Reflecting on practice in children's palliative care

Palliative care nursing practice can be enhanced if the clinical judgements made in applying palliative care philosophy to individual situations are critically examined and challenged. A model of reflection developed specifically for children's palliative care practice is illustrated here using a critical incident in which the parents of a child with complex disabilities were helped to reduce their caring role and accept increased support. As a result of the structured reflection, the importance of assessing for signs of stress in parents and the wider family was recognised. Additionally, the need for more research specific to the needs of families with more than one child with life-limiting illness was identified as a mechanism for improving the quality of care delivered.     

Reflective practice and clinical outcomes: practitioners' views on how reflective practice has influenced their clinical practice

There has been a recent increasing interest in reflective practice in nursing. There is a wealth of literature about its apparent advantages and benefits, but very little empirical research into clinical outcomes consequent to reflective practice. This study attempts an initial exploration into this area. A retrospective, three-phase, multi-method study in a single department of nursing was conducted. The research sample comprised students and former students of the department who had previously participated in an assessed reflective practice course or module. Years of experience, speciality or academic level did not have a significant influence, but the effectiveness of the facilitator was an important factor. The results suggest that reflective practice is regarded highly and that most respondents could identify significant, long-term changes to clinical practice resulting from it.     

Reflecting on forced medication

There are multiple concerns regarding the practice of forced medication of clients with mental illness. Clients often report that side effects outweigh the benefits of psychotropic medication, while mental health clinicians often think the client may become dangerous without medication. Who should have the right to decide whether a client takes medication? Nursing plays an integral role in the decision making by considering alternative therapies and current research, addressing the diversity among our clients, and ensuring comprehensive assessments. This article presents circumstances that may lead to forced medication and explores beliefs of clients, mental health clinicians, and mental health advocacy groups.Building upon Johns' (2008) model for structured reflections of clinical experiences, this article reflects upon the experience of forced medication in psychiatric nursing practice. First, the process and consequences of forced medication are explored. Next, the factors influencing the thoughts and responses of psychiatric clinicians, clients, and advocacy groups is discussed. Finally, possible alternative actions are presented.     

Reflecting on Forced Medication

There are multiple concerns regarding the practice of forced medication of clients with mental illness. Clients often report that side effects outweigh the benefits of psychotropic medication, while mental health clinicians often think the client may become dangerous without medication. Who should have the right to decide whether a client takes medication? Nursing plays an integral role in the decision making by considering alternative therapies and current research, addressing the diversity among our clients, and ensuring comprehensive assessments. This article presents circumstances that may lead to forced medication and explores beliefs of clients, mental health clinicians, and mental health advocacy groups.Building upon Johns’ (2008) model for structured reflections of clinical experiences, this article reflects upon the experience of forced medication in psychiatric nursing practice. First, the process and consequences of forced medication are explored. Next, the factors influencing the thoughts and responses of psychiatric clinicians, clients, and advocacy groups is discussed. Finally, possible alternative actions are presented.     

Reflecting on events.

This article is intended to give an insight into the world of pre-hospital clinical care. For nurses who are not involved with respiratory or emergency care, it also illustrates the importance of T pieces in treating patients with respiratory problems, and that familiarity and practice are crucial for success with these vital, albeit rarely needed, tools.