Reflective Summary Assignment Sample

Introduction To Reflective Summary

This reflective report aims to highlight on own viewpoint regarding my professional consistency and effectiveness in working in health and social care setup. As a care worker, I have worked at the residential care home and offered services to dementia residents for the past three years. In this assessment, I will highlight how my values and principles are consistent with the professional requirements of health and social care contemporary practice. In this assessment, Gibb's Reflective Model has been used.

(Figure 1: Gibb's Reflective Model)

(Source: The University of Edinburgh 2020)

Discussion

Description

I have been working at the residential care home under the NHS for dementia residents for the past three years. Throughout these years, I have faced or encountered several situations, that have highlighted my knowledge, skill set, and understanding of the principles, and values that support to work in health and social care contemporary practice. One of the significant scenarios that I encountered was, once I had to administrate a medication to a dementia patient on an urgent basis due to his deterioration of health condition. Due to time constraints, my registered nursing team did not ask for consent from the patient or share information about the clinical intervention with the family members of that patient. This incident indicated to the bridge of the rights of informed consent for the patient. However, I tried to contact the patient's family apologised, and shared every detailed information about the clinical intervention on behalf of the patient.

Feeling

Initially, in such a scenario, I felt conflicted and stressed. While I recognized the urgency of the clinical intervention for the health condition of the patient, I felt uncanny regarding to avoid the standard process of obtaining consent and providing clear information about the administration of medicine to the patient to his family members. There was always a sense of guilt, a feeling of lack of commitment, and apprehension for violating the rights of the patient.

Evaluation

Upon reflecting on this scenario, I realised that the decision to administrate medication to a patient, suffering from an acute level of dementia, without taking consent or sharing information with him and his family raised ethical concerns regarding the autonomy of the patient and informed decision-making. This situation also highlighted the gap between the principles of support and the practice of legislation that maintains confidentiality and protection from harm. This incident addresses the gap in my values and principles to work in health and social care setup. Considering the above scenario, and my practice and utilization of principles made me realise that, the primary gap lies in my practice in the health and social care system in the area of informed consent. According to the Care Quality Commission, Regulation 11, it should be my duty and responsibility to ensure that informed consent has been asked of the patient before any clinical administration (Alghrani et al., 2016).

Analysis

Upon analysis, it can be stated that, with this incident, I got involved in a complex ethical dilemma. Informed consent is considered to be the fundamental principle in the healthcare system, where it is supposed to be my duty or responsibility to ensure that the patient has access to his basic rights to make autonomous decisions regarding his treatment (Wilson, 2017). In fact, when obtaining consent directly from the patient is not possible, then my responsibility would be to make interaction with the family member of that patient or his legal representative and keep them informed about the scenario, and action taken on behalf of the health and wellbeing of the patient. According to the Mental Capacity Act, 2005 (England and Wales), a nursing professional like me should follow the Mental Capacity Act Code of Practice as a daily guideline to assess their own capacity and make decisions in the best interest of the patient without capacity (Östlund et al., 2023). Here, implied consent could be practiced by me within the context of direct care of the patient. However, my lack of knowledge and lack of adherence to the regulation and code of conduct made me make a decision that breached the Mental Capacity Act Code of Practice. However, as per the Mental Health Act, of 1983, a patient with a mental disorder can be treated compulsorily without consent (Holden et al., 2018). Therefore, based on this regulation, I had made the decision regarding the urgent clinical intervention by taking the health condition and emergency of the patient with acute dementia (Mental Health Tribunal Act) (Beattie et al., 2019).

