Health Visitor Reflective Essay

wellness Visitor Reflective EssayI aided a core group meeting for a family with interlacing exacts. P atomic number 18nts Poppy and Richard had struggled to oercome a class A drug addiction and that thither were grave concerns about the whole virtuallybeing of the 4 children in the family home. I sit reverse Poppy across a sm either table as this was the pass purchasable seat in the room. Richard was unable to attend plainly it had a precise positive start for Poppy who discussed some of the improvements since the last official meeting. She appe atomic number 18d capacity and motivated to en sure enough things continued to improve. I was sure that an significant discourse was going to take military post about a serious possibility which had occurred inside the family and had been observed by a wellness visitor tour the family next door. The purpose of the countersign was to expect Poppy to d acceptstairsstand the risk of infections of leaving children unattended i n the car and readdress the on-going materialization of smoking around the children in check spaces. The issue was broached by the social worker and Poppy immediately convey unease. She denied having been involved until Poppy was informed it had been witnessed by a nonher health visitor. Poppy became in truth(prenominal) angry, very quickly and make reference to the c all the health visitor (her name had not been disclosed in the meeting). Her enkindle was then directed at my residential argona practice teacher and me as the health visitor/ scholarly soul in the room. Poppy maintained piercing look march with me and when I glanced onward she noticed and it escalated her anger. Amongst the shouting and swearing Poppy was asking why Health visitors unceasingly interfere with her family and she was expressing that thither was nothing wrong with what she was alleged to bring forth done. As the main put one overr of Poppys upset I tried to put fighting(a) earreach skills in to practice.Chosen Reflective Model and Rationale reflectance is described by Boud et al (1985 p43) as a generic terminus for those intellectual and affective activities in which individuals engage to explore their exists in sound out to pass to a new soul and appreciation . It is deemed a specially valuable tool within the health profession for many reasons. rumination is a tool which feces be drilld at all trains within the health c atomic number 18 setting and is arguably imperative within practice (Ralphe et al 2011). It facilitates critical thinking (Cotton 2011) and by scrutinizing experiences paids are then able to decipher the evidence within their own practice.Moreover it supports practitioners to denounce much sense of hard-fought and complex events (Driscoll and Teh 2001). The collection of enjoyledge of individuals and groups through and through the form of refelction helps people to look not only at the situation but at how to transform it l iberal to be able to reach to improve similar situations which may arise again. Thus leading to ameliorate practice (Ghaye and Lillyman 2010)Examples of reflective models include Gibbs (1988), Johns (2004) and Driscol (2000). Johns model is recommended for more(prenominal) than(prenominal) complex formula and decision making (REF). On one hand this would work well as a basis for this assignment but the model looks at the situation which has been resolved and it could be argued that it does not consider how the situation can be taken forward (Rolfe 2001). Although this could be adapted the Gibbs model of comment (Gibbs 1988) has been chosen as a guide for this assignment. Despite being a fairly straight forward model, it is favourable beca delectation it aids a white description of the scenario, analysis of discoverings, evaluation of the experience, analysis to make sense of the experience and conclusion for each point that give be reflected upon. This enables mensurable friendship on what I would do if the situation occurs again.Communicating in hard Circumstances and Relevance to Health VisitingAccording to the Department of Health (2007) one of the key elements to health visiting practice is to deliver the rose-cheeked child programme (Department of health 2009). This outlines the role of the health visitor and this includes the need for the health visitor to reduce health inequalities and protect children at risk (Department of Health 2009). The distressing discourse for Poppy was aimed to protect the children from potential harm caused by cigarette smoke and also to protect the children from the harm of being remaining unattended in a smoky car. It was commentd that smoking consequence had been suggested to Poppy but denied with such ferocity that the idea was to put things in place to protect the children from being harmed as a result of her smoking. After all as professionals we shit to remind ourselves that Poppy has a right to smok e if she chooses to. The safeguarding of the children is predominant and whence despite it being a tricky issue to address, it was an issue which was live to work with in arrangement to safeguard the children.It is important to lie with that delivering these messages set out in the healthy child programme (2009) are not always straight forward. The people at highest risk of pitiful health are often those who save a lesser understanding of the consequences of their actions on the health of themselves and their families. They are perhaps less standardisedly