Prepare two critical reflections both of which must relate to the NMC Code and accountability. They should each be of similar length (1100 words each). It is not necessary to use a reflective model.

Critical reflections that relate to the NMC Code and accountability

Detailed Assessment Guidance

“The NMC requires nurses to revalidate and as part of this process to prepare written reflective accounts”.

Prepare two critical reflections both of which must relate to the NMC Code and accountability. They should each be of similar length (1100 words each). It is not necessary to use a reflective model.

Each reflection must be recorded using the template( see attachment ) provided and must refer to either:

An instance of your learning and/or
A piece of practice-related feedback you have received and/or
An event or experience in your own professional practice
As per the tool –

Briefly outline the nature of the learning activity and/or practice-related feedback and/or event or experience in your practice.

Consider what you learnt from the learning activity and/or feedback and/or event or experience in your practice with specific focus on issues of accountability.

How did you change or improve your practice as a result?

How is this relevant to the Code?

The reflective analyses must be evidence based and appropriately referenced. Reflective essays use a combination of the first and third person for the writing approach.

Reflective account: 1100 words
What was the nature of the CPD activity and/or practice-related feedback and/or event or experience in your practice?
The CPD activity in my practice involved attending the nurse revalidation workshop. The attendance of the workshop was evidenced by participatory certificate awarded after completion of the workshop. Key topics covered during the nurse revalidation workshop included the importance of professional development, the importance of nursing appraisal, learning about the most effective ways of completing the revalidation self-assessment and confirmers role in revalidation. Riley et al. (2018) indicate that nurse revalidation causes anxiety among practitioners due to uncertainties surrounding the process. Nurses are usually tense during the revalidation period and fearful of the results. However, Glasper, (2014) notes that revalidation empower the nurses and midwives to reflect on their skills and practices and make positive changes.
The nurse revalidation workshop also focused on reviewing basic processes in the organisation as well as divisional differences. This ensured that the nurses were familiar with the basic operations of the organization prior to the revalidation process. The workshop also involved a discussion on various ways of strengthening the nursing appraisal in order to design an effective revalidation model. According to Grove, Burns and Gray (2012), effective nursing appraisal model leads to better clinical outcomes. The appraisal allows the nursing practitioners to know the critical areas of performance hence improving on those areas. Other than appraisal and revalidation, the workshop facilitators also shared on professional development and ensuring improvement in quality of services as well as the health outcome of the patients.

What did you learn from the CPD activity and/or feedback and/or event or experience in your practice?
I learned how to prepare for the nurse revalidation effectively. I gained new skills on how to complete a revalidation self-assessment effectively. The workshop helped me to know the important areas and elements that the revalidation form should contain. Groves (2014) in a study discussed various proposals outlined by the NMC to ensure a robust revalidation of nurses and midwives in order to enhance public protection. Professional standards of care should be maintained during the revalidation process to minimize bias. The study further highlights that the nurses should feel fully valued and supported during the revalidation process to ensure delivery of safest cafe to the patients. I learned that the revalidation focuses on enhancing the performance but does not centre on reprimanding the nurses. Revalidation ensures that nurse continue to practice safely and closely observe the codes of NMC throughout their profession (Middleton, Ryley and Llewellyn, 2015).
I also learned that the main objective of nursing appraisal is to improve the quality of services delivered by the practitioners and ensure that nurses maintain the expected level of competence during practice. Professional development is another area that the workshop enlightened me. I learned that one must always seek to advance practice knowledge through research and experience. One has to identify the best ways of handling issues through critical thinking and consultations (People, 2016). The workshop also helped me to understand the professional standards of care corresponding to the dynamic health care environment. Through the workshop, I gained insight on various divisions of the organization and their respective processes. This made me aware of the ad-hoc services provided by the organization. I was able to learn how we can work together with my colleagues from other departments to improve the overall outcome of the organisation.

