Reflection at the end of clinical placement

 

Please write 2000 word Reflection (Mental Health Nursing student)

 

Part 1: 1000 words of my clinical placement which was in Forensic Mental health centre. I have highlighted my 5 objectives. I was successfully able to achieve all my objectives and performed all the nursing deities Independently comparing with standards of practice.

Part 2: 1000 words for overall program of mental health nursing course. This was a one year course and had 4 subjects. Through this course I have learned skills and gained expert knowledge to how to provide best quality and evidenced based care to consumers experiencing mental health issues. I learnt how to perform mental state examination, make risk assessment and how to deal in challenging situation or how to manage behaviours. I also gained knowledge about contemporary mental health theories and basic counselling skills.

You can also include that due to COVID-19 face-to-face assessments changed to online or zoom but despite high challenges induced by COVID-19 I was able to complete that program.

Please write the reflection (2000 words) using of 1^st person in academic format using Arial 10 with 1.5 spacing and use peer reviewed recent articles for references at least (20-25) in Harvard style.

Please use Recovery-Oriented-Language-Guide (attached) for appropriate terminology throughout the assignment (e.g. patient=client etc.). Thank you.

 

 

 

My clinical Objective for clinical placement is mental health rehabilitation centre 

Clinical Objective 1

Demonstrate the ability to work collaboratively with the consumers along with other stakeholdersin relation to the consumer’srehabilitation process and utilizetheoretical knowledge together with clinical skills to show competence as a mental health nurse. The objective is related to Course Objective Number 6 and standard 2, 4, and 10 of Standards of Practice for Australian Mental Health Nurses (2010).

 

. Strategies/resources

• I will work in partnership with the consumer towards their rehabilitation goals
• I will use the knowledge and clinical skills that I have acquiredduring my studies from mental health course to achieve this end.
• Effective communication
• Handover (verbal/written)

Clinical Objective 2

Being able to apply various mental health therapy models in the context of the rehabilitation process in order to appropriately respond to diverse consumer needs. The objective is taken from Course Object Number 1 and 5 and relates to Standards of Practice in Mental Health Nursing (2010) standard 3.

 

Strategies/resources

• Foundational counselling skills
• Psychological therapies
• Access organisational resources and using university library data base
• Contribute in the formulation of a comprehensive care plan for the client
• Follow organizational policies and procedures
• Utilise ward resources as per client choices

 

Clinical Objective 3

Demonstrate the ability to establish a therapeutic relationship with the consumers to help them achieve their rehabilitation goals. The objective relates to Course Objective Number 3 and associates with standard 3 of Standards of Practice for Australian Mental Health Nurses (2010).

 

Strategies/resources

• Critical thinking and rapport building
• Effective communication
• Active listening
• Recovery oriented approach
• Continuity of care
• Collaboration

Clinical Objective 4

Critically analysethe significance of social, cultural, and legal aspects of rehabilitation process to be able to provide optimal care to the consumers experiencing mental health problems. The objective relates to Course Objective Number 4 and standard 4 and 8 of Standards of Practice for Australian Mental Health Nurses (2010).

 

Strategies/resources

Review the following legislations

• Review Mental health Act 2009
• Section 55 (transport)
• Section 56 (care and control)
• Section 57 (police)
• Guardianship & Administration Act 1993
• Advance Care Directives Act 2013
• Children’s Protection Act 1993 (amended 2005)
• National Plan to Reduce Violence Against Women & Their Children 2011
• Fire arms Act 1966 SA
• Work Health & Safety Act and Regulations 2012
• South Australian Health Commission Act 1976
• Freedom of Information Act 1991
• Consent to Medical Treatment and Palliative Care Act 1995

Work within the legal parameters,professional practice guidelines and organisational PPG to ensure appropriate delivery of care.

