Nursing, ethics and sociology

Nursing, ethics and sociologyIntroductionIn this essay, I leave alone discuss several issues that seem to check nursing fare with questions of ethics, sociology and focal point. reflective employment is an important aspect of nursing management and in this essay we discuss implications of discrimination in nursing manage and examine the grandeur of anti- jaundiced perspectives in nursing. In this radical, the case study I will elaborate is of an elderly woman who was of a non-British ethnic origin and rundle little English. A junior nurse visited her home to provide disquiet but her attitude towards the patient has been discriminatory and abrupt, a item that c wholes for serious rumination on the issues of racial discrimination at the clinical setting. The patient was apparently treated with leg ulcer. The questions that pee-pee to be considered here areWhere in the observation did discrimination occur and how this could have affected the delivery of care given? And how has discrimination influenced the ladys care?The concept of anti-discriminatory practice as a contemporary issue within adult nursing is discussed here considering observational evidence and similar case studies. reflectiveness in Nursing pensive practice in nursing is guided by models of reflection. Reflective practice model serves as a framework within which nursing or opposite management professions can work. Reflective practice model is also a structural framework or nurture model that serves the purposes of a profession and is particularly relevant to health related professions. Any portfolio of practice includes a model of reflection as reflection helps in determining what was positive or negative or a information puzzle within the profession. Reflective practice highschoollights the importance of learning from experiences after thinking about it and relates the practical experiences to the theoretical learning approaches. The iv important reflective models that for m part of the clinical and nursing portfolio areGibbs feigning of Reflection 1988Kolbs Learning Cycle 1984Johns Model of Reflection 1994Atkin and Murphys Model of Reflection 1994Theoretical FrameworkGibbs Model of reflection is shown in a cyclical manner and is represented a followsGibbs model of reflection (1988)Given by Gibbs, 1988. root CPSU, 2005Unlike Gibbs model that has five stages, Kolbs Learning cycle with iv stages is shown as followsSource CPSU, 2005In the Gibbs model, the event is reflected upon and includes a description of what happened followed by feelings about the situation, and reflection on what the thoughts and feelings were at that time upon being into the situation. The nursing professional then personally measure outs whether the experience has been intelligent or bad for her and analyses whether she can make any sense to the situation. The conclusions are drawn depending on alternative and what else could have been done with the situation and what we re the other options available to face the situation better or more appropriately. Proposed and prospective action plan is thought of and how the situation will be acted upon in the next is also determined. Kolbs model however stresses on the importance of generalizations of concrete experiences testing the implications in similar situations.Whereas Johns model of reflection emphasizes on the stages of description of the event, reflection on what was aimed at, the factors influencing strategies, alternative strategies to what have been used, and learning from the experience, Atkins and Murphys model of reflection is on analysis and identification of the learning experience and action planned based on awareness and evaluation of this relevance of knowledge. Considering these models of reflection, we will use only the more popular Gibbs model to evaluate the case study discussed here and the situation of discrimination against the elderly lady Mrs. B as observed.Background and Lite rature SurveyThe importance of reflection as part of the learning experience and using reflection as a means of improving ones professional skills and future performance by evaluating the situation and the mistakes has been emphasized in many professions including teaching and nursing. In the Kolb cycle, reflective observation is the second phase. Reflection in action or while doing something in the job and reflection on action or some form of evaluation after the job is done, are included within reflective practice. Reflection includes several phases from simple problem solving of individual cases, to analysis of the situation considering relevant literature as well as broader social and political factors.Gustaffsson and Fagerberg (2004) emphasizes on the advantages that could be gained from reflection mainly among registered nurses or RNs. They examine the questions on the implications of nurses reflections, the subject matter of their reflection and how they are able to deal with their reflection and how they improve their professional approach through reflection. The authors get wind the experiences of the nurses and their reflection in relation to the nursing situations to understand how the nurses use reflection in their daily work. The study included interviewing four registered trained nurses and the qualitative differences of the nurses reflective experiences were categorized. One of these is the category of reflection itself but the ethical considerations within the nursing care situation and consequence of facing the situation or meeting the requirements of empathy or professional development are also important. The nurse attitudes and opinions on their reflective practice, what they thought about the situation and how they feel they will control similar future situations serves a model of future professional development. Gustaffson and Fagerberg point out that reflective practice has relevance for clinical practice as by understanding the contents of nurses reflections, it is also possible to understand the advantages of reflective practice and how and when such measures should be used by the nurses for further professional development. Fairley (2005) gives a consultant nurse perspective of a clinical role in critical care unit that has evolved as a central feature of all surgical high dependency units (SDHU) in large teaching hospital trusts. Advanced nursing practice is perceived not as the acquisition and exercise of technical procedures which are usually undertaken by doctors, but also an integration of medicine and nursing where holistic nursing assessment and