Alternate Area of Nursing: Learning Disability

Introduction

Job as a nurse can impact an individual’s life in both positive and negative ways, helping others improve their lives and cope with their issues can put a smile on one’s face, however, at times, having trouble meeting the requirements of the patients can be frustrating and tiresome (Shea, 2015). Recently, I faced such an issue while practicing as a student nurse during hospital placement in a gastroenterology ward where a patient with a learning disability created inconvenience for me and other patients. In the gastroenterology ward, patients having kidney, stomach, and liver issues are admitted, and people with learning disabilities are also treated in this ward when they need similar treatment. The patent with the learning disability that I was looking after had severe abdominal pain and was demanding his pain be soothed instantly. The patient became violent when his specific requirement was not met, and the entire ward was disturbed. The experience taught me valuable lessons regarding safeguarding that I plan to apply in my future as a nurse. I will explain the event and the learning I got from that event in detail using Driscoll Reflective Model. The model will cater to different aspects of the event and give insights that could not have been provided otherwise.

Main Body

The rationale for the Relevance of Reflection

Young student nurses on hospital placement often face issues that require necessary safeguarding training to protect them and other patients (Richardson, Percy, and Hughes, 2015.). Patients can get violent and behave inappropriately in front of other patients, doctors and nurses, usually, it falls on the nurses to pacify and look after such patients (Northway and Jenkins, 2017). Working as a student nurse exposed me to such situations where I was handed the responsibility of solving issues of multiple patients simultaneously. I came out of the situation successfully, but the issue of safeguarding needs to be looked into. I aim to explain the necessity of safeguarding in this reflection, the reflection will add value to the issue of safeguarding from a specific event that befallen me. 

Furthermore, people can act inappropriately in front of a person with a learning disability, their actions can even be disturbing if they succumb to impatience (Department of Health, 2009). In the event I wish to discuss, people acted inappropriately due to the action of an individual with a learning disability. People need to accept that individuals with such disabilities are not at fault thus people should not lose patience when such individuals become violent (Department of Health, 2009). 

Driscoll Reflective Model

I intend on describing my event using the Driscoll reflective model, the model is used for experiential learning. Driscoll's reflective model divides an event into three stages: What? So what? And now what? The stages of the Driscoll model help individuals in reflecting on an important event and making future commitments based on the analysis of the reflection (Snowdon, 2018). Following are the Driscoll reflective model stages of the event that occurred to me  

What?

The event that occurred to me was due to my inexperience in handling violent patients. Many student nurses face or might face such issues, thus the issue must be highlighted. I am taking the responsibility of spreading awareness regarding such issues that needs attention by using my experience as a platform. The event occurred during my time working as a student nurse in the gastroenterology ward, the ward consisted of adult patients needing different treatments regarding the liver, abdomen, stomach, and kidney. One such patient had a learning disability and did not have sufficient cognitive skills to act as a regular individual. The patient was suffering from severe abdominal pain and was having trouble enduring it. I was placed to cater to his needs along with a few others. The patient started acting irrationally and demanded I soothe his pain instantly, he was receiving painkillers through a tube but the dose needed time to take effect. After a moment, he got violent and started wriggling on his bed. Other patients were disturbed by his behavior, they were mostly old people who additionally had diabetics and blood pressure, and were demonstrating their irritation because of the disturbance with inappropriate suggestions regarding solving the situation. Other patients wanted him to be removed from the ward or not to have been admitted to the hospital in the first place, they suggested that his family should have taken him to a different hospital that only caters to individuals with learning disabilities. 

The patient came with his family, his mother seemed to be a strong woman and was trying to control his behavior with gentleness. As I was in charge of him and other nearby patients, I had to take action and control the situation. However, I was momentarily frozen on the spot and did not know what to do as I had never seen such violent behavior or catered to a person with a learning disability before. After taking control of my emotions and realizing my responsibility, I started helping his mother, but nothing was working from our end and my hope was for the medicine to take effect and soothe his pain. Simultaneously, I was also worried about other patients in the ward, I did not take a look at them but I could imagine what they were going through as I, being a nurse, was struggling to keep myself under control.

Nearly 5 minutes had passed since he started wriggling and a nurse injected him with a small dose of anesthetic, he then started to calm down and the situation came under control. He was then transferred to a private ward and her mother went along with him after apologizing to everyone in the ward. 

So What?