• Provide culturally safe care
• Consumer-centered approach

Clinical Objective 5

Employ recovery-oriented approach, trauma-informed care principles and follow Least Restrictive Practices to engage consumers in educational and community service programs in order to minimize social exclusion andstigmatization of the consumers experiencing mental health issues. The objective is taken from Course Objective number 3 and Standards of Practice for Australian Mental Health Nurses (2010) standard 6 and 7.

 

Strategies/resources

• TIC and recovery-oriented practice
• Follow ward and organisational PPG
• Client empowerment
• Strengths based approach
• Use best practice guidelines
• Encourage participation in group programs and ward activities

 

 

This is the last clinical placement ofthe Graduate Diploma in Mental Health Nursing Program, so I would take the opportunity to gain maximum benefitsform this placement. To this end, I have painstakingly formulatedlearning objectives and will strive to achieve them. The clinical objectives act as assessment standards and are used as checkpoints to continually assess the progress of the learnerand to ensure the accusation of specific skill set which arecruciallyrequiredto improvethe provision of quality care and ensure better client outcome. I will use regular reflective practice and seek feedback from mentor nurses and consistently evaluate my progress to ensure that the objectives are accomplished.

 

Course Objectives and Standards for MENTAL HEALTHNURSING Listed below just for your reference

 

Course Objectives

 

1. Critically analyse and integrate contemporary theories and practices to respond appropriately to mental health consumers and promote recovery.
2. Demonstrate best practice in the provision of mental health care to diverse populations.
3. Demonstrate the ability to anticipate and respond to consumers experiencing complex mental health problems, promoting recovery and resilience.
4. Synthesise knowledge of legal, ethical, biological and social factors into mental health care.
5. Critically evaluate the application and effectiveness of mental health models of care in various practice contexts.
6. Demonstrate competence as a mental health nurse.

 

 

 

Nursing Standards

Standard 1: The mental health nurse acknowledges diversity in culture, values and belief systems and ensures his/her practice is nondiscriminatory, and promotes dignity and self-determination.

Rationale

Recognising the cultural context in which mental health issues occur is critical to providing culturally competent services.  Understanding cultural diversity is essential to working therapeutically with people whose experiences differ from those of the nurse.

Practice Outcomes

This standard is being met when:

1. People with mental health issues report that they feel respected and safe in terms of their cultural background
2. Cultural considerations affecting assessment and intervention processes are documented and acted upon
3. Culturally appropriate support agencies have been accessed where appropriate.

Attributes

1. a) Knowledge

The Mental Health Nurse demonstrates an understanding of:

1. how their own personal cultural context may influence their practice
2. the meaning of the principles of partnership, protection, participation and self determination and how these relate to people affected by mental health issues
3. the rights and responsibilities of people affected by mental health issues
4. the application of the principles of informed consent
5. the process to access, and the role of, health consumer advocates and interpreters
6. the barriers which may be present within health care bureaucracies and environments, that influence the provision of health services
7. the theoretical frameworks for cultural assessment.
8. b) Skills

The Mental Health Nurse:

1. respects the uniqueness of each person affected by mental health issues
2. involves family and/or appropriate supports in the decision-making process
3. forms and supports partnerships relevant to the requirements of the individual
4. empowers those affected by mental health issues to be aware of and exercise their rights in relation to health care
5. protects each person’s privacy and confidentiality
6. advocates for the person affected by mental health issues, or accesses appropriate advocacy on their behalf
7. integrates cultural perspectives within the scope of their practice
8. advocates for services to be structured such that they are sensitive to differences in culture, values, belief systems, gender and spirituality.
9. c) Attitudes

The Mental Health Nurse:

1. respects the cultural values and beliefs of all groups within the community
2. values and respects the rights of people using the service and their advocates
3. embraces the concept of partnership
4. accounts for and accepts responsibility for their own judgements and actions.

Independent

Supervised

Assisted

Marginal

Dependent

Standard 2: The Mental Health Nurse establishes collaborative partnerships that facilitate and support people with mental health issues to participate in all aspects of their care.

Rationale

Understanding the value of partnership(s) in promoting optimum practice outcomes is essential in the context of a holistic care framework.

