Reflective essay on communication

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I am a health care assistant (HCA) on an elderly care surgical ward and we nurse many different patients who have had elective surgery and corrective surgery after a trauma. I have a lot of contact with patients who suffer with dementia, ongoing confusion due to urinary tract infections and can often display challenging and aggressive behavior.

I have found on a daily basis that patients become can frustrated when they cannot communicate what they want, and I was sure that with my strong accent I would come across as harsh. This left me feeling worried and sometimes inadequate because it is in my job and personal nature to want to help those in my care. As part of my Personal Assessment Document (PAD) my mentor and I decided that I would I would push myself to speak with patients more and see how they reacted to me. I would read the patient’s purple “This is me” folder to try and engage them on a more personal level.

With this reflective account I will be discussing an experience that I had on my ward and how through reflection I have managed to gain more confidence in my ability to talk to my patients and convey my compassion in the way I communicate with the patients in my care.

I will use the reflective framework devised by Atkin and Murphy (1994) to construct this account. It is the right model of reflection for me to look back and learn from my experiences.

Personally, being a good student and health carer does not just come with reflection in the mind but also reflective practice which, according to the nursing standard “enables a student to develop their skills, increase their knowledge and deal with emotionally challenging situations” (RCN 2012). Reflection is something that should be engaged with on an everyday basis and from very early on in your health care career. It enables you to carry on caring about the patients you treat and how to improve yourself personally and professionally.

I enjoy both the personal rewards and the challenges that go hand in hand with working with patients with dementia. I find that on the drive home I tend re-evaluate everything in my life and be grateful for the now. A patient whom will go by the pseudonym of “Polly” to maintain her confidentiality (The NMC Code of professional Conduct, 2004) was admitted to the ward with a fracture to the neck of her femur. I was advised that the patient was very confused, and would spit at staff and be both physically and verbally aggressive when approached but would constantly cry out that she needed help. She was in the early to middle stages of Alzheimer’s disease and had come from a care home for those suffering with dementia. Alzheimer’s disease is characterised “by the loss of short term memory, deterioration in both behaviour and intellectual performance and slowness of thought” (Dictionary of Nursing 1998).

In handover that morning I found that I would be working with her that day, and as she was post operative I would need to wash her and try to mobilise her to sit out in her chair so that the physiotherapists could help her to walk again and get her on the pathway to being discharged back to her care home. I found that I was nervous in approaching this patient as I did not want to upset her or get hurt. Personally I would always wake patients like Polly who require the attention of more than one member of staff last as it is better to leave the patient to sleep so that they are well rested. That, and from handover I had learned that Polly had experienced a rather active night.

Before waking Polly I had read her personal “This is me” purple file to find out if she had any preferred names, and how she liked to be spoken too. This is me was devised by the Alzheimer’s society and “is intended to provide professionals with information about the person with dementia as an individual. This will enhance the care and support given while the person is in an unfamiliar...
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