Transitions To Graduate Mental Health Nursing Practice

5575 words - 23 pages

Transitions to Graduate Mental Health Nursing Practice

This essay is determined to provide a critical and reflective discussion on my experience of delivering care reinforced by evidence based frameworks throughout my journey as an undergraduate student nurse. This will be achieved by reflecting upon and describing my experiences that is pertinent to my chosen topic of evidence based practice care delivery. I shall make reference to Dreyfus and Dreyfus’s Student Developmental Model (1986) and Benner’s Stages of Clinical Competence (1984) to demonstrate my personal, professional and intellectual growth and maturity. I will conclude by discussing how I will intend to maintain my development ...view middle of the document...

During the common foundation part of my training, I completed 4 placements but I will describe my experience at an acute inpatient unit for working adults 18-65 which I will call the Chelsea Ward. This was my very first placement in a mental health setting so I was in an observer capacity, absorbing and soaking in as much information as I could, however this wasn’t easy. During my first week, my mentor invited me to sit in the weekly ward round. In this meeting the Consultant and the nurses and the occupational therapist discussed the progress of the patients from the previous week. My mentor was the named nurse for Joey a 25 year old gentleman, who had been presenting as floridly psychotic and experiencing distressing psychotic symptoms. My mentor informed the Consultant that Joey’s systems were not alleviating even though he was taking his anti-psychotic medication as prescribed. The Consultant discussed with my mentor that she would commence Joey on Clozapine tablets and that taking a blood sample from Joey would have to be arranged before commencement and the results to be fed back to the Consultant. I was curious as to why changing Joey’s medication required him to have his blood taken, so I asked my mentor why this decision was being taken, he informed me that Clozapine can be used in the management of schizophrenic symptoms when two or more atypical anti-psychotic medications have not seem to alleviate these symptoms. In my spare time I accessed the computer at placement and researched into Clozapine and read that it has been suggested by The National Institute for Health and Clinical Excellence (NICE) (2009b) guidelines on the treatment and management of Schizophrenia as the choice of treatment for patients who are unresponsive to or treatment resistive to their current medication. My mentor was able to take a blood sample from Joey; the results were given to the Consultant who was able to commence Joey on Clozapine treatment with weekly blood tests, to monitor his white blood count, I was given the task to check Joey’s vital signs on a daily basis and to record the readings on his mews chart.
According to the Dreyfus and Dreyfus (1986) model, on reflection I believe that in the level 1 intellectual domain, I demonstrated a willingness to develop my knowledge base by researching into Clozapine and trying to understand how the decision was arisen to start Joey on Clozapine. I believe I also showed an ability to manage my own learning needs in order to gain understanding of the professional principles behind this care intervention. I was also developing my skills domain as I could recognise and understand the need to promote Joey’s health and safety. This was achieved by taking vital signs daily and by testing Joey’s blood on a weekly basis so as to monitor his white blood count due to neutropenia being an adverse side effect of Clozapine, if his white blood count was abnormally low the Clozapine treatment would have to be terminated by...

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