I months on the ward, I assumed

I was able to act as a role
model to Sheila when I confidently took charge and managed the bay even though
I was still a student nurse. Robinson et al. (2012) states that it is important
to act professionally at all times and display behaviours that students can
emulate.  I was able to instil confidence
in Sheila and provide clear direction on an ambiguous situation such as
repeating the observations when the guidelines stated differently. Doherty (2016)
states that role modelling enables educators or trainers to show their
knowledge, attitude or skills, thus establishing their roles as more experienced
clinicians and gaining the respect of less experienced student nurses. This was
evident in my case because Sheila understood my reasons for requesting she
repeat the observations.

A role model is one who
exemplifies positive behaviour or social roles for others to emulate (Price & Price, 2009). They further stated that in
clinical settings, role modelling is an integral part of the teaching and
learning process which occurs between the newly qualified nurse and the
educator. As the experienced and final year student nurse, having spent 2
months on the ward, I assumed the role of the educator and had to model dealing
with a situation that could compromise patient safety if certain decisions were
not taken and relevant skills applied. This was evident when I escalated the situation
and involved the ward doctor for a further assessment of Joan.

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Being assertive helped me to take
charge, be more effective in my work and allowed me act as a role model,
showing a way of working that will support Sheila to do the same in the future (Huggetts, 2011). I confidently escalated the
situation and didn’t just pace around not knowing what to do. As a 3rd year
student nurse, I was more confident due to the quality of nursing education received
and sufficient clinical experience (Güner, 2014).

Furthermore, Podmore (2012)
states that assertiveness is an essential skill which enables student nurses to
effectively advocate on behalf of patients. In the given scenario, I advocated
on behalf of Joan because her health was deteriorating and strictly adhering to
the set guidelines without taking into consideration my observations would have
put her life at risk.    


I demonstrated assertiveness
when I carefully explained to Sheila why the observations should be repeated.
This is supported by Dahlkemper (2017), who asserts that assertiveness is the
ability to express oneself using the right words without a violation of the
rights of others. Similarly, Warland (2014) states that assertive individuals
are able to get their points across without upsetting others or becoming
aggressive. As a 2nd year nursing student, I expected Sheila to understand
deterioration in patients and the need for further assessment, but she did not.
This was upsetting to me as Joan was obviously very unwell. After my careful
explanation, she understood and repeated the observations without objections. Fagan
et al. (2016) states that in clinical situations, assertive communications is
speaking up or questioning with appropriate persistence, which is linked to
patient safety. I also demonstrated assertiveness when I politely insisted that
Sheila should repeat the observations. Rad et al. (2015) states that assertiveness
is the quality of self-confidence and trust an individual has in themselves
without exhibiting any aggressiveness.  

I identified three major
issues which impacted on the incident above, Assertiveness, Effective Communication
and Role Modelling.

Immediately the Doctor arrived
and commenced his assessment on Joan, she lost consciousness. The Doctor raised
the alarm quickly and all the Doctors and Nurses nearby ran to the scene of the
incident with the Crash trolley and Joan was revived.

Sheila carried out the
observations and the National Early Warning Score (NEWS) was 0. According to NICE
(2017) guidelines, the observations should be repeated after 12 hours. However,
looking at Joan, I observed she was restless and clammy. I therefore instructed
Sheila to repeat the observations after one hour but she stated that my actions
were contrary to the NICE (2017) guidelines and needed to be repeated after 12
hours. I was visibly upset but insisted she repeats the observations after one
hour explaining to her that deterioration in patient’s conditions can occur
with the vital signs remaining normal due to Homeostasis, hence the need to
physically assess patients (Page & Mckinney, 2012). Similarly, McCallum et
al. (2012) states that identifying clinical deterioration early is of vital
importance in acute care settings. After conducting the second observation, her
NEWS was 2. I then escalated this to the Doctor in charge of the bay, who came
quickly to assess Joan.

I was assigned to manage a
hospital bay with Sheila, a 2nd year Student Nurse who was also on placement. Sheila
and I admitted a 90year old patient named Joan to the ward and I delegated Sheila
to carry out a set of observations and record the vital signs which was
according to the National Institute for Health and Care Excellence, (NICE)
(2017) guidelines and hospital policy.

This essay will focus on
essential skill 38 which is a critical reflection on how I inspired confidence,
provided clear direction and acted as a positive role model. I will critically
reflect on an incident which took place while I was on placement in my final year
as a student nurse. I will reflect on how the incident will affect my future
practice, Rolfe et al.’s (2001) reflective model will be used and pseudonyms
will be used to maintain confidentiality according to the Nursing and Midwifery
Council (NMC) (2015) guidelines.