Reflection: My Learning Experience

Reflection: My Learning Experience
Description:
John’s model is a structured reflection that helps people learn through reflecting on events (Johns, 1996). This model has guided me to reflect on my experience which has enabled me to be more competent in my practice. During my first day of clinical placement at Extendicare York I experienced a unique event. My teacher, fellow students, and I got the chance to observe a health care aid change a colostomy pouch. I was extremely curious and excited for this new learning opportunity. Before entering the resident’s room I knew a little bit about colostomies. My clinical teacher, Jon Brunetti, attempted to prepare me by providing me with more information about colostomies. This made me feel confident walking into the resident’s room. A study shows that having a good clinical teacher enables students to have positive attitudes and good learning outcomes towards their clinical placement (Campbell, Larrivee, Field, Day, & Reutter, 1994). My clinical teacher further guided us by introducing himself and our class when we entered the resident’s room. He tried to make the resident feel comfortable by talking to her and asking her questions. This approach did not seem to work because of her lack of positive responses. Being the only student prepared with latex gloves I assisted the health care aid with the procedure. I helped by holding the residents legs down thus preventing them from interfering. Then the health care aid removed the used colostomy bag and it caught me off guard. I knew the smell was going to be bad, but I was not ready for it. When I smelt the stench coming from her stoma my face dropped. I acted impulsively. My reaction portrayed similar reactions that students experience during their clinical placements. Research by Cazzell and Rodriguez (2011) states that, “students feel anxiety, loss of control, and reaction under pressure” (p. 711). After my reaction, I quickly realized how my expressions could have affected the resident, so I pulled myself together. While the health care aid finished up the procedure I immediately began to reflect upon my actions.
Reflection:
From my observation, the resident, a 70 year old Caucasian woman, looked sad and lonely. She didn't have any decorations or pictures up on her wall. I perceived her being very uncomfortable with a group of unfamiliar people entering her home; especially with herself being slightly exposed. The resident might have been embarrassed because of her colostomy; she might not have wanted people seeing it. Having a colostomy can change a person’s life dramatically. Living with a colostomy impacts people’s lives due to physical abnormalities, loss of functions, and a change in self-directed care (Carlsson et al., 2010). It is hard for me to reflect on how the resident might have been feeling because I have not been in her situation. As a nursing student with limited experience, I reacted the way most people of my status would. I reacted impulsively. I had very little knowledge about colostomies. My fellow students felt the same way. On the other hand, my clinical teacher and the health care aid acted perfectly to the situation. They have experienced many similar situations to this one, so they knew exactly how to react. This level of care was not challenging for the health care aid. She was prepared and knew exactly what she was doing. As well, I could tell that my teacher has experience in this area of practice due to his professional manner towards the resident. He greeted her friendly and tried to make her feel as comfortable as possible.
