School of Health and Life Sciences

Summative Assessment Title Page Template

Section 1: To be completed by the Module Co-ordinator prior to issuing to students

Module Code NURS09226
Module Title The Principles of Quality Healthcare Practice
Assessment title Reflective Portfolio
Assessment wordage (if applicable) 1500 words
Submission deadline (Date and Time)* Date: Thursday 16 February
th

*The assessment must be submitted prior to Time: 12PM midday

this deadline to avoid penalty

Section 2: To be completed by the student prior to submitting assessment

Word count 1599
Originality Score (for final version of
assignments submitted via Turnitin)
Banner ID number B00517289
(this is an 8 digit number, preceded by the
letter ‘B’, e.g. B00123456)
Have you been granted a formal extension? No

Section 3: To be completed by the student prior to submitting assessment

Is this a resubmission? YES
How have you used previous assessment
feedback to help develop this assignment?
What 3 specific issues would you like 1.
assessment feedback on from this 2.
assignment? 3.
Introduction 

As per Fukada et al. (2018), reflection in nursing is the method that helps to analyse
an individual’s actions and experiences to improve their nursing practice. Reflection
aims to improve patient outcomes and increase skills, knowledge, and understanding
of the nursing practice. The presented reflective portfolio is based on my two
different experiences delivering patient care. The first reflection is based on my
placement experience in which patient-centred care was given and the second
reflective account is based on my placement experience in which the requirements
of a vulnerable person was stimulated in a healthcare setting. To reflect on my
experience and draw a more accurate conclusion, I will use Gibbs's reflective cycle.
As recommended by the NMC (2018), I will protect the patient’s right to
confidentiality by using pseudonyms in my reflective reports.

Reflection-1 
Description

This reflection is about my experience with a patient of 80 years old Mrs. Eva, who
lives with his husband, admitted due to lung cancer to the acute medical unit by A&E
(Accident and Emergency Department). She had a history of smoking, heart disease,
and lung disease and presented with the symptoms of fatigue, cough, and chest
pain. Routine observation of Mrs. Eva typically involved monitoring her vital signs
such as blood pressure, heart rate, temperature, breathing rates; respiratory status,
and lung sound. I noted that she was confused and disoriented, and appeared to be
in a tremendous pain. Therefore, I decided to inform the multi-disciplinary team
(MDT) to employ a person-centred approach to care for this patient because I
thought it would be the best method to meet their unique needs and provide them
with the support they required. MDT encompassed a pain management team,
doctors, palliative specialists, consultants, and intensive care unit nurses (Rodrigues
Martins et al., 2022). I believe that MDT makes a substantial contribution to person-
centred care by incorporating the unique needs and preferences of each individual to
improve patient outcomes and satisfaction and foster more effective and efficient
healthcare.
Feelings

Mrs. Eva’s family seemed worried and depressed due to her being admitted to the
emergency ward. Therefore, I felt uncomfortable interacting with her family members
as well as with the physicians as it was my first time attending a case like this. With
their consent, I notified Mrs. Eva’s family of her diagnosis in their presence. As per
Murgic et al. (2015), consent plays a crucial role in medicine because it builds trust
between patients and healthcare providers and respects patients’ autonomy. I could
imagine how vulnerable and in great pain Mrs. Eva was, and I started to worry for
her. I was worried that I might not be able to provide the patient with the level of care
she needs. However, I also felt a strong urge to help her and apply my skills and
experience to make things better. I was able to overcome my emotions though, and
replace them with a great need to deal with the most excellent, person-centred care
possible. I believe I was able to build a strong patient-nurse relationship throughout
the admission of the patient following NMC code of conduct.

Evaluation

I observed Mrs. Eva for more than 48 hours and her condition did not seem to be
getting any better. I spoke to the patient initially to establish a rapport. In my
experience, this made the patient more at ease and cultivated our bonding. In
addition, I took my time explaining to the patient in words they could comprehend on
what was happening and why they were in the hospital. Therefore, observing all the
medical records and taking consent from MDT and her family members we decided
to start end-of-life care (‌Payne et al., 2014). As per Danforn et al. (2014), healthcare
professional delivers end-of-life care when a patient is found to have an advanced,
incurable illness, such as cancer, and is in danger of dying suddenly. As she lives
with her husband and he was unable to care for her as well, we decided to deliver
palliative care inside the hospital. The positive aspect of this experience is that I had
the chance to learn more and refine my skills for delivering high-quality care.
However, I had to deal with a patient for whom death was anticipated. 

Analysis
It was a great experience although it was my first time addressing a situation like
this. It was an opportunity that allowed me to advance my nursing skills. I realised
that by adopting a person-centred strategy, I could provide Mrs. Eva with the support
and care she needed while also attending to their specific requirements in a way that
was personalised to her situation. I also realised that by spending the time to listen to
the patient and understand their perspective, I might be able to create a relationship
with them that is based on mutual respect and trust. 

Conclusion

To conclude, this experience helped me improve my understanding of the

importance of using a person-centred method in healthcare and how it might have a
big impact on the quality of care. I further learned that by taking time to understand
each patient’s needs and opinions it is possible to establish long-lasting and fulfilling
relationships with them.

Action Plan

I will make sure to always treat patients as unique individuals, listen to what they
have to say, and try to comprehend their particular needs and opinions in the future.
Likewise, I will also make an effort to use simple language and take my time
explaining things to people so that they can grasp them. 

