To Michael Smith
ford2013
re112.docxThe placement was a great learning experience for me due to the different activities that I had to perform during the course of the placement. In this period, I got to work in different hospitals, practicing and broadening my clinical skills in a number of imaging departments.During the course of the clinical placement, I did examine patients with different problems, and record clinical outcomes from the assessment. It is from the experience gained during the clinical placement that I write a reflection based on John’s Model of Reflection This model has 5 steps which are Description ,Refection ,Influencing factors ,Could I have dealt with it better and Learning.(Johns 1995). we can give a little definition for the Reflection which is a process allow to the medical staff who work in the hospital to know and understand every situation that they were facing with the patient. (Johns and Freshwater,2005).
Description of the Experience
My clinical placement began in the general x-ray department, whereby I did some cases that could help me carry out some clinical procedures. I was introduced to the different procedures in the department, as well as the protocols that are carried out to ensure the safety of the patients and to improve patient outcomes. The assessments that are commonly carried out in the general department include mobile chest X-ray, 1 hour Continuous and Challenging Examination. I was particularly interested in the Challenging Examination, so I was keen on every procedure that was carried out on patients who have any difficulty . My observation of the radiographer’s work took around 2 days, whereby he explained to me everything that he was doing. I must say that a field experience in clinical practices is the best way through which one can learn everything that has to do with radiography. The 2 days were also enough for me to learn understand every aspect of the department, and hospital protocols that every staff member has to adhere to while working in this department.
During the course of my clinical placement, I realized that one needed to practice whatever he or she has learnt from the other healthcare practitioners so that he or she can develop some confidence while undertaking similar operations. Therefore, I took an initiative on my second day at the placement, whereby I requested the coordinator at the radiology department to inform me of any patient could have any difficulty coming in. this emerged to be my lucky day because at the end of day and before I finish my shift which was form 9-9, the coordinator informed that there was abdomen X-ray for the patient on the chair, and he needed to know whether I was up for the task. Thus was the first assessment that I was to be in charge of since I started the clinical placement this trimester , and I was determined to do my best and ensure that carried out the examination as expected.
The patient was attending department suffering from an abdominal pain as examined by a doctor she had Clostridium difficile, also known as C. difficile or C. diff, is a bacterium that can infect the bowel and cause diarrhea. The infection most commonly affects people who have recently been treated with antibiotics, but can spread easily to others (https://www.nhs.uk/conditions/c-difficile/)
My assessment of the patient’s functionality indicated that he was on a bad condition as his movement was difficult. However, this was a very tense moment for me due to the radiographer’s silence as I handed over the assessment sheet to him. I can bet that some of my confidence was lost as at that moment because I was not sure whether the radiographer would be pleased with my work, having in mind that it was my first time to do this sort of thing.
Reflection
There were several things that I hoped to achieve through the assessment session, some of them being a thorough examination of the patient’s condition. To ensure that the process was successful, I had to look at the patient’s details on the request card, and the medical history of the Hospital Information System. I hoped that a look at the patient’s medical history would provide an additional insight to his problem., I had to wash my hands and wearing gloves and gown because the patient has infection. The equipment was prepared and cleaned the room. After that I called the patient from waiting area the patient was on chair.
I had to inform the patient that I was an international student undertaking my clinical placement in the radiography department. I also told him that I would be carrying out his X-ray’s to get her consent. (medo.2010) said healthcare effectiveness with patients and involving them in decisions about their care. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1116583/) .Also that the radiographer in the room with us was my supervisor, who was present to ensure that I did everything as required. This step was quite important in the assessment as it made the patient be comfortable with the entire situation, and confirmed his details as they had been indicated in the request card such as his name , date of birth ,address and LMP because she was 38 old .. Additionally, I also had to explain to the patient the process that had to be followed. I must say that I was lucky at this point because the patient was cooperative in doing what I asked him to do, such as to change his clothes in readiness for the procedure.
