Kolb Reflection Model

Introduction

Therapeutic skills play vital role in delivering quality care as it help build interactive relationship with patient that can help in attaining better health outcomes. In nursing, caring for the patient using the concept of care is central in delivering patient-centered care that can result in positive patient outcomes. Risk of developing dementia increases with age and people suffering from this suffer many cognitive impairments. Thus, therapeutic skills can support nurses to support patients suffering from dementia by building the relationship for more effective care.  In this essay, we are going to discuss the importance of therapeutic skills to support patients with dementia, and how it can be implemented in practice. In end, a conclusion relevant to it will be given.

Literature review

Therapeutic skills help build an interactive relationship with the patient that can support the nurses to deliver more quality care meeting patient need (Winter, 2017). The therapeutic relationship is a very fundamental part of patient care and management and can make a significant difference in patient health outcomes. In the nursing field, therapeutic skills can be very helpful when caring for the patient with dementia as identifying the dementia potential sign is an important aspect of a nurse’s role that helps in early diagnosis and better treatment opportunities. The assessment of dementia is complicated because of several factors such as depression or unfamiliar environment etc.  If the patient seems lonely, agitated, sometimes it is misinterpreted as depression (Turner, 2018).  Accurate diagnosis of the condition can help in delivering more effective patient-centered care, thus nurses by being observant, showing empathy, being compassionate can help the patient to identify problems and share effectively so that quality care can be provided. Dementia patient will feel trusted and safe with a familiar environment and nurse and can be able to communicate their concerns and feeling more efficiently.   Therefore, therapeutic skills play a crucial role when caring for the patient with dementia. Therapeutic skills comprise carer to show empathy, demonstrate effective communication and listening skills, and critical thinking (Ersser, 2019). As dementia is a condition that involves deterioration in thinking ability, behaviour, memory, and ability to perform day-to-day tasks, therefore, the carer must provide a friendly approach and setting when caring for the patient with dementia. For instance, the patient bed space is easily differentiated through the use of picture or colour, signposted toilet, decent lighting, etc. when caring for dementia patient it is vital to understand the patient needs to deliver quality care, for instance, the patient suffering from this condition normally face problem in taking medication on time or can take an additional dose if forgot they have already taken medication due to short-term memory. Thus, it is vital to monitor the patient and medication without patient getting annoyed, and to do so it’s vital for the patient to feel comfortable with the nurses, as many time patients refuse to take the medication that is essential for their wellbeing, at the time the nurses using therapeutic skills such as showing respect, using effective communication skills can weigh it up to understand their decision.  If the patients are unable to make the decision for themselves related to medicine then it’s vital to take support from a multidisciplinary team (involving doctor, family member, counsellor, etc.) to explore alternatives and make the decision that is in best interests of the patient.  Therapeutic skills can help nurses in all phases (from very first consolation to throughout the treatment procedure) of care to ensure quality patient-centered care. This support nurses to apply and understand basic psychotherapeutic skills in psychological settings, and be aware of patients’ needs and carer must be aware of their feeling and emotion to help patients conceive better outcomes.  In health care, professionals need to know how to regulate their feelings and emotions so that they can avoid expressing their emotions to patients to be more accepting of patient emotions and to avoid emotional reactivity to what patient presents. Mindfulness can help to deliver quality care for the patient with dementia. Therapeutic relationships help in building positive emotional connections between patient and the carer that support in attaining treatment goals more efficiently through shared conceptualization (Blake and Blake, 2019).  Through good collaboration and planning, nurses can help people with dementia efficiently, such as taking part in the conversation and ensuring patient take personal effects such as glasses, hearing aids, etc. physical and emotional wellbeing are interrelated and any intervention to support one will ultimately affect the other, for instance, dementia patient experiencing pain can lead to agitation, low mood, etc. that became an obstacle in taking their care, and sometimes also lead to behaviour that became difficult to cope with. Therefore, the importance of communication became very significant in these scenarios and its important patient can share their feelings and emotions to the carer without any hesitation so that better support can be provided to the patient.  Therapeutic skills comprise demonstrating active listening skills, empathy, and compassion, effective communication skills (both verbal and non-verbal) to build an effective relationship with the patient supporting better health outcomes (Conceicao et al., 2019).   For high-quality nursing care therapeutic relationship between patient and nurse is crucial, nurses communicating warmly, using non-verbal communication skills such as eye contact, using soft voice tone, showing appreciation of patient strength and individuality can help the patient to feel confident and valued, thus therapeutic skills are very favourable in attaining desired health outcome.