How did you change or improve your practice as a result?
Because of the workshop, I am now extra conscious of the quality of care that I provide to my patients. I am dedicated to providing professional services to my clients and focus on positive health outcome of the patients. The CPD activity enabled me to discover personal weaknesses in professional service delivery. This includes prioritising the information provided by the client other than what I think the problem is. According to Brekelmans, Poell and van Wijk (2013), CPD ensures that a nursing practitioner maintains and enhance the knowledge and skills that are needed to facilitate delivery of professional services to clients and community. The discussion about appraisal mechanisms enabled me advance my practice approach. Knowledge of the changing trends in appraisal and the new appraisal methods motivated me to adopt a new practice approach while focusing to satisfy the current requirements of high performance care delivery. For instance, I began to self-evaluation based on the successful positive health outcome for my clients. Previously, my motivation was to serve as many clients as possible. Currently, I am more determined to achieve good clinical outcomes rather than serving many customers within a short period.
Learning how to develop revalidation self-assessment allowed me to find out about the key areas of practice and identify my weaknesses. This motivated me to seek professional development from the relevant areas to improve my competence in service delivery. For instance, I started engaging in critical research when faced with complex health issue rather than using basic available information. LoBiondo-Wood and Haber (2017) in a study encourages physicians to conduct in-depth research about complex health problems that may not be familiar with or ordinary health conditions that may be modified by dynamic environmental factors. In respect to this newly acquired information, I changed my approach of tackling complex health problems through conducting detailed research and wide consultations with other professionals.

How is this relevant to the Code?
Select one or more themes: Prioritise people – Practise effectively – Preserve safety – Promote professionalism and trust

The CPD activity is relevant to the NMC code of prioritising people. The revalidation workshop was aimed at sensitising the nurses and midwives on the best approach of care and delivery of optimum quality services to the customers, clients, and the community. This coincides with the code where the nurses and midwives are supposed to put the interests of the people first. The code states that the care and safety of the people should be prioritised while their needs should be recognised, analysed and taken care of. Any aspect of discrimination or bias attitude and behaviour towards the people receiving care should be challenged always (Ellis, 2015).
The activity also encouraged the nurses and midwives in attendance to practise effectively. According to Mander (2018), the NMC requires the nursing practitioners to provide care to the patients immediately and to the best of their skills and competencies. This should involve collaboration with other nurses to share skills to ensure positive health outcomes. The revalidation workshop sensitized nurses on improving their performance to meet the required professional standard that involves maximizing the quality of care and working professionally based on the specified practise guidelines.

Please use a separate form for each of your reflective accounts, making sure you do not include any information that might identify a specific patient, service user or colleague.

Reflective account: 1100 words
What was the nature of the CPD activity and/or practice-related feedback and/or event or experience in your practice?
The CPD activity involved attending a regional nursing conference. The conference was organised by regional nursing directors and was conducted by various nursing leaders within NMC. The main theme of the conference was inclusion. Workforce race equality is among the emerging issues in healthcare sector with expansion of globalization trends. Most urban healthcare institutions contain a racial diverse workforce and clients (Hunt, 2007). The conference aimed at sensitizing the nurses on how to work and maintain good working relations with colleagues from diverse cultural backgrounds and how to address the needs of customers and clients from a different racial group. The conference was responding to recent outcry of discrimination among racial groups in the workforce and lack of collaboration among practitioners of different cultural backgrounds. Salway et al. (2016) indicates that professional conduct entails collaboration and team effort among employees irrespective of the social cultural background of individuals.
The conference also educated the attendees on various new nursing policies and care expectations. Under this realm, the speakers addressed the issue of holistic care model among the midwives and nurses. The new holistic model requires the midwife to make autonomous decisions about a patient where necessary, liaison with other professionals where necessary and manage the health and social needs of a woman. The nurse is expected to motivate the woman to establish a trust relationship with her or a team of midwives under her care. This would enable coordinated care during the pregnancy period and postnatal care (Dinç and Gastmans, 2013). The new policy aims at improving care through establishing a favourable working relationship between the midwives or nurses with their clients. A trusting relationship between the nurses and clients would improve the quality of care (Murray and McCrone, 2015).

