Reflection on Refusal of Treatment

The purpose of this essay is to select an incident which occurred during clinical placement and to treat and reflect on it in order to improve future practice. To do this, the framework of the Marks-Moran and Rose Model of Reflection (1997) will be used. Utilizing the cardinal stages of this model, I will describe the incident, give a reflective observation, wrangle related theory and conclude with thoughts for any future actions. Any forbearing discussed will be granted a pseudonym to ensure forbearing confidentiality as described by the Nursing and Midwifery Council (NC) (2010).During a new-fangled placement in an Endoscope day unit, I met Mrs. smith who was attending to change a Gastropod. She had a history of acid reflux and had been referred for the procedure as an out enduring scarce had not attended her Pre-Admission Clinic appointment. Upon her arrival, myself and a staff take for took baseline observations and spoke with the tolerant to ensure that she had faste d from midnight which was necessary for the procedure. On advising her on anesthesia, I communicate her that she had two options. The first was a throat spray to deaden the local area and she could leave almost immediately afterwards.The second was drugging and analgesia in the form of Fontanel and Modally which would be abandoned through endovenous accumulation however, she would be buzz off to rebriny with us for several hours post procedure. Mrs. metalworker began to panic and became quite irate. She declared that she had been low the impression that she would be given a general anesthetic agent and would be asleep the entire duration. I explained that the doctor required her to be awake for this procedure and that general anesthetic was not an option. Mrs. Smith so stated that she was withdrawing her consent and wished to leave.The staff nurse who had been observing me swiftly took oer the conversation and tempted to calm down the patient. She cognizant me to escort Mrs . Smith to the private seating room area that was reserved for consultations but not to offer her anything to drink Just in parapraxis she changed her header about the Gastropod going ahead. Once we were all in privateness, the nurse then sat down and asked Mrs. Smith why she was so s palmd. Mrs. Smith stated that she had heard of complications involved with Stereoscopes and she would rather not take the endangerment.The nurse explained that the risk of a serious incident was extremely rare and at worst, she whitethorn suffer from a sore throat and gastric bloating afterwards. Mrs. Smith was supplied with an randomness booklet and we allowed her few time to digest all of the learning that she had been given and assured her that any questions she wanted to pose would be answered. Afterwards, she stated that she gloss over did not want to brook the procedure and that she wanted to go home. At this point, the nurse advised that she should return to her doctor and inform him th at she had not undergone the test.Mrs. Smith was in like manner advised that she could return at a later particular date if she so wished and then she left the clinic. During my explanation of the procedure, I matt-up resourceful enough to fully explain what it entailed. However, when Mrs. Smith began to panic, I lost some of my confidence as this was something that I had not faced before. Therefore, I felt unable to calm Mrs. Smith down as I was scatty experience in this scenario. I was pleased that the nurse accompanying me took over in an instant. I felt to notice this.As I listened to the nurse, I remark the optimism displayed by the nurse when she instructed me not to provide refreshments for the patient. When I later questioned her on this matter, she told me that she had been in the same position any times before. Mrs. Smith was fitted enough to exercise her amend to refuse interposition. This is the clean and ethical right of every patient so long as they are deemed to perplex the mental capacity to make such a choice (Griffith and young 2012). A medical professional cannot force a patient to undergo a procedure against their will.However, the practitioner must discuss all intercession options, relay the correct information and allow the patient time to surveil to an independent and cognizant decision (Ellen et al 2012). The term Autonomy underpins the patients ethical and moral right to choose which path of treatment, if any, that they will follow. Glibber and Kingston (2012) state that the patients impropriety is in the clinicians circulates under duress of professionalism and nursing ethics, our advice and information is answerable for any decision reached.In this instance, Mrs. Smith was taken to a private seating area where a nurse calmly talked her through the procedure at length, answering any questions and also informed her of the statistical risks of a Gastropod which were her biggest concern. By doing this, the nurse wowed th at she was empathic to the worries of the patient and also did her utmost to preserve patient confidentiality, as well as, providing a wealth of information preceding the refusal of treatment (Torrance et al 2012). It was obvious from the reaction of Mrs. Smith that she had anticipated treatment under a general anesthetic at her appointment.When reading through her notes old to admission, I realized that she had not attended the pre-admission clinic. Had she attended this previous appointment, she would hold in been given all the information required for her proposed treatment. She would abide been briefed fully on sedation, the basics of the procedure and many other factors consistent with treatment. Claritin et al (2009) describes pre-admission clinics as a necessity to provide the correct information and give patients the time to think and digest before presenting at hospital for a procedure.Evidence shows that pre-admission clinics go through reduced the instances of failure to attend appointments and that patients are more than involved in their wish well, which encourages a higher rate of recovery and reduces stress levels pre-operatively (Mitchell 2008). Knox et al (2009) also suggested that the implementation if these clinics have substantially reduced the instances of refusal of treatment due to more accurate information being given in a prospering setting at a more relaxed time. If Mrs. Smith had attended the pre-admission appointment, she would have been given all the information and been able to ask any questions that she wished.Thus she would have been aware that she would not be offered a general anesthetic and a deeper understanding of the procedure. Thus this may have resulted in assisting Mrs. Smith with regards to informed consent. The nurses working within the clinic were all very well versed in the procedures and wel enumerated any questions. As soon as Mrs. Smith began to worry, in that location was decent evidence on hand in the form of a patient information guide as well as a learned nurse. In a study conducted by Amtrak (201 1), patients were found to be more comfortable when in the presence of a knowledgeable nurse.Patients overall cerebrate that this group to benefit from this. Postural et al (2010) suggests that the experiences gained by nurses in narrow down areas are beneficial to the learning curve of student urges and their knowledge is a valuable tool in the production of a more advance health care system. In the case of Mrs. Smith, the nurse highly improve in this area and was able to sufficiently assist the patient in making a fully informed choice without being liberal of any facts. Moser et al (2007) describes this approach as a highly efficient way of achieving patient autonomy.In this scenario, the nurse was catering to Mrs. Smiths first and foremost care requirements. During my reflective observations of this experience in my training, I have realized that there is nothing rater tha n knowledge and experience to assist patients with many aspects of their care. In the case of Mrs. Smith, the manner in which her questions were answered was tactful and informative. However, the patients right to choose was evidently the main priority. Mrs. Smith was never coerced, all information required was on hand and supplied without delay.The nurse ensured that she was competent to refuse the treatment and advised on how to come on following the refusal. An obvious effort to calm the patient was do and the privacy afforded by the private seating area dad a wide difference in allowing her to digest all information that she had been given. The nurse made a tactful decision by advising me not to offer refreshments in case of a decision to proceed, however, this did not occur. In hindsight, I have realized that I have a long and hard avenue to travel before I am capable of the level of care that I would like to give my patients.I can draw from this experience and I can see th at having the correct information is a must date at the same time being aware of the patients feelings and offering them an informed and involved choice in their care. I have also come to understand the relevance and requirement for clinics such as pre-admission. These clinics are congenital in reducing patient anxiety, ensuring that patients have all the correct information and fully understand their proposed procedure prior to presenting for treatment.