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1. Background of reflective study.

Month to month, year by year, times is still moving on without stop, after moving along
of student life, I would like to reflect on an incident, which gave me a lot of lesson. This
particular incident happened to me when I was in semester 5 at 2009 where I was posted at
Ampang Hospital, Kuala Lumpur. I felt so glad to be posted here where I could gain more
crosses and experiences during my placement in such challenging working place. For this
semester, we have been told to get fully the crosses in previous semester which we did not get
yet. And this semester we all about case study, for two weeks I was allocated in Day Care Unit
and on the third week at O&G ward. The day care unit that unit was very busy and every day we
had to do blood transfusion, bone marrow, lumbar puncture. It was a time I think was
challenging and made me physically and mentally tired but it was worthwhile for me. I was
trying to adapt the environment around as well as all the staff in the ward and sometimes I could
not manage to participate in the ward management because it was like something new form to
work in the busy unit.

2. Describe exactly what occurred

I was second semester being student nurse in second year in 2009 where I posted at
Ampang hospital. Before that I just know that hospital from my friend who has experience
posted there before that for clinical practice. I very excited to posted there for my clinical
practice because that hospital were very busy and I will have chance to do many procedure that I
learnt at college before came to clinical practice. I also have a chance to full fill all my crosses
for this semester and previous semester that I didn’t complete. I also excited to post there
because I heard from some friend, student will be sent at Day Care unit for clinical practice. At
there we will chance to handle blood transfusion and the other procedure at there. Actually I
don’t have chance to get blood transfusion before that at previous hospital at Putrajaya hospital. I
very hopefully to be professional at post area.

First day at there we were oriented by clinical instructor at there. They responsible to
arranges us to group and arranges the duty at which ward or unit. I’m so lucky because for the
first week I will duty at Day care unit. I’m so glad because what I hope becomes reality. Before
start my duty for second day. I prepared myself with all knowledge especially about blood
transfusion. I want I did very well without mistake and all staff nurse and CI trusted me.

Second day at that hospital and first day I entered that unit I felt so nervous and confident
because I already prepared myself. Usually that unit start operated at 0800. I come that hospital
so early about 0645, so I get my breakfast and remember what I already read about a few
procedures. I enter that unit with my 5 friend and we go to nurse nurses counter. We wish to all
staff and introduce us and what aim to come there. I so happy because all of staff gives a good
feedback to us. We start very well with help staff nurse prepared all equipment to blood

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transfusion. Staff nurse inform to us that day will receive many patient to do blood transfusion
and she like to teach us and give chance to us to handle it.

I observe staff nurse handle the blood transfusion very well because I don’t want any
mistake when I do this procedure. I can understand all step and how to fill the form of blood.
Staff nurse supervise me to do that procedure, she also advise me to monitor the vital sign every
time. I do that procedure is well. Staff nurse became trust to me. I also do the same procedures
about three times at the same time. I do that very well. I also done get that crosses that day with
supervise by my clinical instructor. I’m so glad and thank to all staff nurse and my entire friend.

For my third day at 17 December 2010. my aim is to done my crosses to assisting doctor
for bone marrow aspiration. I had done my crosses when I do least than 3 times. So many
patients do those procedures at the day. Staff nurse also inform to us last day, that day that unit
will receive many patient to do bone marrow aspiration. I have done my crosses that procedure
than I give chance to my friend to assisting doctor. That day also receive many patient do the
blood transfusion. I inform staff nurse to do it. I will take care three patients in same time to do
blood transfusion. I start those procedures very well without any mistake both of them. I just to
monitor vital sign and assess the condition of patient. Suddenly, sister of this unit entered that
unit and came to me and ask me about the procedures. She forgot to monitor vital sign of one
patient. She so angry and shout me. She tell all complication if didn’t monitor the vital sign.

She also angry to me because handle three patient at the same time. She told my CI to
decross me for this procedures. I’m so scared and start blame myself on my mistake I do. All
staff nurse became didn’t trust me again and I can’t thing everything. I don’t know how to
change that situation.

3. Describe how you felt about what occurred.

Being in such situation make me want to blame myself and very stress for that. My mind
became can’t think properly. I felt as through the whole had turned is back to me. I was very
disappointed of calling myself a future staff nurse where I am not fit to be this career after
enrolling myself in an incident. I never knew it will happen to me and of course I didn’t want it
occurred. I was in shocked when suddenly the sister came to me and approached me that way.
How I felt those times was numb, speechless, blank and ashamed with mistake because thinking
I was done these procedures several time without any mistake. I felt very guilty and can’t stop
from thinking it every time. I was confessed that I should be blamed and I was so stressful for all
my own negligence and careless. This bad incident has been haunting me but I will take it as
greet lesson in the future.

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4. Analyze the situation by asking why it occurred.

As my negligence for this situation, my reflected on how or why it been happen. First
thing, I’m so over confident for what I done before that. So I think I can’t do again very well
without think I will do any mistake and careless. My action was useless for not obey the
guidelines of how to take care of patient. It was also worst because I never think that incident can
happen.

It was also I never think my ability as student and not enough experience to handle many
patient in same time and I will careless. Then, I also careless to assess all patients that I taking
care every time. I must think that is a very important to diagnose any complication early. My
mistake is look easily for that and didn’t think that complication to the patient.

My mistake for careless then was also out of rules, which obey every time. I want to do
this any procedures furthermore. I just take of granted of what I suppose to do what complication
I may get later. The small experience I got in the clinical practice area was still enough to
summarize that I was not already perfect yet. I must learnt more and do this for lesson for future.

