Reflective Practice Portfolio: Nursing Leadership And Management

Reflective Nursing Practice PortfolioNameInstitutional AffiliationDate
Reflective Nursing Practice Portfolio
Question 2: Reflecting My Clinical Experience as a Nurse
There are various circumstances where you as a clinician you are supposed to make an ethical decision when you are dealing with a given situation. In my clinical experience, I also faced challenges, and I was therefore forced to think and make an ethical decision. There was a 43-year-old woman who had lived with disturbing hallucinations which were filled with persecutory delusions for the past 20 years. The hallucinations had interfered with her daily living, and therefore she had been admitted and discharged from various psychiatric hospitals for at least 20 times.
It was discovered that the woman had a mental disorder and she completely refused treatment. The health care providers determined that the woman was not only a danger to herself but also the other people that she stayed with. After being discharged from the health facility, it was agreed that the community mental health clinic would be given the responsibility of treating the health condition of the woman. She was therefore supposed to make regular visits to the hospital for a checkup. During the time of her visit, her diagnosis varied during his rare visits since the healthcare workers who were dealing with her kept changing given the regular transfers that happened at the clinic. She was diagnosed with having disorganized schizophrenia, schizoaffective disorder, borderline personality disorder traits and bipolar disorders.
The woman again came back to the local community psychiatric clinic to seek for assistance. She was admitted to the hospital, and she was later released on only one condition if she agreed to see a therapist. The woman had seen all the other clinicians at the hospital. It was my first week at the facility, and therefore I received the referral. So many questions lingered up in my mind, "Should I accept the referral given that I have the least amount of clinical experience?" Given the deteriorating health condition of the woman, I made a decision to accept the referral.
At the time of the referral, she was on an injectable medication that would help her to control her psychotic symptoms. On most of the occasions, she would refuse the medication altogether and run away from the clinic screaming. On another occasion, she told me that she would only accept the injection if it was given while lying outside naked, with her hands raised up and her legs together. She then began to yell at the hospital "So that God can see what you are doing to me." She sure enough went and did it. I asked myself, Should I go ahead and administer this injection to her? At times she would phone me almost 30 times in a day saying that she was in a dangerous health condition. My colleagues advised me to avoid receiving the calls since it was becoming too much. I asked myself, "Should I avoid receiving her calls?"
As a way of answering the questions that were lingering up in my mind and making a decision, I began by recognizing that the woman is a human being like me with an identity. I used the Relational Ethic Framework in handling the situation. Relational Ethic Framework provides that there are other situations that a health care professional needs to act per the presupposition of the existing situation from their perspective rather than from a generalized view CITATION Che15 \l 1033 (Cheryl, 2015).
These are the relationships in which the healthcare professional acts in accordance to a presupposition of the existence of a concrete other, rather than a generalized other. I, therefore, took my time and sometimes I would visit her home in town and it was tough for me, but after two months the woman continued with her medication. On the visits, I would encourage her with the help of her relatives on the significance of medication. I also realized that despite her condition she was so religious. We would, therefore, study the Bible together by reading to her Bible verses. It was an application of the ACA code of ethics in E5b about Diagnosis of Mental Health Disorders. It states that a nurse must take into account how the culture of the patient influences their way of life CITATION ACA14 \l 1033 (ACA, 2014). Her health condition started improving, and she would sometimes come voluntarily to the clinic.
Question 5: Description of my Healthcare Clinical Agency
The name of my clinical Agency is Burghaton Healthcare Clinical Agency.
Health Care Delivery System
I understand that for the people to enjoy optimal health, my agency must be coordinated with an active public health delivery system.
Burghaton Healthcare Clinical agency will provide three primary delivery systems. We will provide:
1.Outpatient care- for the patients whose condition does not require that they get admitted to the hospital. The patient will first visit the primary care physician who will give the recommendation about the health condition of the patient after which it will be evaluated whether they should stay at the healthcare facility.
2. Inpatient Care- Depending on the recommendation of the primary care doctor, there is a medical facility that will be admitting patients who may require special treatment at the hospital. It is divided into three main sections; acute standard Facility, acute intensive, follow up and long term.
3. Medical Rescue and Emergency Services- There is an emergency phone number for contact. It will be providing hospitalization emergency care to individuals with a severe health condition or someone who is in a life-threatening situation.
Organizational Structure of Burghaton Clinical Agency
132397550165MEDICAL DOCTOR (SUPERVISOR)00MEDICAL DOCTOR (SUPERVISOR)
2695575107315
157162521590MEDICAL ASSISTANT00MEDICAL ASSISTANT
26860504127534956756032500172402541275 
237172562865NURSE00NURSE64770053340PHYSICIAN00PHYSICIAN319087472390SURGICAL OFFICER OFFICERtecTECHNOLOGIST00SURGICAL OFFICER OFFICERtecTECHNOLOGIST
1666875281940PHARMACIST00PHARMACIST609600253365ASSIST.PHYS00ASSIST.P...