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Reflective Critical Analysis – community nurse for individual client

Instructions

The purpose of an RCA is to provide an in-depth exploration of your experience and to demonstrate your professional growth, and the ability to integrate evidence into practice.

Introduction

Clearly identify an experience that relates to the required topic of the RCA ( community nursing in Canada)  and introduce the central idea(s) you will be discussing. You must include a central thesis statement (i.e. what your RCA is going to discuss).

community nurse  –  advocate your client.

Body

Description of the experience.

Provide a clear and concise explanation of the experience. The experience should be clearly

related to, and an illustration of, what you will be discussing throughout your paper. The

following questions may help guide you:

  1. Why is this significant to explore in relation to your practice?
  2. What is meaningful to you about this experience?
  3. Why do you need or want to look at this experience in detail?

The experience – walk in one of my client room as a community nurse ( the client was 20 yrs old girl. The was diagnosed with epilepsy in early age). The client’s father is out of the picture, and her mother was deported back to Jamaica. The client lives with a sister who is a young mother of 4 years old. When I walk into the room that day, the client was on the floor have seizures every five minutes. Although the sister did want me to call 911, I did that to advocate my client.

 Analysis of the experience.

Question the outcomes, rationale, and impact of the experience on your own behaviors and

reactions or the impact on others. Incorporate caring philosophy, ways of knowing, nursing

theories, best practice guidelines, standards of nursing practice, and current literature. The

following questions may help guide you:

  1. What factors influenced the way you feel, think, and respond to this experience?
  2. What factors influenced the way your client (individual, family, group, or

community) responded in this experience?

  1. Why did this happen? What does it mean? What was my role?
  2. What are the consequences of this experience for the client, others, and yourself?
  3. What knowledge informed you? What might have better informed you?
  4. What is in the literature about this experience?
  5. To what extent did I act in tune with my values?

*Each idea links back to your experience.

 Personal areas for development.

Explore personal areas for development that demonstrate a solid understanding of new

knowledge and decision making. The following question may help guide you:

  1. What impact, reactions, and thoughts did this experience have on you?
  2. How might you respond more effectively in this situation again?
  3. How do you feel about the experience now?
  4. What insights have you gained through this reflection (framing perspective)?
  5. How would you revise your approach given this insight?
  6. What would be the consequence of this alternative action on clients, others, and

yourself?

  1. How has this reflection altered or changed your practice?

The body section can take many paragraphs to achieve the description and analysis of the

experience as well as an elaboration of your personal development from the experience. The

guiding questions may help but only use the questions pertinent to your experience. References

should be included in this section and used to support your ideas or conclusions with literature.

Conclusion

Summarize the main points of your paper and propose questions for future exploration. Make

inferences based on the information and link back to the main thesis of the experience from the

introduction.

*No new information, no references, etc. in the conclusion

Structure and Format

Reflective Critical Analysis

RCA papers should be four to five pages and include at least four scholarly, peer-reviewed

references. Other expectations include: proper use of language and grammar; well-organized and

a logical flow of ideas; clear transition between paragraphs; proper use of APA. The use of ‘I’ is

acceptable in reflective scholarly nursing writing and will help to explore one’s own practice,

ideas, new learning.

SAMPLE

Introduction

This paper is a critical reflection of my experience as a community nurse working with an epileptic patient in Canada. The goal of the reflection is to identify my strengths and weaknesses in providing quality care to an epileptic patient experiencing repeated seizures. To this end a description of the experience followed with the analysis of the impacts of the experience on others and my behavior is presented. A discussion of the new knowledge gained from the experience as well as areas requiring further improvement is also provided.

Description of the Experience

While undertaking my role as a community nurse in Canada, I encountered a 20-year old girl who was recently diagnosed with epilepsy. The patient was living with her sister who was a young mother to a 4-year old child. Both parents were absent, as the father was completely out of her life, while her mother had been deported to Jamaica.

On getting into the room, I found out that the patient was having seizures every 5-minutes and was on the floor. Even though her sister, was skeptical to seek for emergency help, I had to call 911 to ensure the patient is taken to the hospital to receive medication. As a community nurse advocate, my role was to ensure that the patient right to medication and proper care is protected. Epilepsy is a highly stigmatized disease that have significant negative impact on the quality of life of an individual. The disease is also associated with comorbidities that increase the direct and indirect cost of care (Prevos-Morgant et al., 2019). Also, the disease is associated with symptoms such as seizures that of not well-managed can lead to the death of the patient (Falco-Walter, Scheffer & Fisher, 2018). To deal with the disease and ensure that the victim achieve a quality life, nursing care within specialized domains are recommended.

Community nursing advocacy is one of the domains that is recommended in the provision of care for patients diagnosed with epilepsy. A nursing advocate working at a community level will ensure that the patient is safe both in a healthcare facility and at home (Dening & Hibberd, 2016). Also, the nurse will educate the patient on how to manage the chronic condition to achieve a quality life and ensure that their rights are always protected. It is important to investigate how well an individual can execute the role of a community nurse advocate, to ensure they offer the best care, thus presenting the need for the reflection of a personal experience in dealing with an epileptic-patient experiencing repeated seizures.

