Tuesday, 10 July 2012

Reflective practice in Health and Social care


REFLECTIVE PRACTICE



Lots of people ask me what this is and how it is done. Here’s an overview:



WHAT IS IT?

Staff who can practice reflectively are in demand. It requires a worker to be non-defensive.

There is ALWAYS something different that you could have done. Not necessarily BETTER….just DIFFERENT!!

To practice reflectively involves being able to think about an event after it happened, critically evaluate your actions and make adjustments if necessary.



WHO DOES IT?

In an ideal world….everyone.

In reality the people you work with are all different. Some find it harder than others. This is largely connected to the need to be seen to be doing the right thing. Let’s face it. We all hate criticism.

Reflective practice is not criticism. It is being open and honest about your strengths and areas for development.

If you are able to do it with others they will feel able to do it with you.

Reflective practice might be done as part of a De-brief, with supervisors or other professionals.



HOW TO DO IT

Pick a recent event and ask yourself the following questions:

How did I work safely? Or not?

How did I use my knowledge of the client in decision making? Or not?

Were there any personal values involved? What were they and how did they impact?

What could I have done differently?

What might of happened then?

What would I do differently next time?



EXAMPLE:

Scenario:

Client X has locked herself in her room. She is not communicating but can be heard making noise. Client X has made suicide attempts recently. I decide that the staff need to enter the room. I give Client X fair warning and then staff use the spare key to enter. Client X has her headphones in and so has not heard us. She is angry and attempts to assault a member of staff which results in Client X being restrained.



How did I work safely? Or not?

I considered current and recent risk of harm to client X as she has recently made suicide attempts.

I could of considered that as Client X was making noise she was clearly alive. I also could have considered the risk to others from Client X.



How did I use my knowledge of the client in decision making? Or not?

I used my knowledge about their risk factors.

I did not use my knowledge of the clients habit of listening to music through her headphones as a distraction when she is feeling low.



Were there any personal values or feelings involved? What were they and how did they impact?

Looking back I was anxious. I was the one who recently found Client X after she had taken an overdose. I was anxious about this happening again. I think this impacted on my judgement.

What could I have done differently?

I could have asked the rest of the team (who may have felt calmer) what their thoughts were, before making a decision.

What might have happened then?

They may have waited longer before entering the room and given Client X more time, as they could hear her moving around.

Client X may have come out of her own accord.

What would I do differently next time?

The actions I took were in the best interests of Client X in terms of safety. However, I may have overreacted because of the previous incident.

If I discuss these types of decisions with other staff they may be able to provide more information about things like the clients behaviour before an event and throughout that day. This may impact on assessment of risk.



This is an extreme example but you get the picture??

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NEXT TIME- Equality and Diversity