I will reflect on an incident that occurred during my shift to develop positive attitude towards nursing informatics. In this reflection, I am going to use Gibbs (1988) Reflective cycle. This model is a recognized framework for my reflection. Gibbs (1988) consist of six stages to complete one cycle which is able to improve my nursing informatics and learning from the experience for better practice in future. The cycle starts with description of the situation, analysis of the feelings, evaluation of experience, analysis to make sense of experience, and conclusion of what else I could have done and also action plan to prepare if the situation arose again.
However, Siviter (2004) explains that reflection is about gaining self confidence ,identify when to improve, learning from own mistakes and behavior, looking at other people perspectives, being self aware and improving the future by learning from the past. In my context with the patients, it is important that the nurse incorporates nursing informatics to improve health care delivery. However Hebda and Czar (2009) defines nursing informatics as the use of information and computer technology to support all aspects of nursing practice, including direct delivery of care ,administration, education and research. Nursing informatics involves the use of computer based information system which according to Stair and Reynolds (2008,pg 4) is defined as a set of interrelated components that collect ,manipulate, store and disseminate data and information and provide a feedback mechanism to meet an objective.
I had just reported from the four months maternity leave and during the shift changeover, I was informed by my colleagues of the new method of requesting for investigations online and that I was to see the team leader to take me through the process. I heard my colleagues discuss a lot on how the new system was consuming their time and since it had been made a hospital policy they had no choice than to adhere to it. This did not sound interesting to me as I did not even have computer literacy and wondered why the institution had changed the system. I shied off from seeking help from my team leader since I did not want to be embarrassed for not being a computer literate. I decided that I am going to use the old method and when I am asked,I will defend myself and say that I did not know about it.
Unfortunately, the team leader did not realize that I had just reported from long leave and needed updates or maybe she waited for me to take an initiative to seek for updates from her as it always happens when one comes back from long leave which did not happen. During the doctor’s rounds, one of my patients had some request for investigations and because the phlebotomy rounds had already taken place, one of the doctors obtained the blood from the patient and left for me to charge and send it to the laboratory. I decided to give the health care assistant the specimen to take to the laboratory hoping that the laboratory technicians would charge it as they had always done before the introduction of the new system.
During the exit round, the doctor inquired on the report and when I called the lab they said that I was supposed to check from the computer. Since I did not have any computer literacy, I pretended that I was checking but the doctor got impatient and decided to check by himself. On checking, the doctor found that the specimen was never charged and so could not access the report. On calling the laboratory technician, it was reported to the doctor that the specimen was discarded because it was assumed to be a reject since they had not found the details online.
The doctor got so upset with me and insisted that I should explain to the patient what happened so that he could obtain more specimen. I got so confused because I didn’t have the exact words to tell to the patient. I then gathered courage and told the patient that the specimen obtained earlier was not enough for the investigations requested and that we needed to obtain more specimen.at first, the patient could not understand but after a second thought, she gave the consent and the specimen was obtained. This time round the doctor lost trust in me and decided to charge by himself and gave a health care assistant to take the specimen to the laboratory.
On reflection of the incident, I felt so embarrassed because such things are not supposed to happen to a senior nurse who is supposed to be giving guidance to the junior nurses. I also felt irresponsible for not seeking help from my colleques on charging the patient’s specimen and that I had not taken the initiative to see the team leader to give me the updates that occurred while I was away.
I felt empathetic for the patient and blamed myself for not taking the proper action. I also felt at my level I needed to have computer literacy because that is what hindered me from seeking help. The American Nurses Association (2007) states that the experienced nurse builds up on the competencies required for practitioners using basic computer skills to information regarding the patient and has to be proficient in her/his area of specialization. The doctors, and other nurses felt upset for my action.
After the incident, it made me think of how I would have handled the situation and how important computer & information literacy is to me and other healthcare practitioners. Selvasekaran (2008) defines computer literate health care provider as that who has basic understanding of the computer hardware, common types of software and different ways in which software application can be used in patient care environment. Association of college and research libraries (2002) defines information literacy as the ability to recognize when information is needed as well as the skills to find, evaluate and use needed information effectively.
