Reflection: Gibbs Reflective Cycle
Working with children often faces various legal and ethical issues in different contexts such as clinical settings. Children occasionally present legal and ethical issues to healthcare settings. The following sections provide an analysis of Kat’s case from the nursing perspective using the Gibbs reflective cycle.
During the proceeding of the case, I felt compassionate as well as annoyed. I was sympathetic with Kat for the misfortune she faced in that the phlebotomist failed to create a good rapport with her. Moreover, it can be inferred that the phlebotomist harassed Kat by failing to meet her demands and of what she had repeatedly learnt to do during checkups. The case is also annoying in that the phlebotomist and the nurse failed to consider here concerns to make her comfortable with the process and rather appeared to “force” her through the process.
Kat can be regarded as doli incapax due to her age and hence could not be awarded autonomy. Therefore, the attempt to take blood from her is recommendable. Her health status could not be overlooked based on her fear of needles because she could not be perceived as being competent to make a decision regarding her check up. However, it is also a failure on the part of the nurse to create a sense of trust between her and Kat. Children develop trust based on protectiveness and nurturance which the nurse would have done by meeting Kat’s demand for angel cream and by trying to assure her and also showing compassion and rather not being angry and agitated by her aggressiveness.
Kat’s case presents several scenario indicative of the failure of a nurse to create a conducive relation with the patient. One of the failures of the nurse is to create a sense of protectiveness to Kat and offer emotional nourishment. According to Rich (2012), such actions would be essential in ensuring trust between Kat and the nurse and hence convince her to undergo the process. Moreover, given the fact that Kat was aware of the circumstances of the check-up, emotional nourishment by giving her the angel cream would have been essential in comforting her emotionally. Consequently, Kat might have proceeded with the check-up comfortably as she would have been confident that the nurse meant her no harm (Kurtz & Burr, 2009).
Kurtz and Blurr (2009) further explain that it is an ethical requirement for nurses to have discernment. Nurses ought to make decisions resulting from insights of a clear history of understanding and judgement. In the case of Kat, there is lack of this pertinent trait. The nurse should have had insights regarding her fear of needles as well as the usual process of her check-up from her claims of angel cream. Brandon et al. (2011) also explain that it is pertinent for nurses to create a good relationship with children and also consider ten to their concerns to make a sense of them as a person. The case of Kat indicates a contrary situation to these requirements as the nurse does not seem to listen to her concerns. Instead, the nurse tells her that she needs to grow up.
Kat’s case has been an eye-opener in my dealing with patients. From the way the case is presented, it’s clear that Kat was aware of what was going to happen although she feared needles. This awareness is pertinent in enhancing the course of treatment. In her research, Knutson (2012) relates patient consent to treatment. However, the poor way of handling of Kat makes her anxious and aggressive due to failure of compassion from the nurse. The case has also informed me regarding issues of autonomy. Despite the fact that children’s autonomy is not considered when it’s contrary to good health status, it is essential to administer healthcare in such a manner that makes sense to the child as a person.
Considering the areas inferred above that are of concern, if presented with a similar case, i would solve those shortcomings by the nurse through various ways. One of the critical ways to address the situation is to show compassion to Kat by showing her that I identify with her problems instead of ignoring them. Such would involve listening to her concerns and meeting them when possible such as by requesting a phlebotomist she is used to take her blood sample. Moreover, I would get to know her to identify her fears and comfort her by making the situation meet her “already” learnt settings by such as giving her the angel cream and offering parental comfort. At the very least, I would also consider postponing the check-up until one of her parents came to avoid creating an instance of terror that might affect her future check-ups considering her development state (Brandon et al., 2011).
Brandon, M., Sidebotham, P., Ellis, C., Bailey, S., & Belderson, P. (2011). Child and family practitioners’ understanding of child development: lessons learnt from a small sample of serious case reviews (Research Report DFE-RR110).
Knutson, G. C. (2012). Nurses’ethical Problem Solving (Doctoral dissertation, University of Toronto).
Kurtz, P., & Burr, R. L. (2009). Ethics and Health. In Lundy, K. S., & Janes, S. Community health nursing (pp.239-269). Jones & Bartlett Learning.
Rich, K. L. (2012). Infant and Child Nursing Ethics. Nursing Ethics, 129.