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    Reflective cycle after watching video of Miss Colo Essay

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    rado speaking about the role of the Nurse.


    Introduction
    It is very important that wedevelop a reflective style in nursingto improve our nursing practice.For the reflective process I will be using the Gibbs reflective process which is a six stage processofdescription,feelings/thoughts, evaluation, analysis, conclusion and action planCITATION GGi88 l 3081(Briggs, 2012).There are a large number of models to choose from,the Gibbs methodallows for a clear description of situation, an expression of how you felt about the situation and an analysis and plan to make sense of the situationCITATION Jay12 l 3081(Jayatilleke & Mackie, 2012)CITATION Som04 l 3081(Sommerville & Keeling, 2004).Reflection is a skill which helps us develop as nurses and make us improve our practices in nursing and utilize the knowledge that we have gained in class, and begin to perfect it in practice.

    Description:
    The YouTube videohas Miss Colorado describing her role as a nurse and discussingthat “one patient that reminds them of why they became a nurse in the first place”. Her story is of Joe who was an Alzheimer’s patient and is so touched by her care that he says to her she has changed his life and she is more than just a nurse.Miss Colorado reflects on this conversation and realizes she is more than just a nurse, she is a comforter and a life saver, not just a number.

    Ms. Colorado somewhat downplays her role when compared to other health professionals and makes it seem small in proportion to other health care professionals and to the role of doctors.WhenJoe says to her canyou change the medication for me,and can change thetreatment status for me she said I am just the Nurse, I am not your doctor. This is an odd description of the situation given that she walks on to the stage with a stethoscope, implying some role in themonitoring and reporting of the health status and treatment effectiveness of the current health intervention.Her discussion concerns the actions of a good nurse, and in particular that of “patient centered care” which has been identified by the Institute of Medicines, quality chasm’ report as one of the six key elements of the New Health Care SystemCITATION Eps11 l 3081(Epstein & Street, 2011). The role of the nurse is a critical element in the process of patient centered careand their role is equal to all other members of a multidisciplinary healthteam despite the difficulties and skepticism that many nurses have for multidisciplinary team workCITATION Atw06 l 3081(Ke, et al., 2013).


    Feelings
    I felt that the speech was very emotive and true and also she managed to get a very positive response from the audience.Iwas drawn in byher story of Joe as it reminded me of the very human element of our jobs, andmany of the patients and families that I have come into contact with.She mentions her impact on Joe but of course does not go into much detail as to the role of modern nurses.She was trying to be empathetic to the patient in the video whichI feel is very important howevermuch of the descriptiondoes not match my personal experience of the nursing profession, and possibly does not give a real insight into modern nursing and the core role of nurses and their everyday experience.I felt the video gives a romantic view of what being a nurse is like and so lacks some realism.

    Good Feelings:
    At a patient care level, she demonstrates a lot of good qualities in terms of how she deals with Joe in that she is aware of the effect of his treatment on the people around him like his family and how this impacts on them which I feel is a very important trait for nurses and secondly, even thoughshe has not mentioned about the roleof every day nursing other than just holding Joes hand when he has night terrors,which is lacking in the video she tries to tell the patient identity in the respectful way which isa very good way of communicating with a patient with Alzheimer’s.
    The Video showed thateven though she will not be able to save the life of Joe, she plays an important role in the comforting and assistance of Joe. In some ways the video significantlydownplays the role of nursing as not being responsible for changing treatments, medication and having no opinions or voice as to the treatment that Joe should be receiving. Another important thing is that she was taking about the twitter and Facebook and she was trying to bring the Nursing professionals together in order todiscuss ideas and concerns online which I feel is a great idea and can improve nursingprofessionalismthrough sharing ideas online and comparing the experiences of everyone
    Bad Feelings
    When the patientasks her tochange the medication andasks if shecan change the treatmenthowever she does reinstate a negative to her argument when she says that “I am just the Nurse” thus downplaying the importance of her role in diagnosis and treatment which I felt was a negative comment and not in line with the rest of her monologue. Thus in some ways she has downplayed the role of nurses as being lower to that of doctors and other health professionals.The nursing profession is becoming increasingly specialized with training and education being at the heart of developing modern nursesCITATION Cro09 l 3081(Crookes, 2009).Shehas therefore lowered the standing of nursing in the eyes of the public with that comment.
    Despite her strong confidence in how she presents herself, I felt that in some ways the videoshows a negative impression to the nursing professionand also forwomen.Her role is subjugated to that of other more important professionals and as a women I found that hard to justify.The good thing about this video is that she has mentioned that every patient is not called by the disease name and by the bed number which is true.This has put a publicface to nursing and importantly shown that Registered Nurse plays a very important role to the health service and we play a vital role in providing comfort and dignified care to people like Joe who really need it.
    .