 
Reflection-2 
Description

When I worked as a nurse in the department of infectious disease, I was given the
responsibility of taking care of patients who had just been admitted with tuberculosis.
A 38 years old single man named Mr. Tom who doesn't have children and lives alone
was admitted to our facility. He was from a poor economic background and was
unable to look after himself and his finances. He was very weak that he required a lot
of assistance with daily tasks. He experienced weight loss, night sweats, and
sickness. His friend Tina brought him to our hospital. Therefore, several tests
confirmed that he had tuberculosis. However, his clinical symptoms began to
improve after 48 hours of medication. He struggled to pay for medical expenses due
to his financial status. Nurses work as advocates for other people in addition to
providing patients with high-quality treatment (‌Davoodvand et al., 2016).

Feelings

As I got to know the patient, my concern for his health increased. He was a single
man without any family to defend him. I felt incredibly responsible to protect him and
make sure he received the best care possible. He could not afford medical care
which severely discouraged me. When he refused to follow the advice given for his
welfare, I became anxious. As a nurse, it is my responsibility to respect and maintain
the patient’s dignity (NMC, 2018). I was unsure of myself when I was talking to Tom.
I was disappointed in myself since I was unable to convince him to agree to a fair
solution.

Evaluation

I discovered that several of the patient's prescriptions had been changed since his
admission when I looked over his medical file. I decided to consult the attending
doctor because I was not sure if these alterations were necessary. Therefore, I
believe strong communication abilities are crucial for nursing advocacy (‌Dithole et
al., 2017). It is vital to provide patients like Tom with all proof openly and honestly
while defending the rights of the weak so that he will understand and take advantage
of the possibility to ask questions. However, I had a terrible time trying to convince
him. The positive side of this experience is that I was successful to convince Tom to
look for charitable groups.

Analysis
I expressed my worries and advocated for the patient, pointing out the benefits one
can get from charitable groups. This experience led me to believe that advocating
nursing plays a crucial role in providing high-quality care. A nurse should be capable
of communicating both verbally and non-verbally with confidence‌ (Vecchio et al.,
2022). I realised that a nurse's advocacy responsibilities often fall within feelings of
rage and frustration. I think that my attempts to encourage Tom to use
communication and negotiation skills were unsuccessful. However, by practicing
patience and treating the patient with dignity and respect following the code of
conduct, I was able to stop the condition from getting worse. This experience helped
me to learn the value of effective communication skills, patience, confidence, and
negotiation skills and their importance to preserve nursing standards (Saylor et al.,
2018).

Conclusion

I am delighted with the advocacy I provided for Mr. Tom. By demonstrating my

commitment to patient-centred care, I was able to ensure that he received the best
care possible.

Action Plan

In the future, I want to take a more proactive approach while standing up for the
rights and values of particularly vulnerable people. Additionally, I will keep an eye on
their prescriptions and medical history.

Conclusion 
To sum up, nurses may frequently expand the quality of the care they provide
through reflection, and interdisciplinary teams can reflect and conduct honest and
open dialogues. After completing this reflection, I have better knowledge of how to
apply recognized reflective models like the Gibbs cycle. Reflecting on both
experiences, standing up for patients, communicating, and protecting the ethical
standards recognized by various medical organizations are all vital components of
nursing work. Thus, I believe that the results of these experiences will improve my
nursing profession in the future.

References
Danforn, L. (2014). Specialty Trainees’ Understanding of End-of-Life Care
Symptom Management and End-of-Life Care Pathway: A uantitative and Qualitative
Pilot Study. Journal of Geriatrics and Palliative Care, 2(1). doi:10.13188/2373-
1133.1000004.

‌Davoodvand, S., Abbaszadeh, A. and Ahmadi, F. (2016). Spiritual

development in Iranian nurses. Nursing Ethics, 24(8), pp.936–949. Doi:
10.1177/0969733016629772.

‌Dithole, K.S., Thupayagale-Tshweneagae, G., Akpor, O.A. and Moleki,

M.M. (2017). Communication Skills intervention: Promoting Effective Communication
between Nurses and Mechanically Ventilated Patients. BMC Nursing, [online] 16(1).
Doi: 10.1186/s12912-017-0268-5.

Fukada, M. (2018). Nursing Competency: Definition, Structure and

Development. Yonago Acta Medica, [online] 61(1), pp.001–007.
doi:10.33160/yam.2018.03.001.

Murgic, L., Hébert, P.C., Sovic, S. and Pavlekovic, G. (2015). Paternalism

and autonomy: views of patients and providers in a transitional (post-communist)
country. BMC Medical Ethics, [online] 16(1). Doi: 10.1186/s12910-015-0059-z.

NMC (2018). The Code: Professional Standards of Practice and

Behaviour for nurses, Midwives and Nursing Associates. [Online] Nmc.org.uk.
Available at: https://www.nmc.org.uk/standards/code/.

‌Payne, S. and Morbey, H. (2014). Support for family carers. Nursing

Standard, 28(26), pp.57–57. doi:10.7748/ns2014.02.28.26.57.s53.
 Rodrigues Martins, M., da Silva Oliveira, J., Ernesto Silva, A., Souza da
Silva, R., Constâncio, T.O. de S. and Vieira, S.N.S. (2022). Assistance to patients
eligible for palliative care: the view of professionals from an Intensive Care
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reeusp-2021-0429en.

‌Saylor, J., Hertsenberg, L., McQuillan, M., O’Connell, A., Shoe, K. and
Calamaro, C.J. (2018). Effects of a service learning experience on confidence and
clinical skills in baccalaureate nursing students. Nurse Education Today, 61, pp.43–
48. doi:10.1016/j.nedt.2017.11.009.

‌Vecchio, A., Moschella, P.C., Lanham, J.G. and Zavertnik, J.E. (2022).
Acting to teach communication skills to nurses. The Clinical Teacher.
doi:10.1111/tct.13489.