What did you learn from the CPD activity and/or feedback and/or event or experience in your practice?
I learned that racial prejudice resulting from retrogressive perceptions among the workforce are harmful the overall results of the organization. Prejudice against people from different racial and cultural background injures collaboration and teamwork at the work place. Racial bias thereby affects the performance of teams that contain people from diverse cultural backgrounds. Further, I learned that prejudice against specific people of different race in the workplace lowers their motivation and general job performance. It may even lead to low self-esteem and depression among the workers. This indirectly affects the quality of care received by patients and lowers the care outcome. I leaned importance of collaborating with racially diverse groups towards improvement of care. With rising globalization trends, work stations will be characterized by racially diverse personnel and clientele hence there is need to avoid negative racial stereotypes as well as racial prejudice (Ragins et al., 2012).
I also learned the need to study the cultural background of racially diverse clients to understand their problems. Leimeister, Ebner and Krcmar (2005) in a study indicated that in order to establish trust relationship with racially diverse clients, the practitioner would need to understand their cultural background. This is because most culturally diverse people do not conform to the mainstream cultures and have different understanding levels and care perceptions.

The conference enabled me to understand the requirements of the new holistic care model and its importance in improving the care outcome. I learned that maintaining trust relationship with clients allows them to disclose pertinent information about their personal issues, which may be necessary in providing care. I was able to learn various strategies of building trust relationships with clients. I learned that establishing a trusting relationship with a woman facilitates provision of holistic services and enhances the safety and effectiveness of care.

How did you change or improve your practice as a result?
The information gained during the conference had a tangible impact on my practice. I changed the perception of the minority racial groups at my workplace and devised strategies of bridging the racial gap. I started encouraging collaboration with my colleagues from diverse racial groups towards identifying solutions to some issues in the workplace. In the process, I discovered that people from minority racial groups are equally talented and skilled in solving job related tasks. I changed my attitude towards the racial minorities at the workplace and adopted a positive perception. I also encouraged my colleagues to adopt the same strategy in order to improve the quality of care for our clients. As a result, most of my colleagues from minority racial groups felt motivated and invited me to assist in complex decision-making scenarios.
I started taking time to study the cultural backgrounds of some of my clients who came from cultural backgrounds that I am not familiar. This enabled me to understand their perceptions and device mechanisms of providing optimum quality care to the patients. Acquisition of knowledge about the new NMC policy has also motivated me to put in extra effort in enhancing the customer experience. I have since adopted the new holistic approach in building my relationship with clients. I have improved my communication skills and encouraged clients to communicate freely. This has also enabled me to build a trust relationship with my clients and hence I am able to manage their health needs succinctly. Belcher and Jones (2009) indicated that health systems are relational in nature and building relationships and shaping good behaviour are among the wanting problems. The new NMC policy of holistic approach seeks to solve the relationship problem among practitioners and patients.

How is this relevant to the Code?
Select one or more themes: Prioritise people – Practise effectively – Preserve safety – Promote professionalism and trust

The CPD activity is relevant to the code focusing on prioritising people. The NMC requires the practitioners to put the needs of the people seeking the services of nursing or midwifery first (Glasper, 2015). The theme of inclusion discussed in the conference is relevant to this code where enhancing collaboration among practitioners from diverse cultural backgrounds aims at improving the nursing and midwifery services. Establishing good working relationship with the patient also ensures provision of quality services and enables them to participate in the decision-making about their care.
The CPD activity is related to the code meant to preserves safety and practise effectively. NMC seeks to ensure sufficient protection of the peoples’ safety. This code is satisfied by recognising competent performance by the practitioners (Feo et al, 2017). This CPD activity satisfied the requirements of this code by encouraging the nurse practitioners to establish a close relationship with their patients to improve care outcome. Further, the theme of inclusion motivates the nurses and midwives to practice effectively through collaboration and teamwork despite divergence in their cultural backgrounds (Ashurst, 2017).