Practice Outcomes

This standard is being met when:

1. people with mental health issues confirm they have been involved in key aspects of their care and express satisfaction with the process and outcomes of the partnership
2. the health care/treatment plan identifies the outcomes of collaborative assessment and consultation
3. collaborative partnerships with consumers, families, community, government and non-government organisations are established across all aspects of the person’s care and recovery.

Attributes

1. a) Knowledge

The Mental Health Nurse demonstrates an understanding of:

1. effective interpersonal communication, advocacy, collaboration, partnerships and participation
2. the scope of partnerships possible, incorporating an understanding of the strengths and deficits in the partnership process.
3. b) Skills

The Mental Health Nurse:

1. plans, establishes, maintains and evaluates partnerships and participation
2. uses reflective practice to analyse partnerships
3. externally evaluates their practice with regard to maximizing the effectiveness of his/her own therapeutic role, utilising clinical supervision.
4. c) Attitudes

The Mental Health Nurse:

1. values partnership and participation
2. values and promotes the leadership role of Mental Health Nurses in collaborative practice and partnership development
3. identifies themselves as a facilitator and supporter of the individual in the recovery journey
4. reflects on their role in partnerships and participation
5. accounts for and accepts responsibility for their own judgements and actions

Independent

Supervised

Assisted

Marginal

Dependent

Standard 3: The Mental Health Nurse develops a therapeutic relationship that is respectful of the individual’s choices, experiences and circumstances. This involves building on strengths, holding hope and enhancing resilience to promote recovery

Rationale

The recovery journey is a subjective experience, defined by the individual.

Practice Outcomes

This standard is being met when:

1. people with mental health issues confirm that their skills and experience have been valued and utilised, and that they feel supported in their individual recovery journey
2. the Mental Health Nurse interprets and contributes to the health care/treatment plan with respect to the principles of recovery.

Attributes

1. a) Knowledge

The Mental Health Nurse demonstrates an understanding of:

1. evidence based practice and the principles of recovery
2. the concept of individuality in terms of experience, needs and strengths
3. the therapeutic use of self in the recovery process
4. the process of clinical reasoning
5. treatment modalities used across the health care service
6. b) Skills

The Mental Health Nurse:

1. adapts to the setting where care is provided
2. establishes trust by developing rapport
3. practises according to the principles of informed consent and confidentiality
4. collaborates with consumers and stakeholders to develop, activate and evaluate coordinated, comprehensive health care
5. works to assist the individual to identify and harness his/her own strengths and skills, encouraging active participation in mental health services at both individual and systemic levels
6. uses reflective practice to ensure conformity to evidence based practice and principles of recovery
7. uses clinical supervision to externally evaluate their practice with regard to ensuring recovery-focused care.
8. c) Attitudes

The Mental Health Nurse:

1. appreciates, values and advocates for the principles of recovery
2. acknowledges the importance of evidence based practice
3. values a collaborative, coordinated and, where possible, multidisciplinary approach to mental health care
4. recognises, respects and promotes individual’s rights
5. values reflection and peer review in their practice
6. appreciates the necessity of clinical supervision to support clinical practice

Independent

Supervised

Assisted

Marginal

Dependent

Standard 4: The Mental Health Nurse collaboratively plans and provides ethically based care consistent with the mental, physical, spiritual, emotional, social and cultural needs of the individual.

Rationale

This standard recognises the mental, physical, spiritual, emotional, social and cultural needs of people affected by mental health issues and supports best practice outcomes.

Practice Outcomes

This standard is being met when:

1. people with mental health issues identify that their mental, physical, spiritual, emotional, social and cultural needs have been consistently considered.
2. where ethical dilemmas exist, the mental health nurse uses ethical practice principles to ensure the consumer’s mental, physical, spiritual, emotional, social and cultural needs are best met
3. where they exist, breaches in ethical practice are appropriately documented and investigated.

