Introduction
The purpose of this assignment is to reflect on and examine my personal and professional development during the two specific learning outcomes from the critical care competencies. These competencies include in-depth information on various care components such as The Bodies Systems, End of Life Care, Intra and Inter Hospital Transfer, Rehabilitation, Professionalism, and Leadership. This must be considered when caring for patients in a critical care environment. I applied these competencies in my nursing practice to ensure that I provide quality care to patients. I will integrate my experience in critical care with my improved knowledge and comprehension from completing the learning outcomes. I will focus more on leadership and Renal Replacement Therapy and discuss general reflection throughout the learning process.
Background
The critical care unit is an area of practice where my personal and professional development occurred. The case studies I focused on were on effect of the COVID-19 pandemic and how the case of a 55-year-old man with kidney issues was handled. It is a place where individuals with illnesses and injuries that pose a life-threatening are handled. In this setting, patients receive 24-hour care from a group of specially trained healthcare professionals. Furthermore, it involves using machines to monitor vital signs and manage different health conditions. The unit played an integral role in my development because I acquired and applied soft skills such as time management, empathy, and critical thinking. I interacted with and worked with other healthcare providers to offer quality care to the patients.
SWOT Analysis
The analysis is an exercise in self-introspection to help one understand themselves and prepare for growth. Despite the fact that I regularly evaluate and go through this process at work, I have never integrated theory into this practice. The first approach in the procedure to enable the focus to be acquired on important topics is SWOT in order to understand the model and use it to enhance my personal and professional development. To effectively undertake the reflection process, I performed a SWOT analysis to determine my strengths, weaknesses, opportunities, and threats. As shown in the SWOT model provided in the Appendix, I completed this analysis prior to the reflection on my competencies (see “Appendix”). I used the information from the SWOT analysis to help with my reflection.
Mentor
For this assignment, a mentor was integral to help in my professional growth and development. I needed someone to guide me in the process despite my ten years of experience in nursing. A mentor’s obligation is to constantly encourage the development of their mentee’s nursing skills (Hayes, 2019). In addition, during a one-on-one conversation with my mentor, I need to feel at ease asking questions and knowing about the social and professional nuances of nursing. For example, we met four times to discuss my progress, placement outcome, and any help required to enhance my professional performance. However, due to the work demand, we were unable to meet more frequently to talk about some of the I was facing in the setting, especially during the pandemic.
Competencies
Competency is an integral skill an individual needs to perform their roles and achieve professional objectives. Since nursing is an essential profession, it needs a higher level of training and education to equip learners with relevant skill sets. I had to complete about 10 competencies in this course to enhance my knowledge. Competence develops clinical nursing, and nursing training raises the profession’s profile and increases the quality of patient care and patient satisfaction with the nurses (Fukada, 2018). Out of the 10 competencies, I was able to reflect on the primary areas. Although it can be challenging, maintaining competency levels is necessary. Competencies give nurses the foundational knowledge and resources they need to offer patients with expert care across a variety of diseases.
Model of Reflection
For effective reflection of my development in the two core areas, there is a need for a framework. Driscoll’s Model of Reflection is one of the most essential teachings and learning strategies since it clarifies the situation and encourages knowledge and contemplation on how to handle it more effectively in the future (Deslandes et al., 2018). I decided to use the model because it was easy to apply and follow when reflecting. Each of the phases in Driscoll’s framework comprises a set of questions that an individual must answer to be as detailed as possible with their opinions. Some steps include responding to questions such as what, so what, and now what (Deslandes et al., 2018). The objective of this paradigm is to categorize and arrange reflections.
Leadership
What? Case Study
The COVID-19 pandemic became a major issue for the healthcare system. As an experienced nurse, I was able to demonstrate my leadership capabilities, particularly to the new nurses and providers. At the critical care unit, we were faced with challenges such as shortage of nurses due to increasing demand for health. In addition, I developed solutions to the always-changing systems, elevated illness acuity in individuals, technological advancements, and rising healthcare prices. I made sure that nurses, like other providers, were required to adapt quickly and provide care. I learned that nurses face challenges daily that require them to use critical thinking to address them. Through leadership skills, nurses make important decisions that could affect patient lives.
So What?
As healthcare providers, the increased demand for healthcare meant we had to work 24/7 to fight the pandemic and ensure that people get care. Despite my colleague and I working hard, the surge continued, and I felt it had a negative effect on my personal and professional development. Furthermore, my exhaustion and anxiety increased, my leave was canceled, and I could not even find time for myself. I could not meet my mentor or have ample professional and personal development time. Therefore, the pressure in the workplace restricted me from interacting with my friends, family, and society. During the course, we have informed the essence of having a mentor because they assist, support, and facilitate the learning of their mentees.
