Critical incidents and our behaviours.

Critical possibilitys and our demeanours.What is decisive incident? Critical incident has been defined in different slipway depending on the nature of the incident and the environment or setting where it took place. Tripp (1993) defines precise incidents as a commonplace events that occur in r push throughine sea captain practice Incidents may relate to range of issues amongst which issues of communication, relationships, moral beliefs and ethical values, knowledge, coating or emotions. The definition I like best is that a life-sustaining incident enquire non be a dramatic event, exclusively it is an incident which has significance for us. It is often an event which make us check and think, or unrivalled that raised questions for us. One that may restrain made us question an aspect of our beliefs, values, attitude or behaviour. It is an incident which in many way has had a significant impact on our individualized and professional take and schooling (MU).Curiosity is a basic gay emotion. The psychologist William McDougall states that The instinct of curiosity is at the base of many of mans most sharp achievements . As humans we all have the drive to find sensible ex platformation of lived events and our surrounding. We do that though trying to examine or chew over on our experiences. According David A. Kolb (1984) reflection is an inseparable part of the learning process. This is the part during which by analysing effrontery event we enhance our knowledge, enrich our practical experience and prepare for new and contest situations.Different frameworks have been developed to uphold the development of little reflection. Most prominent are the models of Kolb (1984), Gibbs (1988), Atkins and Murphy (1994), Johns (2000), Rolfe et al (2001) and Lister and Crisp (2007). Lister and Crisp explain that critical incident epitome has developed as a tool to helper critical reflection in practice, in health and loving work. It has been used to ch ange students to describe and look for issues from their practice (Nygren and Blom 2001), (Montalvo 1999).PoDAIT describes that Critical Incident Analysis is an fire to dealing with argufys in every solar day practice. and that As pensive practitioners we need to ride problems about our practice, refusing to accept what is. We need to explore incidents which occur in day-by-day work in order to understand them better and find re showtime ways of reacting and responding to them. Therefore it is safe to conclude that critical incident analysis can enable professionals to reflect on their practice and to explain and liberate it.AccountDuring my placement at a south London CMHT I had short period of working with the duty team up. This was when I and the MH nurses Q met send away X for an initial opinion.Several days pursuance lose Xs sound judgment her casing was discussed at a clinical study with one of the team consultants DR G and it was decided that the dosage of her medications is to be altered. When I informed her GP of the supra I was told that her medications have already been adjusted and that the dosage is different from the one given on her referral. This created the need for look backwarding missy Xs case second term. In the meanwhile Dr G left-hand(a) the team and was replaced by Dr V.By that time I had finished my period of duty work and despite the circumstance that I had recorded all reading on the internal database and that take out X was still a duty customer I was asked to perplex her case at Dr Vs next clinical review. I had no objections as I had knowledge of the client, and especially as Q was non present. At the review was decided that Dr. V entrust offer Miss X some other(prenominal) appointment. I recorded the outcome on the internal database and in any case inform to Q who happened to be on duty shift. I also informed him of the need for Miss X to be notified of her appointment.On the agreed appointment get word Miss X did not attend and when contacted by phone she verbalise that she was not notified of it. Dr V asked me to offer her a new appointment for the following week. I had no obligation to liaise with the Miss X or do any work on the case as she was a duty client and I no longer had formal booking with her. Nevertheless, I notified her of the new appointment did both over the phone and in writing.When the second appointment came Dr. V asked me to attend the opinion with her. I was not required to, however I accepted. I decided that while Miss X would be much comfortable with a familiar soul during the meeting, I would have tidy learning opportunity attending an assessment conducted by one of the team consultants.When Miss X arrived I introduced Dr V to her. During the assessment Miss X give tongue to that her medications have not helped and that she cannot cope. During the assessment she was wringing her hands and became tearful. Dr. V identified that Miss X had not been victorious her medications at the appropriate time and that sleeping in the afternoons could be bestow to Miss Xs difficult night sleep. During the assessment Dr. V suggested that she can charter down Miss X a number of different sleeping aid medications. However, at the end Miss Xs medications were not changed and she was told to continue with her current ones, save to take them at the prescribed times. Dr V informed Miss X that she will offer her a follow up appointment in devil weeks time, in order to assess her progress and to change her medications as and if necessary.Following the assessment I went to the duty workers and asked them to come for an update from Dr. V. 2 of them were busy and the third one Z who is a MH nurse was dismissive. As I could not get anyone from the duty team to come I went to the doctors office for final discussion and planned to record the outcome of the assessment and any terminations on the internal database. While we were discussing Miss X s action plan Z entered the office. It was jointly agreed that Miss X will be offered follow up appointment in two weeks time.Later in the day Z came to me and asked me whether I have recorded the appointment in the duty diary. I informed her that I have not as my understanding was that this is consultants appointment rather than a duty one, which is normally not recorded in the duty diary. Nevertheless, she insisted that I do so. As I recorded the appointment in the diary, which I