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Reflective writing, I have decided to reflect upon the development of my confidence and practical skills, during the case of a stroke patient I treated over a period of time.

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The purpose of this essay is to reflect upon an aspect of my professional development during my first placement. It will be written in the first person and confidentiality has been maintained along with all names being changed to protect the identities of individuals. I have decided to reflect upon the development of my confidence and practical skills, during the case of a stroke patient I treated over a period of time. To help structure my writing, I will be using the Gibbs (1988) model of reflection. This model supports ?reflection on action?, allowing me to think retrospectively and systematically analyse each phase of the experience. The last phase then allows me to plan a course of action if I were to ever come across a similar situation. I was on my first placement on a stroke rehabilitation unit at a hospital in the Northwest of England. My clinical educator (C.E.) was teaching me about common secondary complications patients suffer from after a stroke that results in severe weakness on one side. The patient, ?Mr A?, had experienced a right side ischemic stroke, resulting in severe weakness of both left upper and lower limbs and disphagia. At the time, Mr A was resting with a number of IV drips attached, an oxygen mask and a nasogastric tube inserted to provide nutrition. Mr A?s oxygen saturation (Sp02) had been low and respiratory physiotherapy had been requested. After being taught the ?ABCDE? assessment tool, I was asked to perform it with supervision. ...read more.


The same could be said about my practical skills. Since I came to realise that at some point I would have to be able to suction a patient, I decided to practice my skill on a model with advice given by other practictioners and health professionals who perform the procedure. With regard to my reaction to the patient?s discomfort where I had to fix the mask onto Mr A?s face, I decided to discuss it with my C.E. and another practitioner who regularly performs the treatment. Both were understanding and said they felt the same way when they first started. They explained that it was necessary for some uncomfortable treatments to be done for the longterm benefit of the patient. After seeing the results of the treatment the next day, I finally came to understand what my C.E. and the other practitioner were trying to explain. After returning and meeting the patient after the weekend, I was worried that our decision to allow Mr A remain sat out in his chair had fatigued him and contributed to his decline. I then reflected on the fact that as a student, my C.E. would be accountable for my actions. However, my C.E. assured me that it was the patient?s choice to sit out and there were any number of factors attributed to his decline. She also noted that she agreed and cleared my decision to let him sit out. My C.E. concurred with my suggestion of suction and as she knew I had been practicing during the past few days on the dummy, suggested that I perform the procedure under supervision. ...read more.


However, one of the main things I will take away from this placement and reflection is something my C.E. told me. That in physiotherapy it is not possible to fully prepare yourself for every situation and that it is an ongoing learning experience. As a second year physiotherapy student who has just completed his first placement, I know that there is a lot more to learn. ________________ Askim, T., Bernhardt, J., Løge, AD., Indredavik, B., 2012. Stroke patients do not need to be inactive in the first two-weeks after stroke: results from a stroke unit focused on early rehabilitation. International Journal of Stroke, 7(1) pp. 25-31 Baker, C., Medves, J., Luctkar-Flude, M., Hopkins-Rosseel, D., Pulling, C., Kelly-Turner, C., 2012. Evaluation of Simulation-Based Interprofessional Education Module on Adult Suctioning Using Action Research. Journal of Research in Interprofressional Practice and Education, 2(2) pp.152-167 Berney, S., Deneby, L., 2001. The use of positive pressure devices by physiotherapists. European Respiratory Journal 17: pp.821-829 Denehy, L., Berney, S., 2001. The use of positive pressure devices by physiotherapists. European Respiratory journal, 17(4) pp.821-829 Endacott, R., Jevon, P., Cooper, S., 2009. Clinical Nursing Skills: Core and Advanced. Oxford: Oxford University Press Law, C., 2003. Using mucociliary clearance methods that do not require an artificial airway. Nursing Times, 99(41) pp.57-59 Penuelas, O., Frutos-Vivar, F., Esteban, A., 2007. Noninvasive positive-pressure ventilation in acute respiratory failure. Canadian Medical Association Journal 177(10) pp.1211-1218s Tuttle, R., Cohen, M., Augustine, A., Novotny, D., Delgado, E., Dongilli, T., Lutz, J., DeVita, M., 2007. Utilizing Simulation Technology for Competency Skills Assessment and a Comparison of Traditional Methods of Training to Simulation-Based Training. Respiratory Care, 52(3) pp.263-270 ...read more.

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