Influencing Factors: My personal beliefs influenced how I felt after this situation occurred. I believe in lifting peoples spirits to make them feel more self-confident and happy. How I reacted to this situation did not enforce these feelings. When I approached the resident to hold down her legs I did not even introduce myself. This inconsiderate action has really bothered me. I did not think about the residents feelings. I simply followed instructions from the health care aid. Another influence that contributed to my actions was my empirical knowledge. This contributed to me feeling confident. I felt prepared; yet, I was not. In school, my curriculum is very heavy; I learn a lot of empirical knowledge. Having this knowledge made me feel superior. Although, simply having knowledge did not prepare me for hands on engagement. The article, Adjustment to colostomy: stoma acceptance, stoma care self-efficacy and interpersonal relationships, relates to my experience at my clinical placement. The way I believed the resident felt towards herself was similar to the way people felt in the article. Many people feel socially unaccepted, distressed, and think about committing suicide (Simmons, Smith, Bobb, & Liles, 2007). From my experience, I could tell that the resident was having some of these feelings because she isolated herself from our class. She was very distant and did not want to converse with us. The article states that, “people who receive care from a stoma therapy nurse had substantially better quality of life than those who did not receive such care” (Simmons et al., 2007, p. 628). The article further explains that when providing ostomy care nurses must be knowledge about all aspects of care (Simmons et al., 2007). This really opened up my eyes to the quality of care patients deserve to receive. When looking back on my experience, I only had one perception on care that the resident needed which was medical. I never thought about the other aspects such as prevention and her feelings. This article gave me a new perspective on ostomies and the level of care people need when dealing with them. Another article, Bags and blogs: Creating an ostomy experience for nursing students, reinforces that people have negative reactions when experiencing ostomies. In this article, nursing students participated in an experiment where they wore a fake ostomy bag for 24 hours which contained fake fecal matter. I believe this experiment was a great learning experience for the students that participated as well for people who read upon their experiences. It is hard for people to understand how people living with ostomies feel unless they are put in their situation. That is why when I reflected upon my experience I tried to picture myself in the residents shoes. I tried to look at things from her perspective. In this article that is exactly what these students did. There was one experience that really caught my attention from one of the students. The student explained, “Throughout this whole experience, what interested me the most were the reactions I received from my roommates and friends. Comments like, Ewwww, that is soo nasty, why would you do that to yourself were all I heard” (Reed, 2012, para. 25). These reactions really surprised me because I thought that friends would be accepting. People that have ostomies have to deal with reactions similar to these ones probably all the time. This article supports my reaction that I had to my experience with a colostomy. It further proves that people react negatively towards people living with ostomies. Reflecting on my practice has been a great learning experience for me. Reading the articles has guided me with my reflection process. It has helped me gain insight from others perspectives. By realizing what I have done wrong I have enhanced my learning. This has made me stronger. When I reacted towards the resident I did not use critical thinking. However, reflecting back on what I did shows that I have gained a level of critical thinking. I could further strengthen my learning by practising my communication skills. In the future, before I provide any kind of care to a patient I will introduce myself even if they are unconscious. By practising this act I will make other people feel more comfortable and I will not be jeopardizing my ethical beliefs. Hopefully continuing to practice my skills will help improve my communication as I continue my journey in nursing. Down the road, I will be more prepared when I face scenarios that I have already experienced and reflected on.
References
Campbell, I. E., Larrivee, L., Field, P., Day, R. A., & Reutter, L. (1994). Learning to nurse in the clinical setting. Journal Of Advanced Nursing, 20(6), 1125-1131. doi:10.1046/j.1365-2648.1994.20061125.x Carlsson, E., Gylin, M., Nilsson, L., Svensson, K., Alverslid, I., & Persson, E. (2010). Positive and negative aspects of colostomy irrigation: a patient and WOC nurse perspective. Journal Of Wound, Ostomy & Continence Nursing, 37(5), 511-518. doi:10.1097/WON.0b013e3181edaf84 Cazzell, M., & Rodriquez, A. (2011). Qualitative analysis of student beliefs and attitudes after an objective structured clinical evaluation: implications for affective domain learning in undergraduate nursing education. Journal Of Nursing Education, 50(12), 711-4. doi:http://dx.doi.org/10.3928.01484834-20111017-04 Johns, C. (1996). Visualizing and realizing caring in practice through guided reflection. Journal Of Advanced Nursing, 24(6), 1135-1143. doi:10.1111/j.13652648.1996.tb01018.x Reed, K. (2012). Bags and blogs: creating an ostomy experience for nursing students. Rehabilitation Nursing, 37(2), 62-65. doi:10.1002/RNJ.00011 Simmons, K., Smith, J., Bobb, K., & Liles, L. (2007). Adjustment to colostomy: stoma acceptance, stoma care self-efficacy and interpersonal relationships. Journal Of Advanced Nursing, 60(6), 627-635. doi:10.1111/j.1365_2648.2007.04446.x