symptom focused natural examination go hand in hand. Fairley presents a reflective account of practical problems encountered relating to role integration, professional autonomy, legal and consent issues, non-medical prescribing, and role evaluation (Fairley, 2005). The paper successfully describes a model of nursing applied to high dependency units integrating t he role of the advanced nurse practitioner within the medical and clinical team an reflective practice plays an important role by being the main method of evaluation of a consultant nurse perspective.In a study on the importance of reflective practice in family care, Peden-McAlpine (2005) discusses the design, evaluation and outcomes of a reflective practice intervention (RPI) that was used to train critical care nurses on how to incorporate family intervention into their nursing practice. The benefits and problems of reflective practice are many and most beneficial aspects include improvement of professionalism and better ability to tackle similar situations leading to professional development through experience in nursing. Reflective practice is of experiential nature, it relates to a nurses experience and learning from the experience. In the study discussed by Peden-McAlpine, interviews were conducted with eight staff nurse participants after the training of RPI to determine chan ges in family practice when reflective practice was used. Three inwrought themes were identified on analysis of the interview texts and the authors have given the three themes relating to experiences in nursing after participating in the RPI program as follows (1) acknowledging, re-framing conceptualise ideas about families, (2) recognizing meaning of family stress, and (3) incorporating family into nursing care (Peden-McAlpine et al, 2005). The reflective practice intervention program practices by nurses helped them to change their attitudes towards critical care especially in family and deepen their communication and ability to build proper relationships with families bringing in a raw way of understanding family stress or appreciating family values. The nurses thus had a new perspective of family system after their training of reflective practice on family critical care.Considering the benefits of changing nursing attitudes and developing professionalism through reflective pr actice, many authors have emphasized the need to use reflective practice as a training method within nursing procreation. Chabeli and Muller (2004) use a qualitative contextual and exploratory descriptive design for theory generation that was used to develop model facilitating reflective thing in clinical nursing education. The authors cited Wilson (1963 and natural endowment (1997) who provided a theoretical framework for a concept analysis of reflective thinking in nursing education. The paper also gives the case o 12 nurse educators who participated in a focus group interview on how reflective practice can be facilitated in clinical nursing education and the consensus was for a classification of reflective practice recognizing the main elements of practice and a deductive analysis and synthesis after conceptualization of each main concept. The importance of a conceptual meaning has been highlighted as theories with well-defined concepts and elements could facilitate reflective practice and can form an important part of clinical nursing education. Guidelines could be developed according to the theoretical framework of reflective practice and can give a new direction nursing education. In a afterward study, Chabeli and Muller also provided a model of reflective practice that could be used as a theoretical framework in nursing education. However, the authors kick up that Reflective thinking has become a popular word in nursing education world wide, but its meaning and effective use the Great Compromiser debatable because of lack of clarity in its meaning (Mackintosh, 1998553 cited in Chabeli and Muller, 2004).Case studyThe case of our elderly patient Mrs. B suggest that the nurses discrimination and ill demeanour against the woman, relates to discriminatory practice, something that could be and should be stopped using reflective practice (also see Sheffield et al, 1999). The junior nurse in direct who was responsible for such an incident was given refle ctive practice as a framework for professional development. She was recommended to go through the Gibbs model of reflection in which she analyzed how and why she behaved the way she did, what she will do in future situations and how she learnt from the experience to not repeat her discriminatory behavior in the future. The implications are that the behavior of the nurse has led to poor quality of care delivery to the patient.The junior nurse who treated Mrs. B badly was recommended to go through reflective practice intervention to change her attitudes towards other races and ethnic minorities. According she participated in reflective practice sessions when she verbally as well as in writing had to describe the events in which she engaged in discriminatory practice and also evaluated her responses and indicated her future course of action and other alternatives for similar situations.ConclusionIn this essay I discussed the implications of reflective practice in nursing considering th e theoretical frameworks of reflective practice. All the main models of reflective practice have been discussed and the models were used to consider a discriminatory case of an elderly patient who was wronged by a junior nurse. The patient was being treated for leg ulcer and was reportedly badly and disrespectfully treated by the nurse. The nurse was asked to go through reflective practice and mainly using Gibbs model of reflection, had to complete an exercise in which she described the event, indicated her feelings of the event, evaluated whether it was a good or bad experience, analyzed her own response to the situation, concluded what else she could have done for the situation and finally drew up an action plan for future similar circumstances.BibliographyAtkins, S. and Murphy, K. (1994) Reflective Practice. Nursing Standard 8(39) 49-56Gibbs, G. (1988) Learning by Doing A guide to teaching and learning methods. Further Education Unit, Oxford Brookes University, OxfordJohns, C. an d Graham, J. (1996) Using a Reflective Model of Nursing and Guided Reflection. Nursing Standard 11 (2) 34-38Haddock, J. and Bassett, C. (1997) Nurses Perceptions of Reflective Practice Nursing Standard 11(32) 39-41Kolb, D.A. 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