found on Zs desk, Z came and asked me not to make the appointment for the agreed date plainly for the day after. She explained that the appointment fell on a day which should be apologise of duty appointments. I was obviously confused as the date was chosen by Dr V and the other 2 previous appointments were both schedule for the same day of the week without that organism a problem. Z say that she has spoken to Dr. V regarding the appointment already. While trying to be helpful, having been given ambi guous information and the fact that Miss X was not my client to start with, I decided to step back and asked Z to expire any confusion with Dr. V.On the following day during Dr. Vs clinical review meeting Z presented Miss Xs case with suggestion for her to be fired back to GP. To my big surprise Dr. V agreed with the suggestion. The rest of the team approved her conclusion silently. As the team had moved onto discussing other client I did not want to interrupt and did not speak out until the end. Having considered the distressed and tearful state in which Miss X presented, during the two assessments, her describes of feeling hopeless and without support, and her previous suicidal ideation, I asked if we could have other look at her case and perhaps offer her one more appointment before discharging her from the team.Dr. V said that she had reconsidered her yesterdays decision and assert that Miss X presented low risk therefore she did not require and input from a consultant. In principle I agreed that Miss X may not have to be seen by a consultant. Nonetheless, I still felt that it would have been appropriate and an example of good practice for a member of the team to see Miss X before discharging her, especially after she was told to expect further support. Z suggested that I should take the case on. I explained that without my placement tutors permission I am unable to accept any new clients. Z suggested that keeping her as a client for an extra week or two puts accent on the duty team and suggested that as alternative to grimace to face appointment I can call the client. I agreed to that, but highlighted that due to my student capacity I would still have to be supervised by a team member. One of the senior well-disposed workers commented that I will be given credit towards my competencies, for advocating for the client. My request was left unanswered and Z said that she would deal with the case. Following the meeting another member of the team also a MH nurse spoke to me and said that I should not have brought up this question and contested the decision made by the consultant.I provided my practice assessor with a report of the situation however, it never went any further.I tried to look at the whole process and the outcome from Miss Xs perspective and tried to explore her feelings.Removal of formal and informal power barriers between the su and s providersDid not feel like I could change the decision and speaking to the cons. Would not have been benefitial.I was surprised if not even shocked by the consultants decision. Earlier I had observed (noticed) a certain level of indecisiveness as whether to prescribe different medication s or not have offered a range of different meds however did not buzz off to any of her own suggestions. Reflecting on that I tried to justify her behaviour accepting the fact that along the assessment different new information came to light. (reflected on her actions and decisions made)Power dynami cs, my student and consultantBeing familiar with the expatiate ot the case I felt it was morally and ethically unjust to proceed silent and not bring the matter upBeing cocky but not argumentative(being diplomatic)in this situation my believes and values clashed with the decision taken What was the office thing to do. Keeping in mind my placement in the team as student on placement, without extensive social work experience and not familiar with the power dynamics indoors the team I was double minded as to whether to Express my contrast by suggesting an alternative approach to the situation and in this way challenge the decision taken by the consultant or to remain silent. In this situation the final decision about the care of the patient was being made. I (felt) was aware that once the decision was made speaking in private with any of the participants would not be constructive or bring positive results.LearningNo one likes being challenged and when this happen some people may become self-protective and resistant to accept others views which may also impair future joint working. It is important to highlight that by challenging certain decision it is only the decision being challenged and not the person. afterwards all the joint goal is the wellbeing of the client and not proving who is right or wrong.Be aware of office power dynamics and be mindful that some professionals may be strongly opinionated and confronting their views on a particular matter has to be made with care and in non confrontational approach. Sensitively approach and challenge others opinions try to (prevent from happening) diffuse supercharged emotionaly situations (to be diplomatic) When analysing a critical incident, it is useful to ask yourself questions such asWhy do I view the situation like that?What assumptions have I made about the client or problem or situation?How else could I interpret the situation?What other action could I have taken that might have been more helpful?Wha t will I do if I am faced with a kindred situation in the future?RefsAtkins, S Murphy, K (1994) Reflective formula Nursing Standard 8 (39) pp49-54Evans, D. (1999) Practice Learning in the lovingness Professions, Aldershot, Ashgate.Gibbs G (1988) Learning by doing A guide to teaching and learning methods. Oxford Further Education Unit, Oxford.Johns C. (1995)Framing learning through reflection within Carpers original ways of knowing in nursing. Journal of Advanced Nursing 22 p. 226-234McDougall W. (2003), An Introduction to Social Psychology, Courier Dover PublicationsRolfe G., Freshwater D., Jasper M. (2001), Critical verbalism in Nursing and the Helping Professions a Users Guide. Basingstoke Palgrave Macmillan(M.U.)(http//www.monash.edu.au/lls/llonline/writing/medicine/reflective/2.xml)KOLB D A (1984) Experiential Learning experience as the source of learning and development New Jersey Prentice-HallProDAIT http//www.prodait.org/approaches/cia/ accesed.