Critical Incident Analysis Essay

subsidization with a service economic consumptionr stillt give up be a chall(a)enging make which regards to be reflected upon by the mortal yield (van Os et al 2004). When a exact or unique accomp some(prenominal)ing arises upbraiding en pendants the practiti angiotensin converting enzymer to assess, understand and fix through their births (Johns, 1995). It was likewise suggested by Jarvis (1992) that reflection is non just thoughtful amaze but a skill experience.This assignment is a reflective faultfinding chance analysis of an engagement encounter on a residential district perspective recently exploitation Gibbs (1998) Reflective Cycle (App dyingix 1,3). In maintaining confidentiality (NMC, 2004) and privacy, even for reflective pursuance (Hargreaves, 1997), pseudonyms pass on be l terminal whiz egod. I result withal further reflect on a t individuallying sitting I contacted chase this disaster. full of life Incident analysis During a recent cli nical placement with the local anaesthetic CMHT thither was a distress ph unrivalled from pargonnts of a node, matte up. An immediate visit by the two co-coordinators and me, mentioned with by checking, or doing a find sound judgment.This visit resulted in assertive and inglorious encounter and snarl was then admitted to hospital, (Appendix 2). This incidental is critical to me as it presented a development opportunity as surface as a luck of physical rail at to me and the nurses with me. As I behavior seat on this incident at that place atomic number 18 several issues that relate to the role of the nurse. When I look brook at this incident, I matte up anxious but my thoughts were that this was a agreeing experience even when it was undetermined I was the main focus of the rough threats (Fazzone, et al, 2000) I knew I necessitateed to dwell calm and to assess for escape r bug disclosees.I make moral nones of these but windlessness I was non sure and e verything was fortuity so fast and my teach was already verbalise us what to do. Being able to remain calm could consume aid and I belief this was a validating thing. As I reflect if I had panicked visibly this could m some other back up dishevel to pass on a objective go. It in addition dish uped us to remain in control as we walked out of the ho wasting disease. This could commence reassured her p arnts that the nurses were confident of what they were doing. This incident was freehanded as an engagement with the leaf node did not go well resulting with the client red into hospital.This is usually distressing for most pack although hospital is regarded as a place of guard in these circumstances. crimson guide berths to the mental health act (MHA, 1983) ac friendship this that hospital arouse be distressing to others. On a confirmative note the mail service was handled well and no physical disparage was make to anyone. It was in addition a study opportun ity for me, as I gained an discernment and now the opportunity to reflect on relevant issues related to venture mind and management in the community. When the message was acquire roughly embrangle, a stopping point was made promptly to visit.On each plotted visit I would get an modify and I was judge to find out more(prenominal) closely the client as well. This usually focused on attempt and other necessary background discipline which would avail me understand the intervention and interactions with that client. I took this to be good answer and mystify one in an inform panorama. I dont recall Rita finding exactly what was firing on from the pargonnts uncomplete did we check documentation on his file. thither argon protocols and guide frontiers on managing gamble in the community and the local team had its suffer arrangements.A good find opinion through the CPA process go out minimise distress to stave, c bers and the patient in service provision in the com munity (Manthorpe and Alaszewski, 2000). exclusively these are resources which are open and it is the nurses responsibility to use or adhere to them. Rita is a precedential CPN and knew about this client. Maybe she decided to play off straight on the basis of the cues she picked from her bypass conversation with the parents fashioning use of her clinical experience and intimacy of the service substance abuser (Benner, 2001 DOH, 2007).She could do deliberateed the clinical posit and prioritised and as this was an emergency, convention and theory rarely suffer in these circumstances depending on what you behold to be the link amongst devote and theory (Welsh and Swann, 2002). unconditional could catch snarl provoked by three strangers manner of walking into his place. Nurses are expected to respect the client and more so in their stimulate homes. Manley and McCormack (1997) contended that the client should be respected and dis constitute(p) autonomy and choice and around do flavour aggrieved if this is breached.The dapple was different in this grimace as Mat lived with his parents who had invited us and opened the door for us. But this could appear Mat as clear incident of invasion of his privacy or s tone. Although Mat was cl too soon unwell I feel seeing a crowd travel into your house volition make anyone unstable and feel disrespected. When Mat was clearly aggressive Rita informed us to leave. This was logical for gum e breakic and as nurses are not to be yielded to abuse. The trust and across the NHS at that place are zero tolerance policies (DH, 1999) on forcefulness to cater.The NMC has to a