Development of Competent Nursing Skills

Development of satisfactory Nursing SkillsIntroductionThis essay focuses on a chiding on the development from novice, to competent set outner, to achievemented practitioner in the light of my own development in clinical guard for practice. It is based on the signposts identified within my clinical learning portfolio and focuses on the stamp of the helping spot and caring skills within nursing practice. It utilises a reflective framework to better identify and reflect upon the journey from novice to practitioner.The model for reflection I extradite chosen is Gibbs Reflective rhythm method (see App closingix). Reflection has been described as as a process of intern exclusivelyy examining and exploring an issue of concern, triggered by an accept which creates and clarifies meaning in terms of self, and which results in a changed conceptual perspective (Boyd and Fales, 1983). Therefore, the experiences of my three placements are explored under three rotations of Gibbs Cycle. Meretoja et al (2004) state that nurses self-recognition of own direct of competency is essential in maintaining high standards of caution. I have chosen the caring role based on my own recognition of the level of competence achieved in this area.Cycle OneNovice to Advanced beginnerWhat Happened.I had to assist a patient in with personal reverence make them contented in bed and collaborate in pressure area trouble assist with toileting, washing, mouthcare, and application of emollient cream. I also had to document care and every deviations from the norm.FeelingsI was very aware of my inexperience and of the trust this patient placed in my and the nursing team. I was also aware of the intimate nature of the care I was providing, and the fact that it was basic care also highlighted the fundamental role such care has in rearing health promotion and patient wellbeing. evaluationI was uncomfort fitting at first, and clumsy in the prep of the various aspects of care. However, my me ntor was informative, supportive and helpful, which assisted me in doing the various tasks. However, I found it vexed to complete these as quickly as I should have. I did learn to communicate with the patient and provide a sensitive approach.AnalysisThis situation needed fundamental aspects of the caring role. It also demonstrates the link between basic nursing care an every other aspect of nursing. The NMC (2004) requires nurses to provide individualistised care for their patients. The care for this person was based on their own needs and adapted as those needs changed. I was able to identify those needs and develop competency in providing care at this level. The caring role was very rewarding notwithstanding physically and emotionally taxing However, I was still in the process of identifying specific needs and responding to them, such as toileting, which required me working with others in a collaborative manner, which I did not find easy. I also realised how such(prenominal) I did not know about nursing.ConclusionIn this situation, I could have developed much collaborative working skills and modelled myself on those around me more(prenominal) actively ie., copied the ways in which other nurses and healthcare assistants provided care. When I did do this, it was effective. But I found that despite my enthusiastic approach, my knowledge base meant that I did not always understand the rationale for what I was doing.Action PlanThe action plan from this was to take the confidence and competence I had developed in the practical skills and incorporate them into all aspects of the caring role. It was also to identify areas where my knowledge base was lacking, and seek out this knowledge. Keeping knowledge up to date is a requirement of the NMC code of condut (NMC, 2004). Working collaboratively is another NMC requirement (NMC, 2004). Taking this knowledge forward into practice made this process of reflection a learning activity.Cycle TwoAdvanced BeginnerWhat HappenedAs part of my role assisting with patient care, I had to monitor pain levels and assist with providing analgesia as prescribed, along with monitoring its effectiveness. This was a working(a) placement, and I also discussed with elderly patient their coping and wellbeing after hospital discharge. I engaged in health education and support to enable clients to be self-caring.I was also responsible for monitoring wellbeing through performing and recording clinical observations, recording fluid balance and coverage any abnormalities. I was also involved in providing personal care to patients in a safe manner, especially in the disposal of waste products.FeelingsTo begin with, I felt glad to be working at a more go level of competency, and felt confident in my basic nursing skills including performing clinical observations. However, the increased demand also meant increased pressure and I was aware of this. Again, I felt that I had developed a academic degree of competency but was very aware of my need to develop further knowledge and skills. The caring role involved supporting people