    Evaluation:
    As discussed earlier there are positives and negatives to the picture thatMs.Colorado painted of the nursing profession. The positives regarding how she portrayed nursing was the positive reaction that she managed to get from the audience which shows that the general public respect nursing and value what we do.The negative of the video is the perception of what nurses actually do as to the little value we are given in terms of medication and treatment advice, and the belief that we are lower than other health professionals in terms of our opinions.Her comment that “I am just a nurse” is an unfortunate comment, implying that as nurses we are lower than other health professionals and is very disrespectful to the amount of training that we have to do and fails to recognize the skills that she should have developed in her role.Also if she has no role in the medication of patients why does she go on stage with a stethoscope?The public has a different perceptionof the role and everyday activities of nurses,and shegives a romantic view of nursing of that one patient that changes our lives and gives us greater perspective.She does give a very proud view of her job for the public which the crown clearly responds very positively towards.

    The role of a nurse is a clinician, health care coordinator, patient advocate and comforter.The role of the nurse will continue to become more important into the future as our population ages with more chronic illnesses. The need to continually streamline services for reasons of funding also means that the role of the nurse becomes more complex and diversified. The Institute of Medicine (IOM) released a report in 2010 which recommended that the proportion of nurses who hold a bachelor’s degree be increased from 50% to 80% by 2020 as a reflection of the increasingly complex and difficult nature of the nursing professionCITATION Aik11 l 3081(Aiken, 2011).
    There is a great deal of interest to many in the health care profession to continually improve the quality of the healthcare system and quality nursing is central to the design of better health care for patientsCITATION Smo15 l 3081(Smolowitz, et al., 2015).The improvements in the care of patients involves a deepening of the role of nurses to improve the skills and responsibilities of nurses to make them more comparable to the role of doctors.Predictions for the future number of nurses has shownthat the proportion of registered nurses to other health professionals will increase and thus the responsibilities of nurses will also increase to reflect the lower ratio of other health professionals and the increase in demand as a result of an aging populationCITATION Aue12 l 3081(Auerbach, 2012).

    Critical Analysis
    When analyzing the video of Ms. Colorado as we have discussed in many ways she has downloaded the reality of being a Registered Nurse in favor of a romantic view of a female who holds peoples hand and comforts them but with no real other responsibilities other than this, beyond the feeding and showering. This was possibly a reflection of how short the monologue was as she did not go into a great deal of detail as to what it is like to be a nurse. The great feature of the video is the focus on the importance of maintaining your compassion on the job, and to always remember that your patient is not just a number but is a human with families.
    The other very important aspect of the monologue has been the discussion surrounding the importance in care of the role of nurses who provide 24/7 care to people in need. Criticism of her monologue has followed in the media on the show “The View” in which Ms. Colorado was mocked for wearing a stethoscope whereby the panelist Joy Behar made the typically misinformed comment “why does she have a doctor’s stethoscope on?” CITATION The151 l 3081 (Brown, 2015). She also perpetuated the stereotype discussing her only slight role in the delivery and the changing of medication of patients. Nurses typically spend a third of their day dealing with delivery of medication so are in a primary position to give advice on the effectiveness of the medication intervention. The opening of the discussion regarding the role of nurses is therefore a very important one and will help dispel the myths regarding nurses and hopefully increase the respect that others have for people in my position.
    In the video Joe reminds Ms. Colorado of the human element of nursing and her impact on him as a person. No detail is provided regarding health interventions for Joe including any medication or treatment problems, any necessary actions to alter Joe’s treatment after he complains, and what specific interventions can she provide to improve the care that he was receiving. Instead a very touching emotive story of the role of nurses with such comments as there were plenty of laughs’ and talking about how Joe felt that she was not “just a nurse”, butshe was his nurse’. Little discussion is made as to the workload of nurses and Ms. Colorado implied that when he would wake up she would be at his bedside almost immediately. The reality of nursing is we are constrained by our large workloads and so the delivery of empathy and compassion is inevitably limited by the time we can spend with each patientCITATION Mer02 l 3081(Ball, Murrells, Rafferty, Morrow, & Griffiths, 2013).