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Conclusion

As a whole, it can be stated that this incident highlighted the areas that I have to develop for providing ethical services in the health and social care system. The primary gap in my practice was the lack of knowledge and understanding of the importance of informed consent. This situation made me understand that while urgent scenarios posed challenges, it should be essential to maintain a balance between clinical needs and respecting the rights of the patient. Informed consent should be asked from the patient or from his family or legal representative to ensure that autonomy and transparency have been practiced in the healthcare setup. The second gap, that I have realised was the communication gap. From this incident, I have understood that effective communication is a fundamental aspect of professionalism. In this situation, despite the urgency and time constraints, the family could have been informed promptly about the clinical intervention, even if retrospective consent was sought later. Another thing I have learned from this scenario is, that to maintain professionalism in healthcare, proper maintenance of documentation is essential for continuity of care, and accountability.

Action Plan

Considering the gap that I have identified in my practice at health and social care setup, the action plan or my approach for the future (if such a situation may arise) will be as follows:

• Education and Training: I could engage myself in continuous professional development to improve my knowledge and understanding of the ethical and legislative framework including the Code of Practice, CQC standards of ethical healthcare practice, Code of Conduct, Mental Capacity Act, and so on to ensure ethical healthcare practice. I also develop my understanding of the importance of informed consent in health care practice. Attending training and developmental sessions, seminars, and workshops on ethical decision-making will help me to strengthen my knowledge base.
• Review and Familiarisation: Regularly review and familiarize myself with the organisational procedures, regulatory principles, and requirements to maintain the confidentiality of patient information, making informed consent, and patient rights. I will try to make myself up-to-date on any changes in legislation or guideline
• Communication: I will try to strengthen my communication so that I can interact with the patient, and his family members, and build trust.
• Documentation and Record-keeping: I will emphasize on the importance of accurate and timely documentation regarding any clinical intervention, decision-making regarding informed decisions, and communication with patients and families regarding the clinical practice. Here I will try to ensure that the documentation is thorough and transparent, and it has been done by adhering to the principles and standards.

References

• Alghrani, A., Case, P. and Fanning, J., (2016). The mental capacity act 2005—Ten years on. Medical Law Review, 24(3), pp.311-317.https://academic.oup.com/medlaw/article-abstract/24/3/311/2733268
• Beattie, E., O'Reilly, M., Fetherstonhaugh, D., McMaster, M., Moyle, W. and Fielding, E., 2019. Supporting autonomy of nursing home residents with dementia in the informed consent process. Dementia, 18(7-8), pp.2821-2835.https://journals.sagepub.com/doi/abs/10.1177/1471301218761240
• Holden, T.R., Keller, S., Kim, A., Gehring, M., Schmitz, E., Hermann, C., Gilmore?Bykovskyi, A. and Kind, A.J., 2018. Procedural framework to facilitate hospital?based informed consent for dementia research. Journal of the American Geriatrics Society, 66(12), pp.2243-2248.https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/jgs.15525
• Östlund, L., Ernsth Bravell, M. and Johansson, L., 2023. Working in a gray area—Healthcare staff experiences of receiving consent when caring for persons with dementia. Dementia, 22(1), pp.144-160.https://journals.sagepub.com/doi/abs/10.1177/14713012221137472
• Padama, L., 2018. Informed Consent and Decision-Making After Loss of Competency in Dementia Patients: A New Model. S. Cal. Interdisc. LJ, 28, p.173.https://heinonline.org/hol-cgi-bin/get_pdf.cgi?handle=hein.journals/scid28&section=8
• The University of Edinburgh (2020). Gibbs' reflective cycle. [online] The University of Edinburgh. Available at: https://www.ed.ac.uk/reflection/reflectors-toolkit/reflecting-on-experience/gibbs-reflective-cycle.
• Wilson, S., 2017. Mental capacity legislation in the UK: systematic review of the experiences of adults lacking capacity and their carers. BJPsych bulletin, 41(5), pp.260-266.https://www.cambridge.org/core/journals/bjpsych-bulletin/article/mental-capacity-legislation-in-the-uk-systematic-review-of-the-experiences-of-adults-lacking-capacity-and-their-carers/3FCD8AA3BE68B9611BFC650924F6549F