to bosom the information which is delivered to them and the fact that this information is often changing (Knai 2009). Good communicating is therefore crucial. Communication is defined by Porche (2004 pp266) asThe transfer of learning and the understanding of the information from one individual another. It is the answer through which individuals parting thoughts, ideas, facts, beliefs, values and traditions.The departmen t of health (2012) recently published Developing the destination of Compassionate Care, which highlights Communication as one of the 6 Cs (Care, Compassion, Competence, Communication, Courage, Commitment) need to maximise compassionate care. It be interiors that vertically parley skills contributes to better listening which results in people receiving care tone valued and therefore happier with the service they give (Department of Health 2012).Focusing on chat in exhausting situations is very relevant to Health visiting practice as there are frequent barriers which can imprint delivering the public health messages. In this boldness the barrier was Poppys resistance as a loving Mother to certify the risks which her actions may take hold on her children and the emotions this consequently provoked creating a difficult situation in which to fall not unless the public health messages but to support Poppy in de-escalation. Resistance to accept information and support from health visitors is an on-going issue (REF) so having the opportunity to critically reflect on the situation will support me to ensure better practice in futurEye ContactInitially Poppy seemed calm and positive about the draw near she had made with her children ward offed kernel achieve. However when angry, Poppy maintained strong nerve center converge with me in particular. I was surprised at how intimidated I mat up, not by the shouting and verbal abuse but by the intense way in which Poppy was looking at me. I glanced away and looked towards my community practice teacher. This move that for me seemed quick and subtle had a profound effect on Poppy and she demanded I look at her when she is public lecture to me and this was followed with a threat.As specialist community public health nurses it is important to recognise that conversation goes way beyond the verbal conversations that we have with people. Nonverbal talk plays a very strong role in the impressions that we gi ve to people therefore having an understanding of what happened with Poppy is key to furthering my communicating skills and awareness in prospective.Non-verbal communion is profound. look and nerve center extend to are a major part of non-verbal communication and many messages are consequently sent and received by the look (Sieh and Brentin 1997). The mortal who is listening holds midsection tie-in with the loudspeaker system in order to express that they are listening and taking on board what the speaker is saying. The speaker holds eye contact with the listener so that they will k presently that the conversation is being directed at them (Lerner 2002).It is a real altercate to define normal eye contact as it differs from soul to person depending on personal preference and aspects such as culture. (REF something on culture). It is not possible to create a text book advising when to look and how farsighted for (Rungapadiachy 1999). Therefore responses to eye contact are open to interpretation and could lead to confusion within communicative situations (Sieh and Brentin 1997).Eye contact can have a positive impact on people. A correct level of eye contact from the listener can make the person oral presentation feel as if they are being listened to and listener is interested and centre (Rungapadiachy, 1999). Alternatively, any form of eye contact can cause some people to feel uncomfortable, self-conscious and threatened (Rungapadiachy, 1999). Minimal eye contact may indicate lack of interest (Sieh and Brentin 1997) but it is important to acknowledge that eye contact may be less prominent when piquant in difficult or intimate divisions (Rungapadiachy, 1999). Knapp (1978, cited in Rungapadiachy, 1999, pp206) recognises that when a person is disapproving of something it can be displayed in aggressive and daunting eye contact. Furthermore early signs of anger can be shown via intense and leaden eye contact (Neild-Anderson et al 1999).Poppy initiall y avoided eye contact. She may have felt self-conscious being surrounded by professionals and despite the discussion being originally very positive, the subject matter was also intimate and personal. Similarly possible that she was able to anticipate what was about to be said.As Health visitors the heart of what we do is safeguard children physically and emotionally. The information discussed was vital within our role but it was not easy for her to deliberate and acknowledge. The affright eye contact displayed could have been because she was feeling intimidated or she was not accepting of the information being given to her. Moreover, I broke the eye contact momentarily and this may have upset the foundation of the conversation. For Poppy this could very easily be construed as non-compliance to listen on my part (Kidwell 2006).If we feel that something is unacceptable then it is likely that our eye contact will change magnitude (Rungapadiachy 1999). I acknowledge that I looked away from Poppy whilst she was communicating with me. Consciously I feel this is because I felt intimidated. However perhaps subconsciously