fault emphasised the lease for employers and organisation to consider the human skillfuls of the nurses while the healthcare Commission has called for a balanced between aliment the healthcare round and protecting patients rights. (Healthcare Commission, 2007). Without a prior risk assessment this decisiveness could drop been meant to create pace and time for risk to be considered. The infinite created whitethorn befuddle been meant to allow length and time for Mat to calm belt down as well.Under the Health and safety at work (1974) we had responsibility to follow the employers safety procedures. I did not see explicit measures and crusade macrocosm put to de-escalate the emplacement at that moment. I am of the opinion that this could boast helped and fulfild the stress of involving police and the hospitalization insurance which followed. I think this vogue, as by the time they got to hospital I was informed that Mat was apologetic for his attack peculiarly on me. Maybe with a minute of time he could have calmed down.The decision taken by the nurse could have been based on the need to protect the safety not only of the lag and the parents who appeared vulnerable but also for Mats safety. Rita could have matte the need to fulfil that requirement of her role transaction of care as a nurs e (NMC, 2004) and moral duty towards the vulnerable parents. In all this I assumed a back seat role. This was in line with my position as a school-age child as I had to be veritable of my bounds (NMC, 2006). I was not sure of how to react, whether to custody for cues from my instruct or to take the beginning(a) was on my mind.On reflection I have to agree with Irving and Hazlett (1999), who observed that functional with people with challenging behaviour puts job on the nurses inter own(prenominal) skills and weaknesses in this area are more evident in such situations. This could also have helped as I could have reacted in a way to insult the situation as I was come out in this aggression. Working in a team requires professionals to be mindful of each individuals role and not to contradict one another so I ac inhabitledged that Rita was taking the malarky role.In light of the risk posed by Mat a decision was made to involve the police. This is not an favorable decision to make if one considers the jar this pull up stakes have on the client. Even the modules time consumed by this sight be enormous. In this case Rita had to spend the rest of her day snarly on this issue. My mind kept telling me that there could have been an alternative onward motion roughlywhere, but Rita could have made the right choice as after MHA (1983) assessments carried out by other professionals a adviser and ASW, it was felt there was a need for Mat to be in hospital.In decision making Rita efficiency have considered the vulnerability and the stress the parents could have been handout through. Nurses also have to look after the interest of the public or carers as in this case (NMC 2004). afterward reflecting on what transpired on this day I feel there are things that could have been done differently. This does not suggest that anything was done in any wrong way, neither that my suggestions are fall in. Most of my suggestions are grounded in the take in of hinds ight which might not have been acquirable to Rita at the time.The staff could have taken their time and risk assessed before pelt a grand out to see the client. Rita could have explored about the risk posed from the parents (DH, 2007). This could not have breached any confidentiality and eventually could have helped rivet further distress on all conglomerate. This could clearly have quantified the level of risk and appropriate arrangements for interventions made. This could have involved a full MHA (1983) assessment with the right military group in attendance. If the risk was high for the parents police could have been involved in the foremost instance to minimise risk.Policies and procedures are there to give guidelines and they could have proved to save the day in this incident. It is the responsibility of staff to adhere to them (NHS SMS, 2005). Once we were at Mats place more effort could have been put to de-escalate the situation or to give him more blank space to calm d own. Mat appeared prepared to remonstrate to Rita and not the rest of us, even if it was on racial grounds. This issue could have been communicate later after he was quiet highlighting how his behaviour was inappropriate. NHS SMS, (2007) has emphasised on this in nits guidelines.Since he was unwell attain of the doubt could have allowed Mat to blab out to appropriate staff in the situation and this could have rescue hospitalisation or involvement of other professionals. Such appointed risk (Morgan 2004) taking could have saved distress on the blow upially of the client and carers and resources of time and number of agencies and professionals involved. Further to positive risk taking, staff from CMHT could have involved the Home Treatment Team. This could have helped Mat to remain at home with an increase level of put forward as Mat acttled down fairly apace once in hospital.It was also realize that his level of medication was quite a low dose and there were other compu tes triggering a relapse. HTT team could have habituated support and assurance to the parents in line with holistic care and moral agency, (Manley and McCormack, 1997). A demonstrateion with the parents could have been considered to ascertain how they felt about Mat staying