Reference List

Ashurst, A., 2017. Understanding the Nursing and Midwifery Council’s code. Nursing And Residential Care, 19(5), pp.294-295.

Belcher, M. and Jones, L.K., 2009. Graduate nurses’ experiences of developing trust in the nurse–patient relationship. Contemporary Nurse, 31(2), pp.142-152.

Brekelmans, G., F. Poell, R. and van Wijk, K., 2013. Factors influencing continuing professional development: A Delphi study among nursing experts. European Journal of Training and Development, 37(3), pp.313-325.

Dinç, L. and Gastmans, C., 2013. Trust in nurse–patient relationships: A literature review. Nursing Ethics, 20(5), pp.501-516.

ELLIS, P., 2015. Ensuring your team is ready for revalidation. Wounds UK, 11(4).

Feo, R., Rasmussen, P., Wiechula, R., Conroy, T. and Kitson, A., 2017. Developing effective and caring nurse-patient relationships. Nursing Standard (2014+), 31(28), p.54.

Glasper, A., 2014. Revalidation proposals: a chance to have your say. British Journal of Nursing, 23(5), pp.286-287.

Glasper, A., 2015. Can the new NMC Code improve standards of care delivery?. British Journal of Nursing, 24(4), pp.238-239.

Grove, S.K., Burns, N. and Gray, J., 2012. The practice of nursing research: Appraisal, synthesis, and generation of evidence. Elsevier Health Sciences.

Groves, W., 2014. Professional practice skills for nurses. Nursing Standard (2014+), 29(1), p.51.

Hunt, B., 2007. Managing equality and cultural diversity in the health workforce. Journal of Clinical Nursing, 16(12), pp.2252-2259.

Leimeister, J.M., Ebner, W. and Krcmar, H., 2005. Design, implementation, and evaluation of trust-supporting components in virtual communities for patients. Journal of Management Information Systems, 21(4), pp.101-131.

LoBiondo-Wood, G. and Haber, J., 2017. Nursing Research-E-Book: Methods and Critical Appraisal for Evidence-Based Practice. Elsevier Health Sciences.

Mander, R., 2018. Floors, ceilings and cellars: Midwives, the NMC and ‘The Code’. In Untangling the Maternity Crisis (pp. 60-68). Routledge.

Middleton, L.C., Ryley, N. and Llewellyn, D., 2015. Revalidation: a university health board’s learning from pilot partner engagement. Nursing Management (2014+), 22(5), p.24.

Murray, B. and McCrone, S., 2015. An integrative review of promoting trust in the patient–primary care provider relationship. Journal of advanced nursing, 71(1), pp.3-23.

People, P., 2016. Professional Standards of Practice and Behaviour for Nurses and Midwives. Becoming a Nurse: Fundamentals of Professional Practice for Nursing, 2, p.44.

Ragins, B.R., Gonzalez, J.A., Ehrhardt, K. and Singh, R., 2012. Crossing the threshold: The spillover of community racial diversity and diversity climate to the workplace. Personnel Psychology, 65(4), pp.755-787.

Riley, R., Spiers, J., Buszewicz, M., Taylor, A.K., Thornton, G. and Chew-Graham, C.A., 2018. What are the sources of stress and distress for general practitioners working in England? A qualitative study. BMJ open, 8(1), p.e017361.

Salway, S., Mir, G., Turner, D., Ellison, G.T., Carter, L. and Gerrish, K., 2016. Obstacles to “race equality” in the English National Health Service: Insights from the healthcare commissioning arena. Social Science & Medicine, 152, pp.102-110.



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