It was a shame that my negligence of seeking information led to the waste of patient’s specimen leading to waste of time in obtaining the results. It also caused more pain to the patient since the patient needed to be pricked again and this added extra stressors to the patient who was already stressed by her illness. The other bad point is that the laboratory technician discarded patient’s specimen instead of calling the ward for it to be charged.
I wondered why the institution had changed from the old system of requesting for investigations, I then remembered that earlier I had read from a book on the importance/benefits of nursing informatics in a healthcare setup which included:
•Improved access to information.
•Error reduction & improved communication.
•Decreased redundancy on data entry.
•Decreased time spent in medication administration & documentation
•Increased time for client care
•Facilitation of data collection for research
•Improved record security
•Improved quality of care and patient satisfaction (Hebda and Czar 2009 pg 37). I then realized that the old method did not have the above qualities and so the institution opted for the new system. In this case there was ignorance of seeking information due to lack of computer and information literacy. Maybe I would have given the sample to my colleagues who were well informed to charge. I also could have called the laboratory technician and inform that the specimen had not been charged. It is good that I finally learnt from my my mistake and that the second sample drawn was charged and results acquired. However, having no computer literacy & information literacy does not make my action acceptable.
My reflection of this event explores how important nursing informatics is in a healthcare set up and that all the healthcare providers should have knowledge on nursing informatics. The whole issue was embarrassing and I felt that instead of just sending the specimen and assuming that the lab technicians will charge, I would have given it to my colleagues to charge or inform the laboratory technician that I was not able to charge the specimen & hence helping them to take an appropriate decision instead of discarding it.
Also instead of shying off from seeking the information on the new system from the team leader, I would have gained a little knowledge from my colleagues on how to operate the computer and then boldly proceed to the team leader for more information. This showed that I was not wise enough. According to American Nurses Association (2007) wisdom occurs when knowledge is used appropriately to manage and solve problems. Results from understanding and requires human effort. However, If I had availed myself for the information, this mess would not have happened.
In order to prevent the incident from happening again, it is important that when I come back from a long leave, I should take the initiative to seek for updates from my colleagues and also the team leader taking in account the sensitive issues like this one.I should also seek help from my colleagues of things that am not certain of so as to prevent unpleasant incidences from happening. The action I took after the incidence was to write an incident form so that others could learn from my mistake.
I also sought the information on online investigation request from my colleagues and team leader and also enrolled in computer classes so that I could have enough knowledge on computer literacy since the information I got from my colleagues and team leader was so particular and only concerned requesting of investigations and obtaining reports.i also called laboratory technicians and informed them to always call the ward before discarding patients specimens. I have learnt that there can be many positive learning opportunities from the mistakes we make. Reflection can sometimes show your shortcomings and this can be an excuse not to reflect, but by taking negative incidences positively you can turn around & change yourself for the better. I am now computer and information literate.
American Nurses Association. (2007). Scope and standards of nursing informatics practice.Washington: American Nurses. Association of College and Research Libraries. (2002). Information literacy competencestandards for higher education. Retrieved in November 18, 2002, fromhttp://www.ala.org/acrl/ilintro.html#ildef. Gibbs (1998). Learning by doing. A guide to teaching and learning methods. Further educatingunit. Oxford: Oxford polytechnic. Hebda, T., Czar, P. (2009). Handbook on informatics for nurses and healthcare professionals.(4th ed.) . Pearson: New Jersey. Selvasekaran, J. (2008). Essentials of computer for nurses. (2nd ed.). Mumbai: Jaypee brothers. Siviter, B. (2004). The student nurse handbook. Philadelphia: Baillere Tindall. Stair, R., Reynolds. (2008). Principles of information systems. (8th ed.).Boston: Thompsoncourse technology.
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