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Reflection Practice
03
Name – Sashini Sandapiyumi
Reg No – ADGN13/16/037
Content
 Gibbs Cycle
 Description
 Inculcating Feelings
 Evaluation
 Analysis
 Conclusion
 References
Gibbs Cycle
(Diagram: Gibbs G [1988] Learning by Doing: A guide to teaching and learning
methods. Further Education Unit. Oxford Polytechnic: Oxford. (Brookes.ac.uk)
Stage 01- Description
 When – 12th of February 2018
Male Acute ward
 Where - Well Reputed Mental Hospital in Sri Lanka.
 Who - Patient X
42 years old and Unmarried.
 What – Admitted due to the opiate withdrawal
 Incident - caught him with weed cigarettes
Stage 2- Inculcate feelings
 Scared
 Confused
 Nervous
 Confident
 Happy
 Sorry
 Glad
Stage 2- Inculcate feelings
 Before the incident
 Confident
 Happy
 Empathy
 After the incident
 Scared
 Confused
 Nervous
 Confident
 Happy
 Sorry
 Glad
Stage 3 - Evaluations
Good Experience
 Knowledge on how to manage such
conflicts.
 Importance of proper observation.
 Importance of Family Education.
 Identify the patient’s actual intention.
 Winning the trust among the Nursing Staff.
Bad Experience
 Patient lost the trust among
Nurse.
 Poor therapeutic effect due to
loosening patient- nurse
relationship
 Patient can be aggressive toward
me.
 Value of Privacy and
Confidentiality.
Prioritized problems of the issue.
 Technical issues
 Organizational issues
 Legal and Ethical issues-
 Legally - Breached the confidentiality of the patient.
 Ethically - breach the non maleficence (Do no harm), Responsibility ,
integrity(Accuracy, honesty, truthfulness ) and the justice
Stage 4- Analysis
 Families are a primary care-giving resource for adults with mental illness, yet they
often lack the knowledge and skills needed to assist their relatives Studies show that
families routinely request information on basic facts about mental illness and its
treatment, behavior management skills, and the mental health system in order to
better cope with their relatives' illnesses
{WHO, 2010}
 Observing peoples’ behavior in psychiatric inpatient units is an essential but
(arguably) undervalued aspect of nursing care.
(Hamilton and Manias, 2007)
 Common situations in which formal forms of observation may be prescribed include
when individuals have self-harmed or attempted suicide, shown potential for self-
harm or suicide, acted aggressively or displayed potential for absconding.
(Bowers et al., 2000).
Stage 5- Conclusion
Two of the largest population-based mental health surveys in the USA found that up
to 37% and 53% of the respondents with alcohol use disorder and drug use
disorders, respectively, had at least one comorbid psychiatric disorder.
(Mentalhelp.net)
 Majority of the patient use these substances in order to gain a temporary relief. But
it can cause long term defects to individual physical, psychological and socially.
 Family Education and support is vital for a quick recovery.
 poor observation can leads to severe complication.
 Poor hospital management, leads unwanted substances barge to the hospital.
Patient tried to consume cigarettes within in
the ward
Solutions
Good Results
1.Effective
monitoring
system
2.Increase
staff
3.Impose
Strict rules
4.Education
session
5.Strengthen
rules
6.Rewards
& Fund
raising
programs
1.Can observe
individually
2.Can focus
on each
patient.
3.Fear to break
rule.
Less illegal
behaviors
4.Minimise the
mistakes.
5.Less chance
for illegal
activities
6.Worker get
motivated.
Financial
support
ECT matrix
 Solution  Effects  Cost  Time  Total point  Rank
 Effective
monitoring
System
06 03 03 12  06
 Increase
Staff
08 02 03 13  05
 Impose
strict rules
08 06 06 20  02
 Education
session
06 07 06 19  03
 Strengthen
the rules
and
regulations
08 08 08 24  01
 Reward for
the good
service
07 02 06 15  04
Stage 6- Action Plan
 Have special training on handling the challenging psychiatric patients,
and deescalating the situation.
 Allocate patients for available staff.
 Think alternative and new method or strategies for observation
 Conduct Family Education sessions to improvise their knowledge.
 Provide hand bill which gives a insight.
 Do more research on Hospital Managing strategies.
References
 Hurley, J. (1999). Mental health. San Diego, Calif.: Greenhaven Press.
 Sri Lanka hits world record in attempted suicides — depression, alcohol abuse main
causes. (2019). Retrieved from http://www.sundaytimes.lk/171022/news/sri-lanka-hits-
world-record-in-attempted-suicides-depression-alcohol-abuse-main-causes-265155.html
 Ali, S., & Fornai, F. (2006). Cellular and molecular mechanisms of drugs of abuse and
neurotoxicity. Boston, Mass.: Published by Blackwell Pub. on behalf of the New York
Academy of Sciences.
 Saarländische Universitäts- und Landesbibliothek. (2006). Schizophrenie und
Cannabiskonsum: Epidemiologie und Klinik.
