Fundamentals of Nursing and Midwifery 2e

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Thoughtful practice and the process of care THE PERSON Each person is unique and has his or her own set of beliefs, values, memories, hopes and history. People are holistic beings with emotional, physical, social and spiritual dimensions and needs that all meld together to create the whole individual person. The fact that a person has a disease is only one aspect of the whole in the same way as having red hair is only one aspect of the whole person. Therefore each person’s health journey and personal care is individual. Clinical care is an interaction between the carer and the person cared for. Each of the individuals within this relationship is unique and so the respect and valuing of the individual applies to both. Relationships based on this principle can become therapeutic. REFLECTIVE PRACTICE LEADING TO PERSONAL LEARNING Reflective practice occurs when the carer has a profound awareness of self, of his or her own biases, prejudgements, prejudices and assumptions, and understands how these may affect the therapeutic relationship. This awareness is developed through the processes of reflection, thinking back on what has occurred for the purpose of learning in order to improve. Chapter 13 outlines each of the components of reflective practice, its professional context, strategies for developing the skill, and models for reflection used in clinical practice. CLINICAL REASONING, JUDGEMENT AND DECISION MAKING Clinical reasoning is the process of analysing a situation, making a judgement, deciding on possible alternative reasons and choosing an action to be taken. It is built on a foundation of knowledge, experience and the personal attributes of the person doing the reasoning. Thinking is fundamental in the process of clinical reasoning, and Chapter 14 describes the role of the many types of thinking such as critical, creative and intuitive thinking. Clinical reasoning is an essential skill for all thoughtful clinicians because, without the power to reason, care can be ritualistic and depersonalised. CLINICIAN’S ACTION IN RESPONSE TO INDIVIDUAL CLINICAL NEED The action that occurs in response to individual need completes the cycle of thoughtful practice when it is considered, personalised, appropriate, valued and effective. Thoughtful practice requires that all the components work in synchronicity for the benefit of the individuals within the therapeutic relationship. PERSON-CENTRED PROCESS OF CARE The process of care is the term used to describe the way in which care is organised through a series of actions undertaken in response to the individual needs of the person. The components of the processes of care are described in Chapters 15 to 19. These components are assessing, identifying health problems, planning care, implementing care and evaluating care.

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