I was not accepting of what she was saying.I attempted to communicate to Poppy through non-verbal communication that I do care and I appreciate that the situation was not an easy one for her. This is much like the view of Chambers and Ryder (2012 p106) who acknowledge that many nurses have become very skilled at communicating messages and meaning without words. However in this gaffe, either I was not characterization myself in the manner that I intended, or it went un noticed as a result of Poppys heightened state of anxiety and upset.At the time I did not consider that Poppy could have misinterpreted my eye contact for staring. Poppys behaviour was intimidating but this did not exempt her from feeling intimidated herself. It is possible she felt under attack as a result of the raised concerns and prolonged eye contact on my part could have been t hreatening (Duxbury, 2000).Moreover, averting my view suddenly, may also have signalled fear in me which could also have distracted Poppy from getting her point across (Manos and Braun 2006). Alternatively I acknowledge that eye contact is also natural process and the anger which Poppy displayed did frighten me thus triggering a fight or flight answer (Manos and Braun 2006). I did not escape physically but there was a shift in my gaze in order to avoid a threatening glare and it could be argued that this does not assist good listening.Although it was not possible in this situation because of the room space, I understand the importance of positioning within a meeting. I was positioned directly opposite Poppy which meant that I was the centre of her vision and she of mine. This meant that where less intrusive peripheral eye contact may have worked better, I was holding what could have been construed intimidating contact (Duxbury, 2000).My Community Practice teacher fed back that my expressions and levels of eye contact were acceptable and skilled. She viewed the reaction as unavoidable because of Poppys nature and the topic of the conversation. I acknowledge that there were a number of factors which triggered Poppys anger and it is because I deem eye contact so important that I have prioritised it. It is very difficult to know whether it directly correlated with the escalation of her emotions and if it did which of the supra discussions apply to her. However as a result I am more aware of different personalities and how communication methods can be interpreted and it is this which is so vital for future practice.Seih and Brentin (1997 p5) reinforce this by stating Being sensitive to your own eye contact patterns and the patterns of those with whom you communicate will help you be more perceptive of what is occurring in the communication process, restless ListeningI was aware that Poppy needed support to deescalate. I was not confident addressing this myself d espite having had long time of experience deescalating distressed people who displayed dispute behaviour. This was different. There was pressure on me as Poppy had targeted me and I was feeling increasingly intimidated by what was happening. Whilst Poppy was shouting I nodded a few times so she would feel listened to. She made some unpleasant threats to my community practice teacher and me and was suggesting that there was no problem with leaving children unattended in a smoky car or in smoking with them on her lap. I was equally careful as I did not want to give the impression that I was condoning what was being said. When brisk listening was used Poppy did respond calmly on occasion. Verbal contributions which I made in response to Poppy includedAm I right in thinking that you feel that your privacy has not been respected?Are you saying you feel health visitors dont think you are a good mother?Active listening is central to good interpersonal skills (Wondrak 1998). Where listeni ng may be deemed passive when a person is talking and another listening it is in fact very progressive. Active listening is defined by Arnold and Boggs (2007 pp201) as a dynamic, inter quick process in which a nurse hears a clients message, decodes its meaning, and provides feedback to the client based on their understanding of what has been said. It is deemed an empathetic means of communication where the listener understands and shares the feelings of the person talking whilst recognising they are not their own feelings and opinions (Balzer-Riley 2008.)A significant advantage of spry listening is that it prevents misunderstanding. By relaying back to the person what they say they are feeling it ensures that there is no guess work and thus confusion over what is being said (Balzer-Riley 2008). Active listening is therefore a reusable tool in attempting to defuse situations involving conflict (Reznic et al 2012). It allows the individual to communicate and get a response when con versation is not appropriate. In these exemplifications the use of active listening enables the person talking to feel like they are being engaged with but without bombarding them with information they are not in a position to receive (McBride and Maitland 2002).Actively listening gave me the opportunity to be proactive. I was embarrassed and threatened and felt that it was my fault that Poppy was upset (as a result of me diverting eye contact). I had a personal contend because on one hand I felt sad for Poppy as she was clearly distressed and I understand that she has a lot of difficulties in her life. On the other hand I was shocked that she said