and how to interpret in the other situations. I’m working in surgical and transplant ward for five years as a staff nurse.
My expectation before I was confirmed working in surgical ward is questioning myself that am I talented to be a good staff nurse in this ward?. According to Julie . D. et al, (2005) is the transition from student to registered practitioners is the most arduous learning journey. Nursing Division has developed an orientation program and it is improve from year to year. Julie . D. t al, (2005) describe the good impact among staff nurses in views of rotational development programme. This program had built strength among staff to work hard and be a good staff nurse. One incident has happened to me and until now I cannot forget about it. It was happened four years ago. On that time, I’m still new qualified staff nurse and lack of experience. I have one post coronary artery bypass grafting patient and planned for discharge the next day. Two days patient keep complaint of vomiting, nauseated, poor appetite and tiredness (Jose et al, 2007).
All vital signs were stable except patient had bradycardia. I thought it was normal, so I did not mention to the doctor in charge during ward round as patient look stable. Two hours before pass over report, patient look very weak. Immediately I ask my senior staff nurse what should I do and she told me to inform to the doctor in charge. The doctor in charge came and asks do urgent blood investigation (renal profile) to check potassium level and ECG (electrocardiograph). ECG showed changes with peaking of T waves (Miller W, 2006).
Result back and showed potassium level was high. Immediately the doctor ordered to give 10ml calcium chloride 10 per cent solution administered intravenously over between two and five minutes to antagonise the toxic (Resuscitation Council 2006) and kiv haemodialysis pertaining to hyperkalemia (Humpreys M, 2007). I feel very scared because I did not inform to the doctor earlier about patient’s condition. I feel like I’m not a good staff nurse because I’m ignored about patient’s problem.
The good thing is this experience make me learnt how to detect patient’s problem from their complaints. The bad thing is maybe I can make the patient died due to lack of knowledge. I should not feel like I’m not a good staff nurse because this is a new experience. I can ask my senior staff what should I do about patient’s complaint. This is to prevent my patient become worse. If it arose again, I should check patient’s vital signs, do ECG and check previous blood investigation results first and inform doctor immediately.
Through this incident it showed that the important to be a knowledgeable person and how to train a new staff. Through the Gibb’s reflective cycle, I’ve learned about important of knowledge and two way of communication (Lisa, R. , Sally, JB. 2007). In brief, I want to be a mentor. So, I can teach a new staff. After five years working in this ward, my aim is I want to be a mentor. This is because mentor not only to provide a high-quality and evidence-based care but also support student learning and the assessment process (Wilkes. Z. 2006). According to Sara J. t al (2007), mentor provides a positive career role model, professional growth opportunities, advice, career challenges, access to learning resources, encouragement and feedback on a mentee’s career progress. As a mentor, we should be well prepared. It shows mentors are capable of coaching, challenging and sophistication in their role (Wendy et al, 2007). The Nursing and Midwifery Council (2006) defines a mentor as a registrant who has meet the outcomes of stage two and who facilitates learning, and supervises and assesses students in a practice setting (Wendy et al, 2007).
Although the mentor gets relationship with student, they must maintain a professional practitioners and unbiased approach to all students. Mentors need skills to achieve an effective communication, interpersonal skills to facilitate, support and assess student in their practice (Wendy et al, 2007). To be a mentor, I need to improve myself. I make a decision to take part in Diploma in Cardiovascular and Thoracic Sciences course. Through this course, I hope that I can develop my skills in many ways.
According to Bennett (2003) and Ali PA, Panther W (2008), to be a good mentor-student relationship, we have to organize a meeting, orientation of the students to the clinical area, provide a good learning environment and offering appropriate support to the student. All this strategies will helps mentor to get to know the students personality, clinical experiences and learning needs. This information helps the mentor to develop an appropriate strategy to aid the students learning (Wallace 2003, Ali PA et al 2008).
There is a challenges and high commitment required to be a mentor. The challenges include dual responsibilities of patient care and student teaching, high workload (Bennett, 2003), collaboration between students teacher and mentor, learning theories and assessment methods (Ali PA, Panther W, 2008). Even though a lot of challenges mentor have to faced, it was not a reason to give up. Once mentor take their role, they need to manage and relevant in service training. A higher education will educate themselves with up to date knowledge (Wilkes 2006).