    Conclusion
    I have drawn two main conclusions from the above reflection. The first is that there are misunderstandings of the role of nurses in the monitoring and evaluation of health interventions, and the second is that we should never forget the importance of empathy in order to be good nurses that can make a difference to the lives of patients. The first is that in the public’s eye, there is some confusion as to the role that nurses play in the administration and monitoring of the medical needs of patients. The second conclusion is that it is important that we never forget the importance of caring for patients in a manner that can genuinely have some positive impact on the lives of patients, their families and our own lives. To become great nurses we should never forget that we play a major role in the lives of people, often shortly before they pass away.
    It is clear from the comments on the view and the discussion of nursing and the role of nursing as a result of the monologue from Ms. Colorado that more needs to be done to lift up the role of nurses in our society and to ensure that the profession achieves the respect that it deserves. Many people may feel that the role of nurses is lower than that of doctors and other health professionals, and that nurses simply have a role in listening to doctors in a passive manner and simply following instructions.
    Action Plan
    From the conclusions above I think it is important that we educate patients and families as to our roles in the health service. As discussed there is some confusion as to the role that nurses play in the administration and monitoring of the medical needs of patients. In the future I will ensure that I talk to patients and families about what I do and how I will care for them while they are in hospital and it is also important to continually communicate with their families and loved ones. Many people may feel that the role of nurses is lower than that of doctors and other health professionals and that nurses simply have a role in listening to doctors in a passive manner and simply following instructions. On a personal level, it is important to continually educate myself as to improve my job performance as it is clear that my responsibilities will continually evolve and become more complex and more diagnostic.

    Secondly I think it is important for us as nurses to continue to communicate with patients and try to make a difference in their lives. From the video we can see the importance that Joe places in Ms. Colorado as his nurse and that she has genuinely made a difference to his life.
    .


    References
    BIBLIOGRAPHYAiken, L. (2011, January 20). Nurses for the future.New England Journal of Medicine, 364, 196-198. doi:10.1056/NEJMp1011639
    Auerbach, D. (2012). Will the NP Workforce Grow in the Future?: New Forecasts and Implications for Healthcare Delivery.Medical Care, 50(7), 606-610. doi:10.1097/MLR.0b013e318249d6e7
    Ball, J., Murrells, T., Rafferty, A. M., Morrow, E., & Griffiths, P. (2013). ‘Care left undone’ during nursing shifts: associations with workload and perceived quality of care.British Medical Journal, online. doi:10.1136/bmjqs-2012-001767
    Briggs, J. (2012). Using reflective practice in frontline nursing.Nursing Times, 108(24), 22-24.

    Brown, T. (2015, September 18). Miss Colorado Started a Needed Conversation About Nurses.Time, p. online.

    Crookes, P. (2009). What is the role of the Registered Nurse?Collegian, 16(2), 47-48. doi:dx.doi.org/10.1016/j.colegn.2009.04.002
    Epstein, R., & Street, R. (2011). The Values and Value of Patient-Centered Care.Annals of Family Medicine, 9(2), 100-103. doi:0.1370/afm.1239
    Jayatilleke, N., & Mackie, A. (2012, October 17). Reflection as part of continuous professional development for public health professionals: a literature review.Oxford Journal of Public Health, 1-5. doi:10.1093/pubmed/fds083
    Ke, M., Blazeby, J., Strong, S., Carroll, F., Ness, A., & Hollingworth, W. (2013). Are multidisciplinary teams in secondary care cost-effective? A systematic review of the literature.Cost Effective Resource Allocation, 11(7), online. doi:10.1186/1478-7547-11-7
    Smolowitz, J., Speakman, E., Wojnar, D., Whelen, E.-M., Ulrich, S., Hayes, C., & Wood, L. (2015). Role of the registered nurse in primary health care: Meeting health care needs in the 21st century.Nursing Outlook, 63, 130-136.

    Sommerville, D., & Keeling, J. (2004). A practical approach to promote reflective practice within nursing.Nursing Times, 100(12), 42-45.

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