When the patient was taken into his private ward, everyone sighed relief and went about doing their usual tasks, however, I was worried about my inaction and had the feeling of powerlessness since I failed to influence his behavior. I was also feeling angry because of the behavior of other patients, I believed that their reaction was inappropriate as the patient had a learning disability and could not act rationally compared to them or me. I was momentarily in an existential crisis and started having pessimistic thoughts about my future as a nurse. After the event, I thought from the perspective of other patients and realized that my anger towards them was unfair considering the possibility that they might not have known that the patient had a learning disability. Furthermore, the event changed the way I look at things: Before, I used to think of nursing as a medium to help individuals in need, however, after the event, I have realized the issues I might face in the future during nursing. I am currently worried about all the stressful situations that could occur in my future and I am frightened of the consequences that could arise if I did not act timely.

After the event, I was impressed by the calm manner other nurses and staff members acted during and after the event. They went about their daily task as if nothing different had happened, whereas, I was perplexed after what I had experienced. When I think of the event, there was not much difference in my actions and the actions of other nurses, the event, though it seemed to have lasted hours, lasted 5 minutes, and not much could have been done by other nurses at that time frame. I have realized that my inexperience in working in such situations had caused me to act differently compared to other nurses, they acted indifferently because they were used to such situations, and as time goes by and I face such situations on daily basis, I might also overcome my anxiety like they might have done in past during their training period as stated by. 

The experience has taught me valuable lessons; I now know what to expect in my career as a nurse. With all that went through during and after those 5 minutes, I learned a great deal about myself, I now have a deep understanding of my strengths and weaknesses than ever. Furthermore, I have started conducting self-reflection on my actions and thoughts since a nurse must remain calm under all circumstances for the benefit of her/his patient.

Now What?

A nurse is responsible for safeguarding her/his patient and must ensure that the patients face no incontinence because of her/him or because of events that could have been prevented with timely actions from the nurse (Nursing and Midwifery Council (Great Britain), 2015). I acted senselessly during the event and was more concerned about my feelings than the feelings of my patients after the event. As a nurse, I must learn to control my emotions to be able to take timely actions when facing similar situations. In my field, I am required to look after adults. Adults are admitted into hospitals for different reasons, furthermore, different adults require different care as per their specific needs, patients are admitted into hospitals when they get injured, have diseases, or require check-ups (Burns, 2018). I will look after different patients with different diseases in the future, some patients will require extra care as per their age while others as per the seriousness of their illness. 

I get anxious when I recall the event or imagine what will happen if I did not control my emotions, the lives of individuals could be at risk if I repeated my behavior and stood motionless in a similar situation. After the event, I analyzed my actions and realized what different I could have done to avoid the situation from occurring at all. At first, when the patient with a learning disability asked me to end his pain, I could have distracted his mind by asking different questions and avoiding the event from happening. Furthermore, during the event, things would not have gotten out of hand if I had timely acted and given him a small but sufficient dose of anesthetic, he would have been awake but would not have been feeling pain with such severity. 

I have accepted what occurred to me and have learned from the experience. For my future as a nurse, I plan to act like other nurses. I have read and researched about controlling emotions and having a calm head during stressful situations. I further plan to spread awareness about safeguarding patients and other individuals, I will contact authorities responsible for the healthcare sector and advise them to conduct safeguarding training for future nurses like me. I want other nurses and myself to be trained when we enter our profession thus in similar situations appropriate actions are taken.

Summary

The issue of safeguarding is very important in aspects of nursing as the lives of individuals can be threatened if appropriate actions are not taken or if no action is taken at all. The event that I experienced has taught me the valuable lesson of safeguarding before I entered the field as a proper nurse. I have learned from my experience and moved on, However, other students like me have not yet been exposed to similar situations thus it is recommended that safeguarding training is provided to all students and current nurses to avoid risking patients’ lives.

Furthermore, people need to understand the situation a person with a learning disability is in, they should think from his/her perspective and have room for patience for disturbances caused by such individuals. People, who disrespect an individual with a learning disability, often deeply offend the feelings of the family of such individual. People should learn from families who take care of an individual with a learning disability and behave appropriately. I encourage people in authority to spread messages to aware people of learning disabilities and how to behave appropriately in situations where they might offend other people. 

Job as a nurse can impact an individual’s life in both positive and negative ways, helping others improve their lives and cope with their issues can put a smile on one’s face, however, at times, having trouble meeting the requirements of the patients can be frustrating and tiresome (Shea, 2015). Recently, I faced such an issue while practicing as a student nurse during hospital placement in a gastroenterology ward where a patient with a learning disability created inconvenience for me and other patients. In the gastroenterology ward, patients having kidney, stomach, and liver issues are admitted, and people with learning disabilities are also treated in this ward when they need similar treatment. The patent with the learning disability that I was looking after had severe abdominal pain and was demanding his pain be soothed instantly. The patient became violent when his specific requirement was not met, and the entire ward was disturbed. The experience taught me valuable lessons regarding safeguarding that I plan to apply in my future as a nurse. I will explain the event and the learning I got from that event in detail using Driscoll Reflective Model. The model will cater to different aspects of the event and give insights that could not have been provided otherwise.