Attributes

1. a) Knowledge

The Mental Health Nurse demonstrates an understanding of:

1. the legislation and principles of ethical guidelines governing practice
2. the interconnected relationships that exist between mental health, physical health and general wellbeing
3. the importance of the social and cultural context with regard to the person’s values and attitudes towards mental health, mental illness and mental health care and treatment.
4. b) Skills

The Mental Health Nurse:

1. develops care strategies in collaboration with stakeholders with reference to the demands of ethical practice and consistent with the identified needs of the individual across mental, physical, spiritual, emotional, social and cultural contexts
2. engages in a process of reflective practice
3. uses clinical supervision to externally evaluate their practice with regard to the provision of ethically based care.
4. c) Attitudes

The Mental Health Nurse:

1. practices ethically
2. values and works with the individual to identify their mental, physical, spiritual, emotional, social and cultural needs
3. reflects on their role in providing collaborative, ethically sound care
4. accounts for and accepts responsibility for their own judgements and actions

Independent

Supervised

Assisted

Marginal

Dependent

Standard 5: The Mental Health Nurse values the contributions of other agencies and stakeholders in the collaborative provision of holistic, evidence based care and in ensuring comprehensive service provision for people with mental health issues.

Rationale

Promoting and facilitating the contribution of others promotes the best practice outcome for people affected by mental health issues.

Practice Outcomes

This standard is being met when:

people with mental health issues identify that the Mental Health Nurse utilised the skills and knowledge of other individuals, organisations and groups wherever necessary

the contributions of other agencies and stakeholders are valued and identified in documentation.

Attributes

1. a) Knowledge

The Mental Health Nurse demonstrates an understanding of:

1. the principles of holistic and evidence based care
2. the skills and expertise of other health care professionals
3. the principles of collaborative and multidisciplinary care.
4. b) Skills

The Mental Health Nurse:

1. demonstrates interpersonal communication skills which promote engagement with other agencies and stakeholders
2. establishes and maintains respectful relationships with other agencies and stakeholders
3. plans care with consumers in such a way as to include, where possible and where desired by the person, other agencies and stakeholders
4. uses reflective practice to review their own contribution and their appreciation of what others can contribute
5. externally evaluates their practice with regard to the use of principles of holistic and evidence based practice, utilising clinical supervision.
6. c) Attitudes

The Mental Health Nurse:

1. genuinely values the concept of consumer/carer participation
2. values the contributions of others
3. values holistic and evidence based practice
4. willingly seeks and utilises the professional and experiential contributions of others
5. reflects on their own contribution and possible impediments to accepting and valuing the contributions of others
6. accounts for and accepts responsibility for their own judgements and actions.

Independent

Supervised

Assisted

Marginal

Dependent

Standard 6: The Mental Health Nurse actively pursues opportunities to reduce stigma and promotes social inclusion and community participation for all people with mental health issues.

Rationale

The recognition of, and taking action to address, the stigma that surrounds and influences the lives of people affected by mental health issues is an important contributor to improving practice outcomes.

Practice Outcomes

This standard is being met when:

1. people identify that they experience an improved sense of community integration and reduced experiences involving stigma
2. the Mental Health Nurse demonstrates active participation in health promoting, stigma reducing activities
3. the Mental Health Nurse engages in opportunities to review and/or develop strategies and policies that promote community integration and reduce stigma.

Attributes

1. a) Knowledge

The Mental Health Nurse demonstrates an understanding of:

1. the impact of stigma for the individual and on the community
2. the principles of health promotion, illness prevention, early intervention and the value of community integration, in reducing stigma and promoting social inclusion
3. the existing strategies and guidelines for reducing stigma, promoting social inclusion and health promotion and illness prevention.
4. b) Skills

The Mental Health Nurse:

1. utilises health promotion and community integration principles in care actions
2. seeks out opportunities to enhance existing levels of knowledge and skill
3. demonstrates high level skills in communication, health promotion and community integration activities
4. uses reflective practice to assess existing skill and knowledge levels and deficits
5. externally evaluates their practice with regard to the reduction of stigma and other important social aspects associated with mental health care, utilising clinical supervision.
6. c) Attitudes

The Mental Health Nurse:

1. values health promotion, reduction of stigma and community integration
2. recognises the impact of stigma on the individual and is motivated towards playing an active role in reducing both stigma and its impact
3. willingly engages in opportunities to enhance stigma reduction, community integration and health promotion
4. reflects on their role, if any, in contributing to or perpetuating stigma and/or inhibiting community integration.