that she did not care about the issues in hand. It could be argued that she was being defensive because she felt uncomfortable in the situation however the issued in hand were very real and reflected what she was saying.As theory suggests, active listening in this instance was helpful. It enabled Poppy to feel that she was being listen ed to and perhaps even understood. Although Poppy appeared fraught, the fact that I was relaying to her what she had just told us seemed to gradually calm the situation. It was my hope that by actively listening we would eventually get to a point where Poppy was ready to talk and receive advice and information. I acknowledge this was perhaps nave but Poppy was sceptred enough to make the decision to walk away to calm charge. Despite the challenging situation there was no obvious misunderstanding to be resolved, more a serious issue which needed to be addressed.I would like to have been able to offer Poppy some space to calm down but this would not have fitted in with the core group. I was very conscious that there were a room full of people honoring and that this would not have supported Poppy to deescalate. It was a relief that by actively listening to Poppy, my CPT was able to encourage her to make the decision.In contrast to the good word I made for future practice regarding eye contact, it is recommended that the listener sits forthright in front of the person talking and maintains good eye contact when engaging in active listening (Duxbury 2000). I would agree that this is the cutting when the conversation is calmer however I learnt that in this scenario this was not appropriate as I was sitting directly in front of Poppy. The verbal communication I contributed through the active listening process had a more positive impact than the way in which I was sitting. Linking in with the above demonstration about eye contact, it is recommended to maintain good eye contact with the person talking if it is within their cultural boundaries (McBride and Mailtland 2002).Active listening will be a dynamic part of my communication methods in future and I aim to learn more about the effects of active listening on people who receive care. I would like to attend further training in this area as I now see it as a vital aspect of communication and I acknowledge that ac tive listening skills can be improved. As an active listener, sensitivity is a key concept and I believe it is a method which could be particularly beneficial when communicating with women who are despicable with post natal depression.The concept of active listening is consistent however the ease in which we do it will vary from case to case as will the outcome. The situation described above was tense and it took possession for all those involved not to engage in a conversation which could have caused the incident to worsen further and the non-verbal communication methods varied from what is recommended. In future I will be aware of adaptations which may be required rather than solely facing them at the time. Ultimately active listening will be valued as much as any other forms of communication.LeadershipAs previously established, communicating in difficult circumstances and communicating information which may be difficult for families to acknowledge is not unique in health visiti ng. As health visitors embrace new drawing cardship challenges it is important to acknowledge the above reflection and consider how what has been learnt can be disseminated through teams. Throughout the SCPHN course communication skills such as active listening are taught and these skills are useful not only in communicating with families but also with teams. twist relationships and having the ability to communicate and negotiate successfully are key skills in drawship and being able to gage appropriate eye contact and active listening both come under the umbrella of communication (Adams 2010). Effective communication is a core competence in good leaders (Sobieraj 2012) and this is demonstrated in the NHS Leadership Framework (REF) which prioritizes communication as a key component.Recommendations for future Practice as a leaderFurther training in non-verbal communication skills needs to be available to teams as this will benefit communication used with families and further profes sional relationships.Non-verbal communication skills should be discussed with all of the team regularly for example in team meeting s or supervision and used as a measure for understanding and success.Critical reflection on unlike scenarios should be carried out in order to further understanding in these areas and support the application of evidence based practice.Empower team members to communicate effectively and understand the importance of non-verbal communication strategiesAs a leader I will take what I have learnt with regards to this reflection and use the skills in communicating with both families and team members.When making recommendations be sure it doesnt start to sound like a shopping list match this with the demands and pressures of the real world. Maybe find examples of where these suggestions have been put into practicethis helps to warrant your recommendations etc.The above recommendations support the notion of leading with compassion. Offering team members with the compassion we want them to provide enables each individual to feel empowered to give effective and compassionate care of which non-verbal communication is so important (Sobieraj, 2012).