 Kalkman, M. (1958). Introduction to psychiatric nursing. N.Y.: McGraw-Hill.

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Relective case study

  • 1. Reflection Practice 03 Name – Sashini Sandapiyumi Reg No – ADGN13/16/037
  • 2. Content  Gibbs Cycle  Description  Inculcating Feelings  Evaluation  Analysis  Conclusion  References
  • 3. Gibbs Cycle (Diagram: Gibbs G [1988] Learning by Doing: A guide to teaching and learning methods. Further Education Unit. Oxford Polytechnic: Oxford. (Brookes.ac.uk)
  • 4. Stage 01- Description  When – 12th of February 2018 Male Acute ward  Where - Well Reputed Mental Hospital in Sri Lanka.  Who - Patient X 42 years old and Unmarried.  What – Admitted due to the opiate withdrawal  Incident - caught him with weed cigarettes
  • 5. Stage 2- Inculcate feelings  Scared  Confused  Nervous  Confident  Happy  Sorry  Glad
  • 6. Stage 2- Inculcate feelings  Before the incident  Confident  Happy  Empathy  After the incident  Scared  Confused  Nervous  Confident  Happy  Sorry  Glad
  • 7. Stage 3 - Evaluations Good Experience  Knowledge on how to manage such conflicts.  Importance of proper observation.  Importance of Family Education.  Identify the patient’s actual intention.  Winning the trust among the Nursing Staff. Bad Experience  Patient lost the trust among Nurse.  Poor therapeutic effect due to loosening patient- nurse relationship  Patient can be aggressive toward me.  Value of Privacy and Confidentiality.
  • 8. Prioritized problems of the issue.  Technical issues  Organizational issues  Legal and Ethical issues-  Legally - Breached the confidentiality of the patient.  Ethically - breach the non maleficence (Do no harm), Responsibility , integrity(Accuracy, honesty, truthfulness ) and the justice
  • 10.  Families are a primary care-giving resource for adults with mental illness, yet they often lack the knowledge and skills needed to assist their relatives Studies show that families routinely request information on basic facts about mental illness and its treatment, behavior management skills, and the mental health system in order to better cope with their relatives' illnesses {WHO, 2010}  Observing peoples’ behavior in psychiatric inpatient units is an essential but (arguably) undervalued aspect of nursing care. (Hamilton and Manias, 2007)  Common situations in which formal forms of observation may be prescribed include when individuals have self-harmed or attempted suicide, shown potential for self- harm or suicide, acted aggressively or displayed potential for absconding. (Bowers et al., 2000).
  • 11. Stage 5- Conclusion Two of the largest population-based mental health surveys in the USA found that up to 37% and 53% of the respondents with alcohol use disorder and drug use disorders, respectively, had at least one comorbid psychiatric disorder. (Mentalhelp.net)  Majority of the patient use these substances in order to gain a temporary relief. But it can cause long term defects to individual physical, psychological and socially.  Family Education and support is vital for a quick recovery.  poor observation can leads to severe complication.  Poor hospital management, leads unwanted substances barge to the hospital.
  • 12. Patient tried to consume cigarettes within in the ward Solutions Good Results 1.Effective monitoring system 2.Increase staff 3.Impose Strict rules 4.Education session 5.Strengthen rules 6.Rewards & Fund raising programs 1.Can observe individually 2.Can focus on each patient. 3.Fear to break rule. Less illegal behaviors 4.Minimise the mistakes. 5.Less chance for illegal activities 6.Worker get motivated. Financial support
  • 13. ECT matrix  Solution  Effects  Cost  Time  Total point  Rank  Effective monitoring System 06 03 03 12  06  Increase Staff 08 02 03 13  05  Impose strict rules 08 06 06 20  02  Education session 06 07 06 19  03  Strengthen the rules and regulations 08 08 08 24  01  Reward for the good service 07 02 06 15  04
  • 14. Stage 6- Action Plan  Have special training on handling the challenging psychiatric patients, and deescalating the situation.  Allocate patients for available staff.  Think alternative and new method or strategies for observation  Conduct Family Education sessions to improvise their knowledge.  Provide hand bill which gives a insight.  Do more research on Hospital Managing strategies.
  • 15. References  Hurley, J. (1999). Mental health. San Diego, Calif.: Greenhaven Press.  Sri Lanka hits world record in attempted suicides — depression, alcohol abuse main causes. (2019). Retrieved from http://www.sundaytimes.lk/171022/news/sri-lanka-hits- world-record-in-attempted-suicides-depression-alcohol-abuse-main-causes-265155.html  Ali, S., & Fornai, F. (2006). Cellular and molecular mechanisms of drugs of abuse and neurotoxicity. Boston, Mass.: Published by Blackwell Pub. on behalf of the New York Academy of Sciences.  Saarländische Universitäts- und Landesbibliothek. (2006). Schizophrenie und Cannabiskonsum: Epidemiologie und Klinik.  Kalkman, M. (1958). Introduction to psychiatric nursing. N.Y.: McGraw-Hill.