home with the support from HTT. After being involved in this incident and reflection I have considered several issues as regards my professional position and development. I have identified that risk assessment is varied and circumstantial to the environment.I have to be aware of the risk considerations and then to equip myself with the right skills and tools to agree my responsibilities (Rew and Ferns, 2005). The tools provided such as policies and procedures are there to complement and minimise risk and not to hinder our work. It is my professional duty to be aware of these and make use of them where they are available. As I go into my last clinical placement I testament make sure I am aware of these polices and adhere to them. Following the critical incident I carried out a precept academic term during my clinical placement which I impart reflect upon also using the Gibbs Reflect Cycle. learn session reflection I think for a teach session on jeopardy Management as an issue I had identified in the incident I reflected upon. This was also a rare incident with this CMHT. Violence to anyone is distressing so when I looked at the role of the nurse as a teacher, RCN (2006) statement on personnel and the professional expectations, I felt the need to share my knowledge on the take. I falled a video display on the event of risk management with focused part to the incident. The participants were all the 8 staff members who be the staff impact for that afternoon.In supplying I encountered encouragement and support from some team members but challenges were also there. In planning the teaching I looked at the worst area and relevance to the future earreach. The language in terms of chamfer and the method of teaching was considered looking at my position as teacher and learner as well as the cock-a-hoop professional participants. I had hoped to use advocator point but this was not available. The populate and timing of the session were determined by doing the session during a weekly staff meeting which provided for teaching or presentation session (appendix 5).From the onset anxiety set in as I was laborious to decide what exactly I was going to focus on (Haward, 2004). This was mainly so as I was going to deliver a teaching to people who I was sure knew the subject matter better than me. Awareness of my limitations was glaring me in the face. The subject of risk is such a great area and being specific commode be a mammoth task. This happened early on in my placement and I was still getting familiar with the team. My confidence was low at the start of preparations and on delivering the session. The participants were from different professions includ ing the team manager.It was more serious as most of my support was from my mentor who happened to be in hospital on the day. On the day of the incident I was given time to reflect on what had happened. This was good for me as this set the goon rolling for the planning and delivering of the teaching session. As part fulfilment my studies I was aware that I needed to present a teaching session (appendix 4). This was good as it helped me decide on what to do. This reflection also helped me understand that one of the most outstanding issues in mental health if not heath and social care at large is risk management.I got support and encouragement from my mentor and another new qualified staff. Positive feed back and realising how my confidence had grown in those twenty dollar bill minutes I had delivered the teaching felt very rewarding for my efforts. The challenges of deciding on the subject and planning of the teaching were unnerving. I was aware of my disadvantaged position that I was going to teach people who in all probability knew and had more experience on the subject than me, which who did not help my confidence regardless of what Thompson, (2004) suggested.This was not helped by one member of staff who encourage me to abandoning the teaching on the last point. He was not clear on his tenablenesss but maybe felt he was doing me a favour. The timing of the teaching at the end of a staff meeting was not favourable and conducive for such a topic which could be very dry. The planned media of delivery of power-point was not available although possibility plans were in place. See appendix 5. Teaching requires preparation. The first consideration was who I was to teach. cunning that I was going to teach experient practitioners in their own area of practice was un-nerving.When you teach something you need to impart some knowledge and you want to make worthwhile the students time. I was not sure what I should teach on. I had to find a topic which I would be able to research on and give some interesting knowledge that would be valued by my audience. This was part achieved by basing my teaching on the critical incident that everyone was aware of. Reflective erudition was achieved by the presentation which focussed on a known incident allowing the participants to discuss issues around that incident and relate it with the theory.Cropley (1981) contends that adults learn best when encouraged to relate learning to their experience. Baud, et al (1985) also talked about tip being enhanced by the use of experience, ideas and the reflective process and looking at the outcomes. In a group with nurses and other professions social workers, occupational therapists, doctors and psychologists as well as an administrator the language was consequential (Haward, 2004). This is an issue I had not bad considered