2809NRS Mental Health Nursing Practice A2 Written Assignment Sample

Introduction: 2809NRS Mental Health Nursing Practice A2 Written Assignment

Reflective assessment

Description

The purpose of this reflective assessment is to reflect on and demonstrate own knowledge and attitudes towards mental health nursing practices during clinical placement. The trigger event for this reflection was my participation in a mental health clinical placement, where my role and responsibility was to provide care to patients with specific mental health conditions like depression and/or schizophrenia. During this placement, I was asked to apply client-centred care principles such as active listening skills, respect for the patient’s needs, dignity, and preferences, and involving the patient and family in decision-making regarding their treatment plan. This event was a significant learning opportunity for me as it made me able to balance the clinical intervention process with the patient’s emotional and psychological well-being and needs, which emphasized the principle of patient-centred and evidence-based clinical practice. This event can also be considered s triggering event as it allowed me to directly apply both theoretical concepts and in-hand experiences that I gained from 2809NRS coursework to the clinical placement program. In this event, I also got scope to know and apply the NMBA Registered Nursing Standards for practice.

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Feelings

Initially, I felt a mix of excitement and anxiety about the placement. The prospect of working directly with a patient suffering from a specific mental illness including either depression or schizophrenia was daunting as I was working and in dilemma about my ability and hands-on experiences of whether I can provide patient-centric care or perform evidence-based practice in the clinical facility. However, with the progression of the placement program, I started to engage myself with the patient and their family members and started to apply my sense of empathy, and understanding. Throughout the course work, or more specifically dealing with the patient, I tried to apply my active listening skills to their concern and preferences and tried to involve them in the treatment plan. This also helped me to alleviate my initial anxiety, and I started to feel confident regarding my ability to balance the clinical care, with the emotional and psychological needs, and preferences of the patients. During this time, I also felt challenges specifically when it came to respecting the patient’s autonomy, and ask their consent before the administration of any medical intervention, due to their incapability of giving concern for the process. However, considering the NMBA standards, (standards 2, 4, and 6), I tried to actively listen to the patient’s concerns and involve them in decision-making, assess the mental health needs of my patients holistically, and consider their physical, and psychological well-being (Swift et al., 2021). As per Standard 6, I also tried to collaborate with a multidisciplinary team, to provide tailored care plans, ensuring the care provided to the patient us culturally appropriate, safe and aligned with the nursing guidelines.

Evaluation

On the positive side, my ability to engage with the patients and application of my active listening skills, and NMBA standards worked well. By involving the patients and their family members in the treatment and decision-making process, I felt that I have the ability to develop trustworthiness and empathetic relationships by fostering a supportive environment by aligning with patient-centric care principles. During this clinical placement program, I was successful enough to apply evidence-based practices, which also increased my confidence in providing patient-centric care holistic care to patients suffering from depression or schizophrenia. Collaboration with a multidisciplinary team ensured that my care plan was well-informed, and culturally appropriate as per the NMBA standards 2,4, and 6. However, there were challenges, specifically, when it came to ask consent from the patient due to their mental state. It was also difficult for me to fully respect their preferences, and autonomy while providing them necessary care, particularly when they were unable to participate in decisions about their treatment. This dilemma created a sense of conflict between maintaining patient autonomy and delivering safe, necessary intervention which I found challenging to navigate.

Analysis

1. Analysis of the event and contextualization of the event

The “triggered” event that I performed during the clinical placement highlighted the complex balance between providing patient-centric care and respecting the autonomy and dignity of patient while providing them care and ensuring to meet their emotional and psychological needs. Working with patients diagnosed with schizophrenia and suffering from depression highlights the importance of client-centric care and the need to apply evidence-based practices to manage mental health conditions. According to Pinho et al. (2021), client-centric care includes the approach to developing trust and managing the dignity of the patient, specifically for those who are suffering from mental health issues and experience stigma and disempowerment during disorder. Sanerma et al. (2020), have mentioned that the core principles of a client-centred approach are respect, partnership, communication, involvement, emotional support, information, and continuity. During the program, I engaged patients in decision-making processes and tried to incorporate their preferences into the care plan, which aligned with the core principle of the client-centric care approach. However, during this process, I faced several challenges including seeking informed consent from patients with impaired decision-making abilities, which highlighted the tension between respecting autonomy and providing care by ensuring patient safety. According to Kwame and Petrucka (2021), the balancing between the patient-centred care principle is important for holistic care in mental healthcare practice. Additionally, the Nursing and Midwifery Board of Australia Standards can provide guidelines for nurses regarding applying patient-centric care, specifically when it comes to dealing with patients suffering from depression and schizophrenia (Nursing and Midwifery Board of Australia, 2018).

1. Influence on Attitudes and Behaviour

The entire ‘triggered’ event has significantly influenced my attitudes and beliefs towards individuals living with mental health conditions. Before my employment, I had a primarily theoretical grasp of mental health, with an emphasis on clinical interventions and diagnosis. However, working directly with patients suffering from depression, and schizophrenia helped me to develop more in-depth knowledge, understanding and hands-on experiences about patient-centric care and the importance of empathetic care in healthcare facilities. I came to realise that although clinical therapies are vital, attending to people's emotional and psychological needs is just as crucial. This aligns with the concept of holistic care, where () has described it as an approach that considers the patient’s overall health and well-being rather than just focusing on symptoms and prevention. My engagements with patients suffering from schizophrenia or depression modified my view of their ability for autonomy. At first, I perceived their decision-making deficits as constraints; however, through close collaboration, I recognized that enabling patients to partake in their treatment, even little, can enhance their dignity and involvement. Liang et al. (2022) contends that honouring patient autonomy, particularly in difficult circumstances, is essential to client-centred care and can improve patient outcomes by promoting trust and collaboration.