One strength that I identified through my SWOT analysis is teamwork and effective communication. As a nurse, I have to work with providers to ensure that patients in the facility get quality healthcare services. Collaboration in the healthcare professional context is becoming increasingly important in the contemporary multidisciplinary treatment environment (Wallerstedt et al., 2019). To foster teamwork, I have to attend rounds while engaging with diverse medical experts, such as support workers, primary care providers, and senior executives. To effectively work in the current environment, communication skills are integral to fostering a workplace atmosphere where stakeholders engage in constructive, pleasant interactions. I needed to build respect for my peers and nurse leaders as they learned about each other’s situations.
The weakness I discovered through the analysis is the lack of leadership attributes such as emotional intelligence. During the pandemic, my capabilities as a nurse were tested because we had to show resilience and commitment to practice. However, the pressure generated by the COVID-19 pandemic increased tension and anxiety among all healthcare providers across the globe. The events took a toll on me; for some time, I was not myself. I was unable to identify and deal with the emotions from the job. My ten years of experience as a nurse did not help me manage the stress I was experiencing in the hospital during the pandemic. Therefore, to effectively deliver quality care and handle the stress of nursing, I must develop my emotional intelligence.
Additionally, due to my experience in the nursing field, I was responsible for mentoring less experienced nurses. I became a leader to my mentees because they would consult with me and seek clarification on challenging matters. However, working in the critical care unit was becoming hard during the pandemic due to the increased number of patients. I recognized my role as a senior nurse and decided to motivate and inspire others to continue the fight. As the situation worsened, the system focused on senior healthcare providers to reassure and encourage others to serve. The crisis in the sector became a nightmare for inexperienced nurses. As a result of the pressure in the healthcare system, I decided to take the mandate of encouraging my colleagues, especially the newcomers.
Despite the nurses’ best efforts directed towards handling the situation, I realized that the lingering possibility of a positive outcome undermined my confidence. I discovered that confidence in oneself is crucial in emergency medical care. Critical care nurses, who are an essential component of a multidisciplinary team that uses cutting-edge medical technology to treat critically ill patients, often struggle with low self-esteem and confidence. When things are moving swiftly, and people are being pushed to make their own decisions, nurses need to assist patients and their families in coping with symptoms and receiving emotional support. Therefore, I discovered I needed to work on my confidence to handle difficult times effectively.
Now What?
Confidence is the belief in one’s ability to do a task or reach a goal. Nurses must possess the necessary skills and autonomy to work (Baljoon, Banjar and Banakhar, 2018). A lack of confidence can easily compromise one’s abilities. According to nursing ethics, trust in a person’s nursing skills and practice. Self-awareness and a desire for personal and professional advancement on the nurse’s part can help develop, sustain, and improve confidence (Rasheed, Younas and Sundus, 2019). After speaking with my mentor, I realize I must develop the courage to challenge colleagues’ methods while keeping clients’ interests in mind. I understand how crucial it is to stand by colleagues when they are struggling while simultaneously ensuring their work does not put customers in danger.
A contemporary nurse must be able to manage their time well and remain organized. Effective time management provides more efficient work, higher quality, and fewer missed chances (Talebi, Ahmadi and Kazemnejad, 2019). With excellent time management, I would be able to develop my sense of self-control, an improved self-image, and less stress. Good time management in healthcare settings is nearly impossible without real organizational skills. Because a nurse’s to-do list might be unpredictable, organizing skills are vital, and an organized nurse performs better. Organized nurses can manage their time well and know how to commit daily hours to plan, carry out, and follow up on events and activities.
Renal replacement therapy
During the pandemic, I was assigned to the critical care unit, where the incident I will be reflecting on happened. One day, a 55-year-old man was brought to the critical care unit in the hospital with a fever, shortness of breath, and acute kidney damage. The patient was healthy as usual until three days before he was admitted, when he got a fever with a temperature of up to 39.9°C and chills. He stopped taking long-acting insulin for his diabetes three days before he was admitted because of his fasting blood glucose level. Further diagnosis indicated that the patient had a kidney problem as one of the conditions deteriorating his health. However, based on the high number of patients scheduled in the unit, we were forced to transfer the patient to another department.
So What?
During the incident, I was busy handling other patients who had critical health issues and needed specialized attention. At the start of the incident, I had only worked in the critical care unit for a few months. From this, I was still unsure about my role in the group. At the end of the day, I did not think I knew enough or had enough experience to handle this situation on my own. However, it is quite evident that my coworkers and I ought to have intervened sooner in order to guarantee that the patient received the appropriate level of care. My mounting anxiety made it difficult for me to accomplish anything. It came as a surprise to me that the hospital needed to move the patient to another department since there was an insufficient number of nurses working in the intensive care unit.