Routine procedures in carrying out a Challenging Examination assessment had to be utilized, whereby the x-ray was carried out in Anterior-Posterior view.The tube was vertical at 90 degree to the grid and I used 120cm distance between the grid and the tube, and factors 63 KV and 2.8 mAs. The positioning for over a point in the midline of the abdomen, level with the iliac crest.( Medical imaging : techniques, reflection & evaluation.2010)
point The resultant images from the x-rays were acceptable for diagnostic purposes. The radiographer appeared pleased with my efforts, since I had learnt so much in my placement and was able to successfully carry out an assessment. I got an excellent feedback from the radiographer, which showed that the clinical placement was impacting some knowledge on me.
Influencing Factors
My decision-making process in the course of this situation was affected by emotional conflicts that were going on within me. I had negative feelings, which I can attribute to the fear that I would not perform as expected in the clinical placement. Fear has dominated a huge part of my journey. However, after seeing how the assessment session went by quickly without facing any major problems, and the positive feedback from the supervisor, I no longer felt fearful. I came to realize that as long as put my mind to what I was doing, and followed the protocols appropriately, then I was capable of doing well in the radiography department.
I think the fear that I had from the beginning emerged from the lack of confidence. I failed to believe in myself, and the possibility that I was as equally as good as the other radiographers in the department since they started in the same position as I was, then worked their way up to perfection. However, I am glad that I did not let this issue become a barrier to an effective assessment. It is important note that nervousness was a key barrier to the entire procedure. I was nervous because of the supervisor’s presence. I did not know if he would be pleased with my assessment skills. I felt that I had been put on the spotlight, performing an assessment that I was not mentally prepared for.
Another factor influencing the entire placement period was communication, especially in instances where I had to deal with patients that have fast accent. In other instances, the patients could not understand what I was trying to say, because the English was not my First language. which made my work quite difficult? This issue was a bit difficult as each patient’s imaging procedure had to be undertaken differently due to the difference in problems.
Could I have Dealt with it Better?
In reflecting about how I could have sorted my emotions better and effectively dealt with the influencing factors, I looked at the pros and cons of the entire situation. Through this strategy I realized that I was not the only one who was nervous during the staged assessment because other students also claimed the same. The nervousness was also notable each time I had to deal with a new patient. There is a difference in the cases that I was assigned, and I got nervous because I was not sure if the patient would be willing to cooperate with me just as it had happened in the first staged assessment.
One of the notable cons of how I dealt with the situation is that I showed my weakness to the supervising radiographer. This issue made me seem like I lacked confident in myself and whatever else that I was doing when examining the patients. I should have tried to act confident so that the radiographer could have had some hope in me.
Regardless of all the emotions and feelings in me at the time of the staged assessments, the pro in this situation is that I did not let the feelings and emotions pull me down, but rather I used them to boost my performance. I needed to prove to myself and the radiographer that I was good at doing the work just as any other person in the department. With that it in mind, I put aside the lack of confidence and carried out the assessments as required with minimal hiccups. I used the knowledge that I have to push myself harder, so that I was able to produce excellent diagnostic images with the cooperation of the patients involved. At this point, I think that the one thing that I could have done differently includes learning how to take control of my feelings so that they do not get in the way of my work.
Learning
I learnt that I could overcome them all, which has made me a positive student. Rather than rushing through challenging situations, I have learnt to take my time and think through the situation before acting. It is through reasoning that one can developed the best and most appropriate solution to a given situation. ( Boud et al, 1985).
Moreover, this experience provided me with knowledge and skills to enhance what I had learnt in the classroom.(kolam2011) said placement can enhance understanding of clinicians of the student placement process that has contributed to improved satisfaction and outcomes for the students.( http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2934.2006.00634.x/full). which am sure impacts on my application of the knowledge and information gathered. Additionally, I am now quite familiar with the machines used in the radiography department, and confident that I would use them appropriately when left unsupervised. Additionally, the staged assessments equipped me with the skills that I can apply in an extreme practical case. I also learn how to quickly adopt to change. For example, dealing with different patients and performing various imaging procedures. Moreover, from the entire experience, I have learnt how to evaluate any professional limitations, as well as emotional reactions that could affect my performance in a clinical setting.However, a challenge lies in the application of these advantages to influence a change in practice and behavior.
Conclusion
