(Gibbs 1988)
Apart from being simple and easy to understand the reason of choice for the Gibbs reflection cycle is that it takes in to account the need to include feelings and emotions which were experienced in a particular event (Ghaye and Lillyman 1997) compared to other models such with the exception of Baud.
Description
During one of my early placement days, my mentor was not able to come in and so I was assigned to work with a midwife T who I had not worked with before. She asked me if I could palpate patient B and write down my findings. I had only done this procedure once under supervision with my mentor and had observed midwife T palpating patient A earlier on. I imitated the procedure she had done, by beginning with gaining consent from the patient. She agreed and I began to feel her tummy while trying to ask questions that I had heard my mentor ask such as” Does your baby move frequently and where does he seem to kick a lot?” Patient B had two accompanies and a child who kept shouting, “Mommy what is she doing to you? “The midwife was observing me in total silence. I was not so confident in fundal height measurement and before I could even confirm the correct procedure to it, she stopped me and said I was not holding the tape measure correctly. The patient and her family made a big sigh noise and showed faces of disappointment. I asked her to kindly take over, which she reluctantly did and asked if my mentor hade not taught me anything yet.
Feelings
I felt really scared when the midwife asked me to do a procedure I was not so competent in yet, however I did not want to look or sound like a failure so I proceeded. I had thought she was going to oversee me and guide me through the palpation, telling me what to-do step by step. Instead she stood in silence as if she was grading my performance. This made me feel belittled and terrified. I was very nervous when the client’s child asked what was happening to his parent. By the end of the procedure I felt embarrassed and upset.
Evaluations
Negative
When the client and her family had left, I was still quite upset and not happy with the midwife. I had wished she had given me a warning that on the shift she will ask me to do a few procedures and I should feel free to let her know if I am happy to do them. She waited till the client was present and put me in a position to seem like a failure if I do not try. Her silence was intimidating and when asked for assistance she portrayed that I was not receiving enough mentorship and I should be more advanced with my skills.
Positive
I learnt that there may never be a time that one will feel ready enough to become hands on. Although I was upset, I felt that given another chance repeat the same procedure I would do much better. It made want to research on palpation techniques and the correct way for measuring fundal height. I also got home and spoke to other colleagues who were not having an easier time and reassured me that when I master the skills required, I will forget that ever trying was so stressful.
Analysis
When I looked back at the scenario, I felt I should have either declined to palpate the lady in a calm manner and explained that I do not feel confident enough yet or I could have agreed but requested her assistance in talking me through it. I was threatened by her coat of authority and felt refusing may have a negative outlook on me as a student. Although I spoke to her a week later and let her know how I felt, I should have done so immediately after the incident. I had a word with my mentor about this episode who later spoke to her. This may have made her feel like a victim as I only spoke to her after another authority above both of us. This probably worsened the situation as suggested by Daynes and Farris (2003) who believe that by avoiding to deal with a situation immediately and personally and opting to take it to another in authority can worsen the the situation.
Conclusion
I could have been more assertive and stern. I should have stood up for myself and not feared being judged negatively and asked her to give me time to o observe and learn skills before putting in such a spot. I could have apologised to the client and said I was not prepared to take a chance on fiddling with her belly until I was confident with my observation skills since the midwife had already told the patient I was going to palpate her. If I had strong assertive skills, I would have probably asked the family to wait outside or draw a curtain to separate them from the client to avoid anxieties. If the child would not want to be separated from the mother, I would kindly tell her the Midwife is in a procedure which acquires a short period of silence.
Action Plan
With this reflection, I feel the need to improve on my assertive communication skills and put them to practice.
Assertiveness creates respect for one another and, does not despise, scorn or undermine the other. It does not enhance or cultivate blame. ( Porritt 1990)Being assertive is not being abusive or aggressive. For instance with assertiveness it is important to use the exact word you mean and not presumption. If answering a questing, using the word “No” shows assertiveness compared to “Not really”
I feel the need to develop this skill so I can provide appropriate midwifery care and I may be understood. As a part of an n interprofessional team, we constantly share information amongst ourselves with the intention to enhance care provision. It is essential our communication skills match our actions.
For instance being assertive could simply be switching off a television whilst speaking to a parent or asking children or partners not to interfere while you provide their care. This is not done rudely and in a way to offend. It could simply be a suggestion one brings up such as, “How about playing catch with the kids in the backyard while I just assess your partner’s wellbeing.
When being assertive eye contact, appropriate facial expression and body language is important. It is not appropriate to laugh and smile when serious. One must speak firm, loud and not too fast. There is a need to avoid bodily communication such as hair flicking, or fiddling with fingers, or slumping in the seat. An aspect of assertiveness which I need to overcome is the fear of rejection, criticism or being hated or liked for the wrong reasons {Jones 1989}
An assertive person is empathetic, an active listener and seeks to make sure they are understood through clarification.(Creasia et al 2001)
Another scenario I would use is when were at the University for out IPL Study days. Using the Gibbs (1988) cycle again I will display the need for me to become more assertive.
Description
One part of an afternoon lesson was aimed at getting everyone in the room to get involved a project within a group. All group members were randomly selected and most did not know each other. The tutor delegated one member to sit in silence and judge on the performance of each group. We had to work as a team of interprofessional to achieve the same goal. This was producing an advert to promote entirely anything we agreed on.
Feelings
I felt uneasy and uncomfortable to easily open up to a group of people I didn’t know. In our group there was one specific lady who dominated and appeared to be more of a bully than a team member. She was intimidating and sounded knowledgeable making many feel reserved and speechless.
Evaluations
Although the other member seemed to be confident she was not very knowledgeable and the ideas she brought up did not make sense. She knew she was intimidating to many and used that to her advantage. The advert sketch she proposed was not very attractive but everyone followed it as they felt she would do most of the talking. For some it was an easy way not to take part. It got us all interacting although some were very quiet.
Analysis
If I was as confident and assertive maybe the whole group would not have followed her planned advert and taken my ideas as well. I could have brought in some great ideas which would have been considered.
Conclusion
As part of a team everyone’s opinion is valid. It is not right for others to hide away and avoid input because there point could make a difference. When you are assertive it does not always mean you are perfect. It can help to lead clients and team members to better healthcare provision.
Action Plan
Practice to be more confident and assertive. Avoiding shying away and assuming my point is not valid.I could interact with different people more often. I could read ahead and understand things beforehand so as to speak in confidence among others with the relevant literature as reference.
Having used Gibbs reflective cycle, I have been taught the purpose of reflection and how it can enhance my communication skills as a professional. It makes one realise where they need to develop themselves and seek help when necessary
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