Nursing Practice: Using Gibbs Cycle To Reflect On Smart Goals (Term Paper Sample)

USING GIBBS CYCLE TO REFLECT ON SMART GOALS Student’s Name Course Professor’s Name Institutional Affiliation Submission Date Using Gibbs Cycle to Reflect on SMART Goals SMART Goal Evaluation After reflecting on my current knowledge base and skills as a part-time nursing student, I set a goal to enhance my understanding and performance of respiratory assessment. My main objective was to competently identify the different auscultation areas for the different types of breathing. I would then spend two hours every day going through different learning materials such as books, conducting online assessments on accredited websites, and practicing the different breathing sounds to meet my goal. I am glad I was able to fulfil my goal despite the constraints encountered. For a full month, I dedicated two hours going through either respiratory books or videos. I would then practice the acquired knowledge whenever I felt I had understood the reading, and finally evaluate my performance by doing an online exam score. However, studying and practicing during the weekend was challenging, which limited my reading schedule to weekdays. I also had a difficult time finding a competent nursing practitioner to evaluate my practice. Even though I was determined and optimistic about fulfilling my goals, I experienced self-doubt and reluctance. The mixed feelings faded during implementation, and I felt motivated to go further after hitting daily targets. A break was mandatory whenever I felt overwhelmed or incompetent to study at a particular time. Eventually, I had an in-depth knowledge regarding the assessment of tachypnea, apnoea, Cheyne-stokes, dyspnea, bradypnoea, and hyperventilation. A Review of Respiratory Assessment based on Current Best Practice Evidence A peer-reviewed article by Hunter and Rawlings-Anderson (2008, 41-43) discusses respiratory assessment. They state that a respiratory assessment aims at ascertaining the patient’s respiratory status and giving information relating to other systems of the body. Furthermore, the nurses require skills and knowledge on the respiratory function to conduct a basic assessment and interpret results. Nurses should be competent at peak flow measurements, arterial blood gas analysis, pulse oximetry as well as auscultation (Hunter Rawlings-Anderson, 2008, 41). An empirical study that Leech (2015, 71) conducted on lung ultrasound in cases of critical care discuses auscultation at length. Auscultation entails a routine of assessing respiratory status and a measure of determining interventions for patients. However, the research reveals that although auscultation is immediately available to patients and has minimal discomfort, it has limitations. Incompetent or inexperienced nurses using this routine may generate low accuracy reports due to poor diagnosis. Therefore, nurses are encouraged to use auscultation alongside other assessment tools such as arterial blood gasses and clinical examinations. This information is consistent with what I had learnt but, in this case, it is detailed and specific. Precisely, evidence-based research indicates auscultation is an old diagnostic technique that helps physicians to examine the respiratory system of patients (Bohadana, Izbicki, & Kraman, 2014, 745). It helps to distinguish normal and abnormal sounds based on frequency, timbre, and intensity. The diagnosis should be carried out in a quiet room with the patient seated. The stethoscope is first placed at the apices then moved down gradually until breathing sound fades completely. The second step involves listening to the neck by placing stethoscope at the apices and moved down. A nurse should hear a complete respiratory cycle to ascertain normal breathing (Sarkar et al., 2015, 159). Importantly, Ferns & West (2008, 773) emphasize that nurses should promote patient dignity and privacy and create a conducive environment for patients. These findings correlate with the knowledge I gained during my studies which categorized respiratory sounds based on their clinical characteristics and their correlations. The current hospital guidelines on conducting auscultation are primarily based on giving detailed information regarding particular respiratory diseases and their pathophysiology. They also outline the treatment methods and raise awareness regarding their pathophysiological measurement which is essential in monitoring patient’s health (Johnson & Smith, 2016, 257). The research on respiratory assessment, precisely auscultation, is consistent with hospital guidelines since the study shows that physicians ought to be competent and aware of diseases and their pathophysiology to use the technique effectively. The study also reveals that auscultation applies to specific respiratory diseases. The evidence-based practice and clinical practice guidelines are closely related. However, clinical based practice guidelines are meant to aid nurses in making decisions about diagnosis and treatment that will improve patient outcome. They help physicians to assess the harms and benefits of choosing a particular method of attending to a patient. These guidelines give nurses detailed information regarding respiratory diagnostic criteria such as the use of a stethoscope and the steps involved in conducting the examination. For instance, the guideline provides nurses with tips of improving auscultation such as asking patients to exhale for the stethoscope to receive sound especially if it is faint. Additionally, the examiner can request a patient to inhale deeply then exhale slowly as a technique of slowing down the cardiac cycle to enable the recording of sound pattern. Hence, physicians may follow clinical practice guideline more than evidence-based practice since it is practical. Evidence-based practice has contributed significantly to the improvement of nursing ethics which has resulted in quality patient care. However, its major limitation includes the biased approach to treatment and diagnosis which entails relying solely on published research which may fail due to a restricted view of the evidence. It is, therefore, difficult to translate to clinical practice due to lack of access to best evidence-based practice. The existence of a vast number of published evidence-based research makes it difficult for health instit...