Main Body 

The rationale for the Relevance of Reflection

Young student nurses on hospital placement often face issues that require necessary safeguarding training to protect them and other patients (Richardson, Percy, and Hughes, 2015.). Patients can get violent and behave inappropriately in front of other patients, doctors and nurses, usually, it falls on the nurses to pacify and look after such patients (Northway and Jenkins, 2017). Working as a student nurse exposed me to such situations where I was handed the responsibility of solving issues of multiple patients simultaneously. I came out of the situation successfully, but the issue of safeguarding needs to be looked into. I aim to explain the necessity of safeguarding in this reflection, the reflection will add value to the issue of safeguarding from a specific event that befallen me. 

Furthermore, people can act inappropriately in front of a person with a learning disability, their actions can even be disturbing if they succumb to impatience (Department of Health, 2009). In the event I wish to discuss, people acted inappropriately due to the action of an individual with a learning disability. People need to accept that individuals with such disabilities are not at fault thus people should not lose patience when such individuals become violent (Department of Health, 2009). 

Driscoll Reflective Model

I intend on describing my event using the Driscoll reflective model, the model is used for experiential learning. Driscoll's reflective model divides an event into three stages: What? So what? And now what? The stages of the Driscoll model help individuals in reflecting on an important event and making future commitments based on the analysis of the reflection (Snowdon, 2018). Following are the Driscoll reflective model stages of the event that occurred to me  

What?

The event that occurred to me was due to my inexperience in handling violent patients. Many student nurses face or might face such issues, thus the issue must be highlighted. I am taking the responsibility of spreading awareness regarding such issues that needs attention by using my experience as a platform. The event occurred during my time working as a student nurse in the gastroenterology ward, the ward consisted of adult patients needing different treatments regarding the liver, abdomen, stomach, and kidney. One such patient had a learning disability and did not have sufficient cognitive skills to act as a regular individual. The patient was suffering from severe abdominal pain and was having trouble enduring it. I was placed to cater to his needs along with a few others. The patient started acting irrationally and demanded I soothe his pain instantly, he was receiving painkillers through a tube but the dose needed time to take effect. After a moment, he got violent and started wriggling on his bed. Other patients were disturbed by his behavior, they were mostly old people who additionally had diabetics and blood pressure, and were demonstrating their irritation because of the disturbance with inappropriate suggestions regarding solving the situation. Other patients wanted him to be removed from the ward or not to have been admitted to the hospital in the first place, they suggested that his family should have taken him to a different hospital that only caters to individuals with learning disabilities. 

The patient came with his family, his mother seemed to be a strong woman and was trying to control his behavior with gentleness. As I was in charge of him and other nearby patients, I had to take action and control the situation. However, I was momentarily frozen on the spot and did not know what to do as I had never seen such violent behavior or catered to a person with a learning disability before. After taking control of my emotions and realizing my responsibility, I started helping his mother, but nothing was working from our end and my hope was for the medicine to take effect and soothe his pain. Simultaneously, I was also worried about other patients in the ward, I did not take a look at them but I could imagine what they were going through as I, being a nurse, was struggling to keep myself under control.

Nearly 5 minutes had passed since he started wriggling and a nurse injected him with a small dose of anesthetic, he then started to calm down and the situation came under control. He was then transferred to a private ward and her mother went along with him after apologizing to everyone in the ward. 

So What?

When the patient was taken into his private ward, everyone sighed relief and went about doing their usual tasks, however, I was worried about my inaction and had the feeling of powerlessness since I failed to influence his behavior. I was also feeling angry because of the behavior of other patients, I believed that their reaction was inappropriate as the patient had a learning disability and could not act rationally compared to them or me. I was momentarily in an existential crisis and started having pessimistic thoughts about my future as a nurse. After the event, I thought from the perspective of other patients and realized that my anger towards them was unfair considering the possibility that they might not have known that the patient had a learning disability. Furthermore, the event changed the way I look at things: Before, I used to think of nursing as a medium to help individuals in need, however, after the event, I have realized the issues I might face in the future during nursing. I am currently worried about all the stressful situations that could occur in my future and I am frightened of the consequences that could arise if I did not act timely.