Independent

Supervised

Assisted

Marginal

Dependent

Standard 7: The Mental Health Nurse demonstrates evidence based practice and actively promotes practice innovation through lifelong education, research, professional development, clinical supervision and reflective practice.

Rationale

Understanding the value of and utilising evidence based practice is essential to promote best practice outcomes for persons affected by mental health issues. Ongoing professional development, education, clinical supervision and reflection provide the basis for the consistent evolution of practice required to enhance recovery for people with mental health issues.

Practice Outcomes

This standard is being met when the Mental Health Nurse:

1. consistently engages in activities to use and develop evidence base for practice, and utilises practice innovation where evidence is lacking or a novel approach is required
2. demonstrates regular engagement in activities of research, education and professional development, clinical supervision and reflective practice
3. engages in activities which support others in activities of research, education and professional development, clinical supervision and/or reflective practice.

Attributes

1. a) Knowledge

The Mental Health Nurse demonstrates an understanding of:

1. the principles and processes required for evidence based practice, professional development, clinical supervision, research and reflective practice
2. the benefits for a variety of relevant stakeholders when nurses engage in these practices.
3. b) Skills

The Mental Health Nurse:

1. incorporates the principles of these activities to their own practice
2. establishes and maintains a pattern of incorporating these practices into their own professional life
3. plans, develops and takes opportunities to enhance their knowledge and skill level in these areas and share them with others
4. uses reflective practice to analyse their practice in terms of the above areas
5. uses clinical supervision to externally evaluate practice and identify areas for professional development.
6. c) Attitudes

The Mental Health Nurse:

1. values evidence base and innovation in their practice
2. values the contributions of professional development, lifelong education, research, clinical supervision and reflective practice
3. willingly engages in opportunities to participate in these activities and supports others to do the same
4. reflects on areas of need for improvement and/or greater activity in reference to the identified activities
5. accepts responsibility for their own actions.

Independent

Supervised

Assisted

Marginal

Dependent

Standard 8: The Mental Health Nurse’s practice incorporates and reflects common law requirements, relevant statutes and the nursing profession’s code of conduct and ethics. The Mental Health Nurse integrates international, national, local and state policies and guidelines with professional Standards and competencies.

Rationale

Legal requirements and professional codes of practice are incorporated into clinical practice to safeguard the rights of people with mental health issues.

Practice Outcomes

This standard is being met when:

1. people affected by mental health issues and/or relevant others identify that the Mental Health Nurse’s practice is consistent with common law requirements, relevant statutes, policies, standards, competencies, guidelines and the nursing codes of conduct and ethics
2. the Mental Health Nurse utilises legislation, relevant statutes, policies, standards, competencies, guidelines and the nursing codes of conduct and ethics in their practice
3. the Mental Health Nurse acts to safeguard the rights of people with mental health issues, the family, carers and the community.

Attributes

1. a) Knowledge

The Mental Health Nurse demonstrates an understanding of:

1. the relevant policies, guidelines, statutes and codes of conduct and ethics governing practice
2. the mechanisms by which their practice may be reviewed in terms of their adherence to the above identified issues, their rights and the possible repercussions of breaches.
3. b) Skills

The Mental Health Nurse:

1. relates the policies, guidelines, standards, competencies, legislation and codes of conduct and ethics to their practice
2. practices in accordance with legislation, policies, guidelines, standards, competencies, codes of conduct and ethics at all times
3. identifies areas of need and takes appropriate action to address them
4. uses reflective practice to analyse their practice in terms of these issues
5. uses clinical supervision to externally evaluate practice and identify areas for professional development
6. acts as a role model for others in terms of these issues.
7. c) Attitudes

The Mental Health Nurse:

1. values the contributions of the various guidelines including the benefits, protections and means of redress for the profession and people affected by mental health issues
2. willingly engages in activities to ensure their practice reflects
3. reflects on their practice to identify areas of need for improvement
4. accepts responsibility for their own actions and their own limitations.

