Introduction

One of the key ways we can develop and learn from our experiences is through reflective
practice. Jasper's (2013) literature described it as a critical tool designed to aid students; it is a
developmental link between theory and practice. Thus, reflection is essential for ethical-based
professional practice (Hargreaves and Page, 2013). The use of purposeful thinking,
understanding the different processes and taking action, as a result, can only be achieved
through reflective processes. Nurses or Healthcare practitioners learn from these experiences
and develop their practice through reflective practice (Masuku, 2022). Continuous thinking about
our actions or experiences can mitigate the chances of adverse medical errors; through
reflective practice, Health and Social care practitioners engage in a lifelong learning process. By
applying evidence-based research to our professional role, patients can receive the best care.
Evidence-based practice helps health and social care professionals to develop the practical
skills needed to achieve the standards for registration as an Independent
Practitioner/Consultant (Jasper, 2013).
Gibb's (1988) reflective cycle will be vital for this assignment. Gibb's reflective model is divided
into six stages, such as, (Description, Feeling, Evaluation, Analysis, Conclusion and Action
Plan). This reflective essay will follow the six stages of discussion, summarizing the model's
guidance. The paper uses the case study 2.2 - Juggling time, basing the reflective account on a
critical incident from an activity in a lecture. This research presents a case where the involved
practitioners in charge of the care of an inpatient lacked effective communication. This scenario
negatively impacted the patient.
The research study stresses the need for proper communication.
In a tabulated format, this reflective essay identified and demonstrated the FIVE (5) SMART
goals needed to fulfil the chosen Health and Social Care professional role.

Description (Stage One)

Although several things had happened that day, one stood out for me. A client named Joe, 40
years old, had a stroke four (4) months ago. Due to this condition, Joe found it very difficult to
accept his current state or seek help. He rejected every aid that came his way, including
accessing rehabilitation services. Since Joe was in denial about his condition, the patient
continued working from home with his computer and refused to address his immediate need
consequent from the stroke. By the time he accepted to seek medical advice, it was too late
because the bleeding to his brain had stopped, and Joe suffered from left-side hemiplegia.
Despite his illness, it did not affect his speech, but the stroke made Joe very emotionally
volatile, and he became very suspicious about the motive of everyone around him. The
practitioners in charge of Joe's case believed that he was cognitively impaired, making it hard to
accept treatment in the short and long term. Joe had resisted his physiotherapy and
occupational therapy treatments, and the patient judged the treatment inappropriate. However,
Joe is an educated professional, but he was a heavy smoker and had a poor diet. His lifestyle
made Joe resist inpatient care in the unit as his smoking was necessarily restricted - Joe was
unable to cope. It was this restriction that led to the following incident.
Although Joe was extremely violent and emotional, I feel that the practitioner in charge of his
case would have done a better job of making Joe feel more comfortable and at ease or relaxed.
For example, Joe believed that the practitioner saw his medical condition as a case instead of
treating and respecting him as an individual/patient. Seeing this, Joe became more violent and
hostile to everyone around him. Focusing on your patients as individuals rather than cases is
essential (Masuku, 2022). Joe saw he was not receiving the best quality care and that the
practitioner did not understand him enough. The practitioner needs to maximize her learning
potential.

Feeling (Stage two)

The practitioner needed to be more patient by offering the patient support and a more conducive
environment for him to open up. The practitioner must develop the critical and analytical skills
needed to make a judgment and arrive at an effective decision-making process (Masuku, 2022).
The practitioner in charge of Joe's case did not do a better job. She allowed her emotion to get
the best of her. There seems to be a miscommunication between the practitioner handling Joe's
case, Kerry, and the ward manager (supervisor). Since the practitioner knew Joe was extra
violent to everyone, she could have sought advice from other colleagues/practitioners or
consultants to learn more about the best ways to help the patient.
Kerry should not have left Joe for ten (10) minutes. Because Kerry had left Joe outside for ten
(10) minutes, it led to raised voices. The practitioner thought that Joe wanted to hit Kerry, and it
made her yell at the top of her voice, causing Joe to hit his head on the wall. Although she
immediately called out for help by trying to assess Joe's physical condition, the patient began
shouting, asking the practitioner to leave him alone. He pushed her away - the practitioner hit
her rib, and she fell on the floor, hurting her back. This incident attracted many onlookers, and
the ward manager arrived and took over the case, asking the practitioner to complete the
accident report.
In this situation, I felt that the ward manager was wrong to have shoved the practitioner in
charge of the case without asking what happened. On second thought, she was trying to give
the patient (Joe) the best care possible.
The practitioners in charge of the case allowed their emotions to control them.
I had mixed feelings, so many negative emotions, pity, sorrow, sadness, and empathy. If Joe
had received individualized care and the practitioner had better researched Joe's problem by
assessing his treatment plan, her experience and expertise, the patient's illness would have
been more managed. The receiving of individualized care contributes to the quality of care
patients and service users receive. It mitigates the number of adverse patient/client incidents
(Davies, 2012; Jasper, 2013; Masuku, 2022). The practical implications are wrong established
protocol and routine care (Pattinson, 2011) that fails to treat the patient as an individual.
In my reflection, I realized that effective communication was lacking (Masuku, 2022) between
the practitioners.
If the practitioners had been more kind and courteous and listened to each team member to
understand their assumed professional role and the professionals involved had agreed to the
effective communication protocol, it would have prevented the inpatient accident.
Evaluation (Stage three)