After the event, I was impressed by the calm manner other nurses and staff members acted during and after the event. They went about their daily task as if nothing different had happened, whereas, I was perplexed after what I had experienced. When I think of the event, there was not much difference in my actions and the actions of other nurses, the event, though it seemed to have lasted hours, lasted 5 minutes, and not much could have been done by other nurses at that time frame. I have realized that my inexperience in working in such situations had caused me to act differently compared to other nurses, they acted indifferently because they were used to such situations, and as time goes by and I face such situations on daily basis, I might also overcome my anxiety like they might have done in past during their training period as stated by. 

The experience has taught me valuable lessons; I now know what to expect in my career as a nurse. With all that went through during and after those 5 minutes, I learned a great deal about myself, I now have a deep understanding of my strengths and weaknesses than ever. Furthermore, I have started conducting self-reflection on my actions and thoughts since a nurse must remain calm under all circumstances for the benefit of her/his patient.

Now What?

A nurse is responsible for safeguarding her/his patient and must ensure that the patients face no incontinence because of her/him or because of events that could have been prevented with timely actions from the nurse (Nursing and Midwifery Council (Great Britain), 2015). I acted senselessly during the event and was more concerned about my feelings than the feelings of my patients after the event. As a nurse, I must learn to control my emotions to be able to take timely actions when facing similar situations. In my field, I am required to look after adults. Adults are admitted into hospitals for different reasons, furthermore, different adults require different care as per their specific needs, patients are admitted into hospitals when they get injured, have diseases, or require check-ups (Burns, 2018). I will look after different patients with different diseases in the future, some patients will require extra care as per their age while others as per the seriousness of their illness. 

I get anxious when I recall the event or imagine what will happen if I did not control my emotions, the lives of individuals could be at risk if I repeated my behavior and stood motionless in a similar situation. After the event, I analyzed my actions and realized what different I could have done to avoid the situation from occurring at all. At first, when the patient with a learning disability asked me to end his pain, I could have distracted his mind by asking different questions and avoiding the event from happening. Furthermore, during the event, things would not have gotten out of hand if I had timely acted and given him a small but sufficient dose of anesthetic, he would have been awake but would not have been feeling pain with such severity. 

I have accepted what occurred to me and have learned from the experience. For my future as a nurse, I plan to act like other nurses. I have read and researched about controlling emotions and having a calm head during stressful situations. I further plan to spread awareness about safeguarding patients and other individuals, I will contact authorities responsible for the healthcare sector and advise them to conduct safeguarding training for future nurses like me. I want other nurses and myself to be trained when we enter our profession thus in similar situations appropriate actions are taken.

Summary

The issue of safeguarding is very important in aspects of nursing as the lives of individuals can be threatened if appropriate actions are not taken or if no action is taken at all. The event that I experienced has taught me the valuable lesson of safeguarding before I entered the field as a proper nurse. I have learned from my experience and moved on, However, other students like me have not yet been exposed to similar situations thus it is recommended that safeguarding training is provided to all students and current nurses to avoid risking patients’ lives.

Furthermore, people need to understand the situation a person with a learning disability is in, they should think from his/her perspective and have room for patience for disturbances caused by such individuals. People, who disrespect an individual with a learning disability, often deeply offend the feelings of the family of such individual. People should learn from families who take care of an individual with a learning disability and behave appropriately. I encourage people in authority to spread messages to aware people of learning disabilities and how to behave appropriately in situations where they might offend other people. 

References

Shea, M.L., 2015. Determined persistence: Achieving and sustaining job satisfaction among nurse practitioners. Journal of the American Association of Nurse Practitioners, 27(1), pp.31-38.

Northway, R. and Jenkins, R., 2017. Safeguarding adults in nursing practice. Learning Matters.

Richardson, C., Percy, M. and Hughes, J., 2015. Nursing therapeutics: Teaching student nurses care, compassion and empathy. Nurse Education Today, 35(5), pp.e1-e5.

Department of Health, 2009. Valuing people now: A new three-year strategy for people with learning disabilities. Department of Health.

Watson, G. and Rodwell, S. eds., 2014. Safeguarding and Protecting Children, Young People and Families: A Guide for Nurses and Midwives. Sage.

Snowdon, K., 2018. Humour in reflective practice. Journal of Paramedic Practice, 10(4), pp.144-146.

Nursing and Midwifery Council (Great Britain), 2015. The Code: Professional standards of practice and behaviour for nurses and midwives. NMC.

Burns, D. ed., 2018. Foundations of Adult Nursing. SAGE Publications Limited.