Reflective Writing Assignment 2

Melissa Amos
NURS 3020
November 7th 2014
Identification
The incident that I will be reflecting upon took place on the 7th week of clinical
practice. A nurse had asked some students to bathe and perform morning care on a male
patients, the nurse stated that the patients were not cooperative with the staff so that we
shouldnt let them abuse us. When we entered the room I could see that the patient did
not like being in the hospital and constantly being interrupted by hospital staff. When we
entered the room and asked if he was ready to get ready for the day he responded
sarcastically towards us.
Description
We entered the room at which point we asked the patient id he was ready to get
ready for the day and that wed help him. He responded by hassling us saying that the
other students looked like police women. After this we attempted to get him to give us
permission to wash him and get him to take his pills. After a while of him not giving us
consent I realized that a new approach was needed. The patient obviously did not
appreciate being treated as we were treating him so our behaviour would need to be
modified. Understandably having individuals coming into his room at telling him what
they were going to do agitated the man. In order to attempt to have him undergo as much
morning care as possible without forcing him I adapted my behaviour in accordance with
his reactions. For example when it was stated that wed take care of the wash basin
after he was done he responded aggressively so in order to help I clarified that when we
said take care of we meant get rid of the container. I let him guide the care that we

performed and allowed him to perform as much care as possible. I did not force him to do
anything as I realized that he was competent enough to decide what care he needed to and
by forcing him to perform care that wasnt absolutely necessary I would create a poor
relationship with him and any other possible care would be even more difficult.
While I believe some of the other students felt as though the man was difficult to
deal with I believe that all that was needed in the situation was adapting to his person.
Not only his individual desires, but also what he felt was necessary and explaining to him
why we believed these actions were needed. For example he claimed that he did not need
to wash himself because he did not get dirty. In response to this my intuition told me that
having him wash his whole body would be difficult at best. So we had him wash his face
and as much of his body as we could convince him to. While this may not have been
what the nurse providing his care wanted it I believe it was what realistic could be
achieved without violating the patients right to choose his own care.
By using the CNOs Practice Standard:Therapeutic Nurse-Client Relationship I
can see that my behaviour was congruent with the standards of care outlined by the CNO
for a therapeutic relationship. Additionally I also used the literature surrounding the right
of the patient to choose their own care needs as long as they are competent in the CNOs
Practice Standard: Decisions About Procedures and Authority.
Significance
By using what I had learned over the past few years I was able to apply the
standards of practice to my care in order to know how to interact with the patient.
Applying the standards stated above helped me to provide the best care possible.
Implications

This experience helped me to better engage with other patients that appeared to be
uncooperative, it also opened me up to better understanding the importance of adapting
practice to the individual and respecting their rights. In the future I will make a conscious
decision to monitor the patients behaviour before I begin to engage with them in order to
have the best possible interaction with them while avoiding as many misunderstands as
possible.

Reference:
College of Nurses of Ontario. (2006). Practice Standard: Therapeutic Nurse-Client
Relationship. CNO Standards of Care. Retrieved November 7, 2014 from
http://www.cno.org/Global/docs/prac/41033_Therapeutic.pdf.

College of Nurses of Ontario. (2006). Practice Standard: Decisions about Procedures
.CNO Standards of Care. Retrieved November 7, 2014 from
http://www.cno.org/Global/docs/prac/41071_Decisions.pdf