It is paramount that the practitioner in charge of Joe's condition is aware of the vital role she is
playing in inpatient care. She should have thought critically about the set guidelines, standards,
and protocol of her professional role as a Health and Social care professional and ensured
timely and effective communication between herself and the ward manager (supervisor).
According to healthcare research, eighty per cent (80%) of all unfavourable medical errors are
due to miscommunication (Jasper, 2013). The lack of evidence-based care derived from
patients' needs can lead to adverse medical errors. The practitioner was not accountable and
responsible enough for the patient. She did not value her practice and lacked apt and emotional
intelligence. The practitioner was impatient, leading to a negative experience for the patient. The
practitioner should be more responsible by developing a reflective skill/practice. Becoming
aware of your shortcomings; taking responsibility for your actions so that you can be more
competent and safe is the process of reflective practice (Hargreaves and Page, 2013; Jasper,
2013). Healthcare is a very complex and diverse profession. Enhancing effective
communication will bring about safe patient or inpatient care. Incomplete, inaccurate, and
untimely communication led to the negative outcome of this incident. From experience, critical
thinking is an essential tool of reflective practice (Masuku, 2022). Thus, learning to effectively
communicate my professional role, understanding each team member's assumed positions, and
keeping my emotions in check through emotional intelligence will enable me to become a more
critical and reflective health and social care professional.

Analysis (Stage four)

Several pieces of research on the Health and Social Care profession found that
inefficient/ineffective team working and poor communication are the most cause of adverse
medical errors and low levels of inpatient care (e.g., Jasper, 2013; Masuku, 2022). This results
in poor patient quality care and emotional and physical harm to all concerned. By becoming
critically aware of the happenings within their units or departments, management can raise
awareness about the need for proper teamwork and enhanced communication. By coming
together to share vital information about a patient/client's needs, values, and goals that are
imperative to this condition/illness, the management and handling of inpatient care can be
improved (Masuku, 2022). Therefore, collaborating with the patient's values and beliefs can
facilitate shared decision-making. Having the prerequisite skill mix, teamwork, and excellent
interpersonal skills can reduce the number of adverse patient incidents (Pattinson, 2011). For
example, inpatient quality care and safety can be mitigated - by identifying learning needs and
developing the practitioner learning base potential.
Another potential danger that might lead to communication failure is the poor administration of
drugs. The miscommunication between the practitioner and her units/department - resulted in
the patient thinking that his medical prescription therapy was inappropriate.
Reporting the case to the various psychological groups (departments) will ensure a never-
recurring scenario. Discussing the issue will guarantee that all practitioners handle their patients
with the utmost care and make them a priority by following with all keenness the procedure,
standards and protocols or code of the Nursing Midwifery Council (NMC). Conversely,
discussing this situation during the monthly meeting where health and social care professionals
are present, including the practitioners involved, to reflect and explain what happened and why
it happened will aid their professional role (Hargreaves and Page, 2013). Asking the
practitioners involved in the case to apologize to the patient and their family and to address the
issue will ensure these practitioners become more conscious, responsible and accountable.
These measures will ensure all patients receive proper treatment and the best quality care for
their needs (Masuku, 2022).
The point of addressing and writing about this incident is to prevent future occurrences (Davies,
2012). It will help professionals to reflect on the professional practice as it relates to their
learning development; learn from the experience to develop the necessary skill to effectively
practice the profession with more confidence and increased competence as an Independent
Practitioner.