Independent

Supervised

Assisted

Marginal

Dependent

Standard 9: Specialist Professional Leadership: The [Student] Mental Health Nurse [is working towards] a specialist qualifications and demonstrates advanced specialist knowledge, skills and practice, integrating all the Standards competently and modelling leadership in the practice setting. This standard has been adapted to identify that the Student Mental Health Nurse is working towards a specialist qualification.

Rationale

Recognising the value of Standards for clinical practice promotes optimal care for people with mental health issues and establishes the role of specialist mental health nurses as leaders in the promotion and provision of optimal care.

Practice Outcomes

This standard is being met when:

the mental health nurse is acknowledged by peers as expertly integrating all of the Standards with advanced specialist knowledge, skills and practice.

Attributes

1. a) Knowledge

The Mental Health Nurse demonstrates knowledge and understanding of:

1. the Standards of Practice
2. the advantages of having, using and evaluating Standards of Practice
3. the benefits of attaining and maintaining advanced specialist qualifications, skills and practice
4. the principles and importance of leadership.
5. b) Skills

The Mental Health Nurse:

1. relates theory to practice and incorporates Standards into practice
2. establishes and maintains an advanced level of expertise
3. utilises reflective practice to identify areas of deficit and acts to address them
4. uses clinical supervision to externally evaluate practice and identify areas for professional development.
5. c) Attitudes

The Mental Health Nurse:

1. values Standards of Practice, knowledge and advancing their practice
2. values their role as leader and role model to novice and non-specialist colleagues, supporting them and willingly contributing to their professional development
3. willingly engages in activities to enhance their expertise and incorporate it into practice
4. reflects on their practice and how this may influence others.

Independent

Supervised

Assisted

Marginal

Dependent

Section 10: Demonstrates knowledge and clinical skills competence as required to work successfully as a Mental Health Nurse in contemporary practice settings

Demonstrate a sound working knowledge of legislation in particular:

• Mental health Act 2009
• Section 55 (transport)
• Section 56 (care and control)
• Section 57 (police)
• Guardianship & Administration Act 1993
• Advance Care Directives Act 2013
• Children’s Protection Act 1993 (amended 2005)
• National Plan to Reduce Violence Against Women & Their Children 2011
• Fire arms Act 1966 SA
• Work Health & Safety Act and Regulations 2012
• Freedom of Information Act 1991
• Consent to Medical Treatment and Palliative Care Act 1995

Demonstrate proficiency with mental health nursing assessments in particular:

• Mental State Examination
• Behavioural assessment
• Risk assessments
• Biopsychosocial assessments
• Physical assessments
• Verbal and written reports on observations of consumer status
• Comprehensive assessments
• Emergency assessments
• Risk assessments
• Physical assessments
• Neuro-vegetative assessments
• NOCC assessments (National Outcome and Casemix Collection)

Demonstrate therapeutic engagement by utilising the principles of:

• Therapeutic use of self
• Engagement focussed observations
• Working within a multidisciplinary team
• Effective communication skills
• Motivational Interviewing
• Demonstrate proficiency in managing consumers with a challenging behaviour

Demonstrate competent ‘Medication management’ by:

• Knowing the indications for psychotropic medication administering and monitoring
• Knowledge of medication administration principles
• Competence in psycho-education for consumers and carers
• Initiate appropriate interventions for occurrence of unwanted medication related side effects/ toxicity
• Be competent in the administration of long and short acting injectable medication
• Utilising principles of ‘10 Rights of Medication administration’