Analysis of the Experience

Epilepsy is identified as a complex brain disease that requires a specialized nursing approach in providing care for persons diagnosed with the condition. Adequate knowledge about epilepsy management is required of all nurses and other health care practitioners if the patient is to receive the recommended quality care (Smith, Wagner & Edwards, 2015). Seizures, sudden and uncontrolled electrical disturbance of the brain, is a major symptom of epilepsy that require specialized management to improve the safety and well-being of the patient. According to Johnson (2019) seizure affects the sensations, behavior and emotions of an individual, and in some cases resulted in convulsions and loss of consciousness. In instances, where convulsions or lapses in consciousness are reported, the patient is at risk of reporting physical injuries if proper care is not provided. Also, repeated seizures, seizures associated with high fever, seizures that last for more than five minutes and lack of consciousness after the seizure stops, are danger signs that requires the victim to seek medical help (Smith, Wagner & Edwards, 2015). Such severe cases of seizures may lead to permanent injuries or death of the patient thus should be treated as conditions requiring urgent medical attention.

According to the CNO guidelines on provision of first-aid to persons experiencing seizures, it is recommended that the care giver understands the nature of the seizure prior to offering any care (Higgins et al., 2017). The aim of first aid for seizures is to keep the victim safe from any physical harm of further complications until the seizure stops on its own. The first aid is accomplished by loosening anything around the neck of the person, clearing the area around them, avoiding restraining them or placing anything in their mouth and staying with them until the seizure stops (Prevos-Morgant et al., 2019). However, some seizures are complicated and do not end on their own. Seizures that lasts for more than 5 minutes or repeated seizures where a second seizure occurs immediately requires medical care, as can result in serious complications and even death of the victim.

The patient in the current case experienced repeated seizures, as such, I treated the situation as a “seizure emergency” necessitating urgent treatment and medical care. As much as the patient’s sister was reluctant to call 911 and ask for medical help, I insisted on the same knowing that the situation was life threatening. My decision was informed by my knowledge on the type of seizures that an epileptic patient is likely to encounter, as well as seizure conditions that must be treated to protect the patient from developing permanent injuries or dyeing such as the repeated seizures (Johnson, 2019). As much as my decision was not welcomed by the primary caregiver of the patient, I was advocating for the rights of the patient and ensuring that she gets quality care, thus insisted on calling for emergency medical help.

However, I ought to have educated the patient and her sisters on the dangers of such repeated seizures and the most appropriate care that needs to be offered. As reported by Johnson (2019) a basic knowledge of the types of seizures and their probable impacts on a patient is desired for an individual to effectively offer first aid to a patient. Educating the patient and the community at large on various diseases, health conditions and their management is a primary role of a community nurse to ensure they offer quality care to the patients as well as minimize the risks of death (Dening & Hibberd, 2016). From the observation made, the patient’s sister was reluctant to seek for medical help having known that seizures are likely to stop on their own, and that the patient only needs care during the process. Her lack of knowledge on the dangers and management or repeated seizures resulted in her reluctance to seek for medical help. As such, educating her on the risks of repeated seizures for an epileptic patient would ensure that she handle the situation amicably if it reoccurs in the future.

Personal area for Development

Educating community members and specifically family members that offer direct care to a patient is a major role of a community nurse. Such learning process is desired to ensure that the care giver that interacts with the patient on a daily basis have the desired knowledge in the management of the condition and any issues that might arise (Dening & Hibberd, 2016). As such, for a patient that is likely to develop seizures, it is imperative that the primary care giver understands the nature of the seizures and its suitable management plan (Falco-Walter, Scheffer & Fisher, 2018). My failure to convey the information to the patient’s sister is a weakness that I hope to correct in my future interactions with an epileptic patient. I will not only communicate the basic seizure treatment interventions for various kinds of seizures to the family member or caregivers, but I will also develop a written seizure treatment plan for the patient based on her/his type of seizure. The plan will avail information on the type of seizure the patient has had, prescribed dosage for maintenance of the epilepsy and an intervention needed in addressing the type of seizure. Such information is important in ensuring that the patient receives quality care and effective management of the seizures even in the absence of a nurse.

Conclusion

Nursing advocates working at a community level plays a major role in offering quality care to patients in a community setting. In my experience with an epileptic patient who was experiencing repeated seizures, I discovered the importance of understanding the various kinds of seizures and their recommended management plans. My decision to seek for urgent medical help for the patient was effective since repeated seizure poses serious health risks that might lead to death if not treated with prescribed medication. However, I learnt the importance of educating the caregiver/family members on the effective treatment interventions for different kinds of seizures, to guarantee quality care to the patient at all times.