Conclusion (Stage five)

In conclusion, the lack of dedication to the patient's time, quality care, miscommunication, and
poor teamwork cause this incident. Following the established protocols, standards and
procedures as laid down by NMC would have prevented this incident from occurring. Aside from
following the established guidelines, an effective leader (the ward manager) who would have
directed and checklist the structured plan of the practitioner was absent.
The practitioner involved in the incident should maximise their learning potential. They should
reflect on their learning needs by reflecting on the method to build and develop their practice.
The lack of individualised patient care made Joe experience poor patient outcomes. In the
(Jasper, 2013; Masuku, 2022) literature, poor individualised patient care is a causal factor of the
many adverse patient incidents and medical errors. The patient saw that the practitioner was
treating him as a case instead of a patient. He also realised the ineffective communication
between the practitioner and her unit - this led the patient to believe that the prescribed medical
condition or therapy was inappropriate, thus, his resistance to accepting help. Effective
communication and team working are critical skills for Healthcare practitioners. The practical
implications are poor patient safety and quality care.
In brief, the need to continuously update your skill and knowledge and the learning from your
clinical experience are all valuable sources of lifelong learning.

Action Plan (Stage six)

The proper training and development of healthcare professionals are paramount. Developing
the required skills, knowledge, and experience essential towards becoming a professional
practitioner can only be achieved through lifelong learning and training (Jasper, 2013; Masuku,
2022). The continuous development and training will increase effective communication and
teamwork among health and social care professionals, making them more accountable,
emotionally intelligent, and responsible practitioners. Recommending structured documentation
and checklist will ensure patients are safe and receive the best quality care (Masuku, 2022).
The barrier to miscommunication or ineffective communication is an interprofessional and
multidisciplinary team working.
Communicating effectively within healthcare teams can be enhanced if management considers
the different intercultural backgrounds of their team's communication. Creating strategies to
implement effective intercultural communication within healthcare teams will bring about proper
communication, effective teamwork, and collaboration.

Table 1.1 in this section will demonstrate the FIVE (5) SMART goals or ways I hope to develop
to fulfil my chosen career as a Health and Social Care Professional through learning or training.

Five Smart Goals Learning Development or Training

1. Develop Critical and Analytical thinking skills

Critical and Analytical thinking: Fron the incident, the practitioner involved in Joe's case had
not critically analysed the patient's illness using research and evidence-based learning from
experience. Critical analytical skills help healthcare professionals develop the knowledge and
skills to make reasoned decisions (Jasper, 2013).
To effectively fulfil my chosen career as a Health and Social Care Professional in the future, I
hope to learn through training and develop efficient critical analytical skills needed to become a
responsible and accountable professional.

Interpersonal Relationship: Whilst Reflecting critically, I found that the lack of interpersonal
skills made Joe receive poor healthcare.
As a future health and social care professional, my goal is to learn and develop through training
the necessary interpersonal relationship skills needed for effective team working. Effective team
working is an essential skill for healthcare professionals (Masuku, 2022). Thus, developing this
skill through learning and training will stay with me, becoming the foundation of my professional
role.

Reflective skill: The practitioner lacked reflective skills from the reflected case study. Her
refusal to assess the treatment plan of Joe both from evidence-based research and drawing
inferences from experience resulted in a negative experience for the patient. As a future Health
and Social Care Professional, my third smart goal is to develop the skill of reflective practice.
Developing this skill through learning or training, I would be working or operating according to
the established procedures and standards laid down by the NMC (Masuku, 2022), thus,
improving patient/client satisfaction quality.

Emotional Intelligence: The practitioners in charge of Joe's condition allowed their emotions to
control them. Reflecting on this incident, I realised that the practitioners had not developed their
emotional intelligence skills (Pattinson, 2011).
To fulfil my chosen career as a Health and Social Care professional, I need to develop
emotional intelligence skills. I hope to develop this skill through learning, training, and reflective
practice.
Emotional intelligence is a critical tool for Health and Social Care professionals.

Effective Communication: Whilst extensively reviewing the literature (e.g., Davies, 2012;
Hargreaves and Page, 2013; Jasper, 2013; Masuku, 2022; Pattinson, 2011), I found that
ineffective communication causes adverse effects in medical errors and poor patient safety.
Poor communication between teams (the practitioners) cause Joe to experience poor patient
safety and care. As a prospective Health and Social Care professional, I hope to develop
communication skills through learning or training. The perfecting of this skill will bring about a
higher standard of quality care and a multi-skilled workforce.

References

Davies, S. (2012). “Embracing reflective practice”. Education for Primary Care, 23. 9–12.

Gibbs, G. (1988). Learning by Doing:A Guide to Teaching and Learning Methods. Oxford,
Further Education Unit Oxford Polytechnic: Oxford

Hargreaves, J and Page, L 2013. Reflective Practice. Hoboken: Wiley

Jasper, M., (2013) Beginning Reflective Practice, 2nd edn. Andover: Cengage Learning

Masuku, S. (ed). (2022) The Healthcare Professional MOD005910. Custom eBook. ARU
London: John Wiley & Sons Publishers.

Pattinson, S. (2011). Medical law and ethics. (3rd ed), Sweet & Maxwell/Thomson Reuters,
London.