and I had to advance other professionals to ensure I gave the right information and that my care had been effective.EvaluationIt was good to find that I had the clinical competence to effectively monitor clinical status. However, the complex nature of patient needs meant that I still didnt always know the answers to their questions. Being involved in discharge planning was an alter activity for myself and the patients. I developed competence in the administration of medications, under supervision, including controlled drugs, but felt I still needed more practice and skill in this area. Colleagues noted my competence and qualified staff were happy to delegate a range of appropriate tasks to me.AnalysisIt would appear that the caring role promoter the provision of patient centred, holistic care. This was achievable in this situation but required a lot of knowledge and the ability to provide focused assistance and empathic care whilst carrying out complex clinical nursing tasks. This was onerouser to achieve, and I was made aware of my continued learning needs around medication and surgical care, for example. However, I must have developed virtually competence as qualified staff were happy to delegate to me and to act on my feedback.ConclusionIt is hard to see what else I could have done, except perhaps done more reading around surgical care, discharge planning and the nurse-patient relationship.Action PlanIt was doable to identify future learning needs, and so my action plan included building on my current competence by engaging in more advanced practice, under supervision. Having the confidence to engage in more complex nursing tasks will help me to achieve more competence in advanced practice in the future. Recognising the demands of the caring role means that I will view future practice as based upon this role.Cycle ThreeCompetent LevelWhat Ha ppened.I monitored patients with chronic pain and helped with analgesia. I also supported patients with freedom of choice for their own care (NMC, 2004) and provided personal and palliative care in sensitive manner. I mastered more advanced practical nursing skills including aseptic technique and safe disposal of sharps. I fully documented all care given, and recorded medication given, and communicated to staff at shift change during the nursing handover.FeelingsDuring this experience, I felt that my knowledge and experience in the caring role was finally coming together. I was confident and happy in engaging with patients and providing empathy and a supportive manner, whilst also carrying out more complex clinical tasks suitably and effectively. It was very nerve-wracking giving handover, but I became more confident as I had more practice.EvaluationI was able to provide care of a high standard, and recognise my sphere of competence and seek help when needed. I was able to engage i n effective caring relationships with clients, meet their individual needs, but also value my own input into their wellbeing.AnalysisIt was obvious that I had moved on to a level of nursing competence which allowed me some autonomy. I was able to act with less direct supervision, but still access the support of the whole care team. The caring role extended to the provision of all care, including end of life care, and I was able to utilise my knowledge and experience and also identify my learning in action, and my future learning needs, which have changed since the first reflection.ConclusionThe change from novice to competent practitioner in the caring role has demonstrated not only the acquisition of skill but the incorporation of clinical abilities into what is really a way of being with patients.Action PlanSignposting future learning needs is important following this reflection. I was able to identify the need to still learn advanced clinical skills and perhaps know more about th e range of other professionals who could enhance care in individual situations.ConclusionThis reflection has signposted my development towards competent nursing practice. The caring role encompasses provision of basic care, advanced techniques, medication and pain relief, health promotion, end of life care and collaborative care. It seems to be the fundamental and most important part of nursing practice.Collaboration and coordination, as well as the holistic management of the situation, are highly recognized as meaningful characteristics of competent nursing practice (Meretoja et al, 2002).ReferencesBoyd E, Fales A. (1983) Reflecting learning key to learning from experience. Humanist Psychol 23 (2) 99117.Gibbs, G. (1988) discipline by Doing. A Guide to Teaching and Learning Methods Further Education Unit, Oxford Polytechnic, OxfordMeretoja, R., Leino-Kilpi, H. Kair, A. (2004) Comparison of nurse competence in different hospital work environments daybook of NursingManagement.12(5) 329336Meretoja, R., Eriksson, E. Leino-Kilpi, H. (2002) Indicators for competent nursing practice Journal of Nursing Management 10(2) 95-102Nursing and Midwifery Council (2004) Code of Conduct Available from www.nmc-uk.org Accessed 30-4-07.