5. Explain how you feel the situation have been improved

In my point of view, this incident can be prevented by continuously and repeated again
when I come to be a staff nurse at any hospital. It was prevent from any complication to patient
at my future. I was should improved my skill and be careful from do any careless.

For any opinion for my mistake, what I suppose to do is improve my skill and don’t give
up to do this procedures repeated. I must think the vital sign is very important because it will
help to diagnose any complication early during blood transfusion. I was supposed to monitor vita
sign assess the patient every time and never forgot it.

I can’t throw this mistake and this lesson to me to improve my clinical practice skill. I
remember that until I become staff nurse to prevent do a same mistake again. I very thank to the
sister because scold me.

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6. Outline what you could change In the future.

In my future, I want to be a professional staff nurse and give quality care for all patients I
will treat. The experience at the Day Care Unit is didn’t enough to me but what have been
happen I can’t forget and that make me wake up from my mistake. To be a professional staff
nurse I must professional about all procedures and look easy for simple procedures. I will
prepare myself better than now.

In my opinion, I should improve my skill and nursing care. I also must prepare myself
before go to clinical practice area. For the main point, I must improve myself in theory and
clinical practice. I also should update my knowledge and update my clinical practice skill before
to be a real staff nurse.

I also should update my knowledge and my clinical practice skill before treat any patient.
That very important to prevent any mistake and negligence will occurred. I should treat any
person sincerely and don’t hurt them.

7. Description of what I have learnt from the experience

Through this incident, I understand that I have learned a lot. I have learnt to be
responsibility on taking care of someone who has no blood relationship with me. I also
understood that we must not take advantage on patients seeking for treatment such as using them
as a model to improve our clinical practice skill and communication skill. After going through
the bad experience, it is always kept in my mind that nursing career is a profession that deals
with life and death. Moreover, aware that I have to obtain more knowledge and gather an
experience to build up my confident in action and clinical practice skill (burned 2002). As a step
to improve, I have to practice more on what I weakness in care of the patient and reflect it every
time when start the any procedure and responsible. I learnt from my negligence from avoid
repeated again the mistake.

I also realized that nowadays staff nurse would help to observe student do the procedure
and make sure student done everything from avoid patient get any complication. I would think
that simple procedures like vital sign is important too, it can help to prevent any complication to
patient. We don’t see easy the vital sign when blood transfusion in progress not important. It so
important while not blood transfusion only.

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8. Describe the theory and research knowledge you apply to situation.

9. Choose issues to discuss with your supervisor (CI/LP)

They are few issues that I have discussed with my CI and they are:

 The purpose of this reflective study especially on guidelines of the study and a bit of
description/example.
 Decision making bout what is the most idea/suitable topic I should reflect of and how
to recall it.
 Some detail of “care about the patients” which I should emphasize more
responsibility about patient.
 Discussion of structuring the essay and correction of the any mistake of my essay like
grammar.
 Sharing some of good idea in this reflective study and exchanging the point of view
with other college.

10. Write you have discussed with your supervisor (CI/LP) and any conclusion/action and drawn
from the discussion.

The purpose of this study especially on guidelines of the study and a bit of description/example:

 Clinical instructor explained me on how to do reflective study and the purpose of


study.
 Clinical instructor told me to write an essay regarding to the guidelines given.
 Clinical instructor showed me a some example to do reflective study.
 Clinical instructor explained me how do I apply the theory related to my case and
searched for the best one to put on here.

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Decision making about what is the most ideal topic I should reflect of and how to do recall it.

 I have shown to clinical instructor the cases of reflective study to be choose.


o Wound dressing
o Medication error
o blood transfusion
 We have discussed about what is the most ideal topic I should take and eventually we
decided to choose “blood transfusion”.
 I then explained to CI about the incident and start recall the past incident.

Some details of “blood transfusion” which I should emphasize more clearly for this study are:

 information about blood transfusion


 obtaining the issues regarding blood transfusion
 Searched the theory related to blood transfusion.
 Shared some experience from staff nurses and the other nursing student about the
common mistake of doing blood transfusion.

Discussion of structuring the essay correction of the error (E.g.: grammar)

 I have written draft of my reflective study to CI and some of it got a miss-spelling and
a little bit mistaken in grammar.
 The outline was arranged accordingly as exactly the same in guidelines given.
 The format of reflective study using the A4 size paper, single spacing using Times
New Roman font. American Psychological Association (APA) format for
bibliography.

Sharing some good idea in this reflective study and exchanging the point of view with other
colleges:

 The sharing session carried out in order to again some good idea to form an
interesting and effective reflective study.
 Sharing between clinical instructor and students every time during a meeting or any
discussion.
 I had combined the selected idea and start structure my framework of my case.

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Conclusion

In conclusion, I realized that once a person had chosen nursing as a profession, they
should commit themselves fully as a pledge nurse no merely the implication of responsibility.
My reflection skills have developed through the production of this essay. Using a model of
reflection has helped me to structure my thoughts and feeling appropriately. My level of
awareness concerning enhanced with the use of critical reflection. My competence within this
clinical skill has been further development is progressing. Using this reflective model also has
helped me to realize that my learning is something which I must be pro-active in.

Furthermore, as a student nurse, I have recognized that reflection plays an important role
as a learning tool in practice. The bad experience I got in semester 6 had guided me well
throughout my pathway as a lesson. I hope this incident will turn me into a great nurse just like
Florence Nigthtingale in the future.

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