1. Link Between Nurse’s attitudes and effective delivery of person-centred care

According to research by Grilo et al. (2023), nurses’ attitudes play an important role when it comes to delivering person-centred care to patients with schizophrenia. For example, empathy and understanding are two important attitudes or behavioural approaches that a nurse must maintain while dealing with patients. Babaii et al. (2021)have mentioned that a nurse must show empathy, and a non-judgmental attitude to the patient irrespective of his mental status or psychological condition, which can help nurses to build trust with the patient, which is essential for effective care. On the other hand, Grilo et al., (2023) has mentioned that a positive attitude toward patients with depression and schizophrenia can help them reduce the stigma associated with their disorder, which can also encourage patients to carry out more open communication and take an active part in their treatment plan. Negative attitudes and stigmatization can lead a patient to feel devalued, and disempowerment, which can decrease the effectiveness of care. During my practice, I tried to follow this attitude where my purpose was to deliver client-centric care to the patient. I tried to engage with patient effectively, and by listening to their concern while aligning with standard 2 of NMBA Registered Nursing Standards for practice.

Conclusion

This trigger event during my health clinical placement provided me with opportunities to reinforce the importance of integrating theoretical and practical knowledge and skills when it comes to delivering client-centric, and evidence-based. This event allowed me to critically apply NMBA Registered Nurse Standards for Practice, specifically standards 2,4, and 6 which emphasise patient autonomy, holistic assessment, and collaboration with multidisciplinary teams. My initial anxiety was replaced by confidence, as I engaged the patient in the decision-making process, and used active listening skills to develop empathetic relations to the patient suffering from depression and schizophrenia. However, during this event, I also faced several challenges, though as a whole it was a great experience which helped me to develop my knowledge and skills as a nurse for future purposes.

Action plan

1. Future Application: Moving forward, I will apply the lessons that I learned from this place, ent program in recovery-oriented and client-centric practice in my future nursing practice. I will aim to prioritise building strong therapeutic relationships with clients by using active listening, and good communication skills. In future practice, I also try to maintain a balance between clinical intervention and addressing the psychological needs of patients specifically those who are suffering from mental illness. I try to ask for consent before the administration of any therapeutic intervention and try to engage patients in meaningful conversations, to ensure an effective patient outcome.
2. Key Skill: Communication skill

One of the important skills that will significantly improve my future nursing practice as a Registered Nurse is communication. According to Kwame & Petrucka, (2021), effective communication is a critical component in client-centric care, which can allow nurses to better understand and acknowledge the needs of patients, build trust, and provide support in an empathetic and respectful way. According to Babaii et al., (2021), communication in nursing practice is not just merely transforming information, rather it includes nursing attitudes like being attentive to patients’ emotions, responding to them emotionally, and maintaining a link between patients, and other healthcare professionals. Therefore, in future practice, with clear and compassionate communication, I can provide effective, evidence-based, and well-informed care to patients, specifically those who are suffering from mental illness.

References

• Babaii, A., Mohammadi, E., & Sadooghiasl, A. (2021). The meaning of the empathetic nurse–patient communication: A qualitative study. Journal of Patient Experience, 8(8). https://doi.org/10.1177/23743735211056432
• Grilo, A. M., Vinagre, G., Santos, M. C. D., Martinho, J. F., & Gomes, A. I. (2023). Attitudes toward Patient-Centred Care, Empathy, and Assertiveness among Students in Rehabilitation Areas: A Longitudinal Study. Healthcare (Basel, Switzerland), 11(20), 2803. https://doi.org/10.3390/healthcare11202803
• Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: Barriers, facilitators, and the way forward. BMC Nursing, 20(158), 1–10. https://doi.org/10.1186/s12912-021-00684-2
• Liang, Z., Xu, M., Liu, G., Zhou, Y., & Howard, P. (2022). Patient-centred care and patient autonomy: doctors’ views in Chinese hospitals. BMC Medical Ethics, 23(38). https://doi.org/10.1186/s12910-022-00777-w
• Nursing and Midwifery Board of Australia. (2018). Nursing and Midwifery Board of Australia - Guidelines. Nursingmidwiferyboard.gov.au. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Codes-Guidelines.aspx
• Pinho, L. G. de, Lopes, M. J., Correia, T., Sampaio, F., Arco, H. R. do, Mendes, A., Marques, M. do C., & Fonseca, C. (2021). Patient-Centered Care for Patients with Depression or Anxiety Disorder: An Integrative Review. Journal of Personalized Medicine, 11(8), 776. https://doi.org/10.3390/jpm11080776
• Sanerma, P., Miettinen, S., Paavilainen, E., & Åstedt-Kurki, P. (2020). A client-centered approach in home care for older persons – an integrative review. Scandinavian Journal of Primary Health Care, 38(4), 1–12. https://doi.org/10.1080/02813432.2020.1841517
• Swift, J. K., Mullins, R. H., Penix, E. A., Roth, K. L., & Trusty, W. T. (2021). The importance of listening to patient preferences when making mental health care decisions. World Psychiatry, 20(3), 316–317. https://doi.org/10.1002/wps.20912

Author Bio

Morghan Elis   5 Years | Masters

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