After doing some more research, I discovered that a treatment catheter was put into the left internal vein so dialysis could begin. A chest x-ray showed that the patient was getting worse with azotemia, mixed metabolic and respiratory acidosis, and more diffuse interstitial and airspace opacities. Since the patient was getting help from a vasopressor, he was given continuous renal replacement therapy with continuous venovenous hemofiltration. However, continuous therapy could not go on because the RRT filter kept clotting again and again. This was a problem that many Covid-19 patients had. Trying CRRT on this client was hard because there was not enough blood flow through the dialysis catheter. This was caused by clotting inside the catheter and vascular breakdown around the catheter.
We learned that Renal replacement therapy, also known as RRT, is a term used to refer to treatment modalities that replace the functions of a normal kidney responsible for filtering waste. Acute kidney insufficiency is characterized by a gradual decline in the body’s ability to regulate acid-base balance, electrolyte balance, and fluid balance. In these circumstances, RRT is necessary to help the body survive the subsequent metabolic disturbances. Since dialysis, one of the most common RRT used, cannot compensate for all of the tasks performed by a kidney has been suggested as a more accurate name for the treatment. This is an important healthcare practice in critical care because it helps rectify patients’ kidney problems.
Kidney failure is dangerous to an individual’s life, especially if they have COVID-19, because you are more likely to have other vital organs fail as well. I discovered that when people who have COVID-19 or other serious illnesses get very sick, their kidneys may start to fail. If this happens, they might need to be taken care of in a unit for very sick people. We had to undertake some kidney dialysis processes to keep these patients alive. Dialysis is a treatment that removes harmful toxins and extra fluid from the body when a person’s kidneys cannot. In addition, some patients with kidney disease can get dialysis in regular hospital wards. However, patients with kidney problems and failure of other organs can only get dialysis safely in a critical care unit where they get other treatments to keep them alive.
Now What?
Despite my role on the team or the amount of experience I have, in the future, I want to be more aggressive in confronting problems head-on rather than avoiding them. This includes treating a service user who is stressed out, ensuring that information is given to the relevant staff, and intervening directly when I believe there is a risk to a service user’s physical or mental well-being. In addition, I will take into account the requirements of patients with learning disabilities, and I will adjust how I interact with these patients in the future. I will make it a point to use various communication strategies, and I will conduct my independent research on the specific needs of these patients; the findings of this research will then be incorporated into my nursing practice.
In the future, one of my goals is to collaborate with my other employees in a more assertive manner in order to ensure that any healthcare professionals who are brought to our unit receive treatment. This will be one of my learning goals for my upcoming placement, and in order to find out how I may achieve this objective, I will discuss it with my mentor. In addition, I will not presume that other members of the staff will always be aware of or care about the particular requirements and triggers of a service user. As a result, I will not presume that the responses provided by other members of the team will always be totally professional. I will make certain that each provider who works in the unit has a distinct position, and that workers are adaptable in order to maximize productivity, as my responsibility in this regard.
Conclusion
By completing my two learning outcomes and using a model of reflection, competency analysis, and evaluation of my learning style, I feel I have improved. I am pleased I had the opportunity to follow the complete process with my colleagues in the unit. I was able to effectively work with other healthcare providers to ensure that patients get quality care. In addition, I could withstand the challenges we faced during the pandemic. The first competency was leadership, which I demonstrated to my colleagues in the critical care unit, especially among the newcomers. The second area of my competency achievement was Renal Replacement Therapy which was integral during the pandemic.
Reference List
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Fukada, M. (2018) ‘Nursing competency: Definition, structure and development’, Yonago acta Medica, 61(1), pp.001-007. Web.
Hayes, S. D. (2019) ‘Using developmental relationships in mentoring to support novice principals as leaders of learning’, Mentoring & Tutoring: Partnership in Learning, 27(2), pp.190-212.
Rasheed, S.P., Younas, A. and Sundus, A. (2019) ‘Self‐awareness in nursing: A scoping review’, Journal of Clinical Nursing, 28(5-6), pp.762-774.
Talebi, M., Ahmadi, F. and Kazemnejad, A. (2019) ‘Dynamic self-regulation as an effective time management strategy for clinical nurses: A qualitative study’, Collegian, 26(4), pp.463-469. Web.
Wallerstedt, B., Benzein, E., Schildmeijer, K. and Sandgren, A. (2019) ‘What is palliative care? Perceptions of healthcare professionals’, Scandinavian Journal of Caring Sciences, 33(1), pp.77-84. Web.