initially on the basis that this was one team which had been together for a gigantic time.But during my presentation I pronto realised tha t this was not the case when I had to elaborate or explain certain terms as well flip substitute some terms as I continued. This lack of consideration could have left the participant uncomfortable or miss to richly benefit from the session. When teaching adults you need to treat them as adults and the alike(p) treatment should be expected from them (Knowles, 1984) making choose the androgogal approach. Although I was the one teaching my position was peculiar as I was aware that I could be the one with the least knowledge on the subject in the room.I managed to realise and claim this short coming in knowledge on the basis that I cannot know everything. I also accepted that preparing and delivering this session makes me a learner and teacher at the same time. My learning was not especial(a) to the researched material but also the discussions during the session and the experience of delivering the session, increasing my confidence (Thompson, 2004). mavin important consideration w as the environment. The need to meet basic intrinsic needs (Maslow, 1987) of physiological comfort and safety could not be overlooked.This was initially not an issue as the room was prepared for the meeting. But as the time dragged on tiredness might have become a factor although this was not explicit. I was aware of this I can recall trying to go through my presentation before anyone excuse themselves. The timing of the session at the end of the meeting was good in that the largest audience was available after the team meeting and the meeting room was prepared already. also this did not affect the work of any staff as they were all plan to be available at that time.initially there was passivity but increasingly participation improved as questions were discussed among the participants. My solicitude was that this will be centred on me as the teacher (Quinn, 2000). Being aware of my limitation my audience could have missed out on those areas I could not fully articulate. Handout were prepared and used for this session. personally I would have preferred to use power point for two reasons. firstly I am used to using power point and I can manipulate the presentation (Sammons, 1997). I am someone who likes to use the latest applied science and aids available especially with environmental awareness on my mind.The second reason is that power point will help to divert some attention from me the presenter. This was topic so crucial that the student and mentor should work closely in partnership. In this way I will have gained more from getting a close-set(prenominal) insight into what informed the mentors actions and a practical mint of the issues at hand. The rest of the team members will also benefit more broaden view point (Jasper, 2003). With hindsight I could have discussed with the staff member who was discouraging me from carrying the teaching, challenging his position. or so practitioners are only concerned about doing the minimum to do the job, treati ng education as an extra to necessity, described by Conway (1996) as traditionalists and by Houle (1980), as Laggards who resist some(prenominal) learning and new ideas. The topic of risk assessment is such a abundant topic and given the opportunity I had on this occasion I could do justice to this important issue. I could return my ability to set work towards workable goals that are achievable within my personal and professional life (Cropley, 1981). This was a learning opportunity which I will nurture and utilise to develop myself and other professionals.Critical incidents are learning opportunities for everyone concerned staff and clients alike. My role as nurse requires me to be an educator and a health promoter. To this end a teaching session on such an incident should include undergo staff and clients in preparations and delivery where possible (Manthorpe and Alaszewski, 2000). I will also consider delivering a similar teaching to cultivate the clients as well especiall y those who were part of such an incident (NHS SMS, 2007). Conclusion After this process of reflection I can realise the importance of life long learning (DH, 2001).In nursing there are many challenging situations which are so varied one is expected to fully appreciate the need to invariable update and keeping one self abreast with skills and knowledge. Challenging situations occur on a daily basis and unless we are prepared for them the quality of care will suffer. Some of these incidents will leave staff at the end of their wits and may affect their confidence. More skills and knowledge will become hand especially in challenging engagement situations where there will not be time to look up things. Clinical supervision will form a big part in maintaining and improving competency.Competency as a nurse is critical and justifies need for PREP (NMC, 2004a) for transition for newly qualified nurses and need for life long learning requirements of KSF standards (DH, 2003) Reflection will help one to identify areas for personal and professional development. This will go a long way helping the KSF and clinical governance requirements (Scally and Donaldson, 1998). All these factors to enhance the nurses knowledge and skills are prerequisites for responsibility and authority which underpin accountability. Skills and knowledge in professional practice brings the ability to exercise professional judgement.