This reflective essay will adopt Rolfe’s model of reflection, (Rolfe, G et al. 2001) which was derived from Borton’s developmental model. (Boyd E et al. 1983) The scenario is presented as Appendix 1 and the patient has been anonymised as ‘Lee’ in accordance with the NMC guidelines (NMC 2008)
When analysed in overview, one can note that the main issues contained in this scenario are that a schizophrenic patient, who may therefore be psychotic, who is certainly confused due to his metabolic disturbances (hyponatraemia) and possibly idiopathic confusion, has made an allegation of physical assault against another staff member. The patient is also forgetful and the event happened three days ago. Clearly the incident cannot be confidently verified at this stage and there is a question as to whether the patient is reliable in making this allegation. Analysis revolves around my reflection on the actions that I took and whether they could be considered appropriate or capable of improvement. My role in the situation was that I was the recipient of the allegation. Having heard the allegation, I tried to make sense of it. On the one hand I was aware of the seriousness of the allegation if it were true, and therefore I was also aware of the potential harm that an untrue allegation could cause to the professional integrity of the ‘Special‘ who was involved. I was obviously aware of Lee’s potential for confusion and psychosis, but I was also impressed by the apparent veracity of his recollection and also by the fact that he started to cry when he was recounting it. (Nicol M N et al. 2004) On balance, I did believe his account of the situation. I therefore felt that I had a moral and professional duty to escalate the complaint to the Senior Ward Sister. After a period of discussion with the Ward Sister, I filled in an Incident Report Form (IR1), which was then forwarded to the hospital management. After the event, I experienced a period of prolonged self-examination. I was concerned in case I had inadvertently been party to a false allegation and considered further the consequences for the ‘Special’ involved. After a period of intense reflection, I concluded that I was right to take the action that I did, both because of my professional duty to ‘do my best for the patient’ but also because I was acting as the patient’s advocate in these circumstances, which seemed entirely appropriate. (Brooke C et al. 2007) The response of the Ward Sister seemed entirely appropriate. I believe that she went and spoke to Lee herself and determined that there was sufficient evidence to make the reporting of the incident (IR1) appropriate. This reassured me greatly. The Ward Sister also discussed the ethics and implications of the situation with me, which was both professionally helpful and considerate, as she could see that I was unclear about what I should do in these circumstances.
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