Reflection

In relation to the skill I have considered the self-reflection tool to identify my own strength, weakness, and area of improvement to best deliver the quality care meeting the patient need. I learned that working with patient with dementia communication play key part in comforting the patient and building trust with the patient. Also I have learned that basic concept of care is also very important and helpful in delivering patient-centered care. From the patients check in it’s important to use effective communication skills and showing positive support can benefit in easing patient discomfort. The 6 C’s concept for care can help in demonstrating compassion, confidence, conscience, commitment, competence, and comportment. In healthcare, compassion is vital to certify that patient receive quality care and by showing compassion nurses can understand the patient needs that can help in delivering better health outcome, confidence support health care professionals to reflect upon their personal knowledge and skills to act proficiently in demanding situations and deliver care putting their best foot forward to meet patient needs, determination to deliver quality care is result of nurses strong conscience, commitment comprise working in obligation organization and federal polices and prioritizing patient needs and working to efficaciously meet those need, competence also involves working in obligation workplace policy and procedure, being aware of ethical responsibility to avoid the medical errors and ensuring patient safety, comportment help carer to work in dignified manner conducting duties, demonstrating active listening and communication skills to create comforting environment (Bradshaw, 2016). This concept helped me work as per my strength to deliver quality care to meet patient need.  I recognised that communication can help in comforting patient that can help them feel included and valued, and to improve communication with dementia patient I try to use short sentences, using familiar vocabulary, positive body language, eye contact, using warm tone, smiling during conversation is supportive in comforting patient so that they can communicate their discomforts and needs. Through therapeutic communication skills I also practise active listening to respond to patient emotion if patient is unable to communicate feeling verbally.  Active listening and monitoring the patient with dementia is important to be aware of patient feelings and emotions so that carer can provide support to the patient, for instance, patient walking due to pain looking agitated or sad, in this scenario, it is important that nurses put themselves in the patient shoes and understand how patient might be feeling, that can help patient to empathise and respond compassionately that can comfort the patient (Percy and Richardson, 2018). I recognised that behaviour provided clues about patient feelings and needs thus, being observant and using acting listening skills are very supportive when caring for patient with dementia. I also realised that to build therapeutic relationship with patient hospital environment also play a key role comforting the patient. Hospital environment are fast-paced and noisy that the reason that patient suffering from dementia face troubles in coping with (Donovan and Mullen, 2019). I think whether its home or hospital its vital to do environmental adjustments as per patient requirement, for instance, labelling or using colours for beds, kitchen, toilet, etc. so that patient can access those easily. Talking with patient avoiding the rush hours and ensuring that room has plenty of light, using soft furnishing and colour to convey safety. Consultation with multidisciplinary team to ensure patient needs are met effectively, as a carer I must be more aware of the patient, needs, feeling and thought thus, working with team carryout assessments in consideration to valid documents to decide treatment and to seek advice for better medication and management to assist patient to meet those needs.  Working with patient having dementia might challenging and fulfilling thus, it is important that nurses work considering concept of care and using therapeutical skills to attain desired outcome and delivering patient-centered care. The therapeutic skills help in developing sensitivity, compassion, and empathy that are key qualities and strength require to ensure quality care, nurse’s ability to communicate and listen help in meeting the patient needs and recognising their individuality and strengths that is key in wellbeing of person with dementia (Cox, 2020). Thus, I believe that therapeutic skills are beneficial in building effective relationship with the patient that can support in all phases of treatment that can help in attaining the wellbeing goals more effectively.

Kolb reflective Model

Kolb reflective model consist of four learning stages that help in reflecting on internal cognitive process. The first stage comprise the concept of learning through experience, second stage comprise the idea of reviewing reflecting own experience, third stage is abstract conceptualization to understand what individual has learned from their experience, fourth part of the learning comprise experiment of the learnings/experiences to understand the effectiveness of it (Long and Gummelt, 2019). In relation to that I have learned that every interaction and intervention is an opportunity for carer to build rapport and trust with patient thus, understanding patient behaviour and implementing communications skills can be supportive in delivering quality care. In healthcare, the importance of providing comfort is key to certify quality care and enhance patient experience. For example, if patient see that carer are sensitive, careful, attentive, and honest in providing care patient feel comfortable that will support in better treatment ensuring better health result for the patient. As in detailed the Kolb model comprise the idea of active experiment and reflective observation which involves the idea of doing the delegated tasks and watching. When caring for patient with dementia I have realised that observing, and active listening is vital to find the non-verbal clues that help in identifying and understanding the patient feelings and concern which people suffering from dementia usually unable to communicate clearly unless have comforting relationship with the carer. Kolb model elucidate the fact that different people have different perspectives, and therefore some people like being observant rather than taking action immediately to avoid the misinterpretation of people thought or feeling (Burn and Danyluk, 2017). When caring for people suffering from dementia I understand that this theory support the fact that it is important as carer to put yourself in patient shoes to understand their viewpoint for better quality patient-centered care. Kolb called this method diverging because it provide opportunity for people to brainstorm and gather information to facilitate better care (Miniano and Rui, 2020). Kolb diverging style involves the idea that people perform better in situation that require brainstorming, they will provide support in basis of data and information to best support their decision, on other hand converging style of learning involves using interpersonal skills to solve the problem, converging style is practical way of solving problems, and accommodating way of solving problem involves intuition rather than logic (Morris, 2019). I will implement these styles with the therapeutic skills to support me in future to deliver more effective care as these style provide a guidance for doing and monitoring that can support in solving problem and taking decision that will be in best interest of the patient. Kolb reflective model will help in evaluating the learning and experience more efficiently that can help in delivering quality patient-centered care to the patient suffering from dementia.

Conclusion

In healthcare, proving comfort to ensure quality care and enhance the patient experience is vital especially when caring for dementia patient, implementing therapeutic skills can help in building interactive relationship with patient that can support in identifying and understanding patient need so that effective care can provided meeting patient needs.  As the Kolb model comprise the idea of active experiment and reflective observation which involves the idea of doing the delegated tasks and watching. I will implement Kolb reflective model with the therapeutic skills to support me in future to deliver more effective care as these style provide a guidance for doing and monitoring that can support in solving problem and taking decision that will be in best interest of the patient.

References

 

Blake, T. and Blake, T., 2019. Improving therapeutic communication in nursing through simulation exercise. Teaching and Learning in Nursing, 14(4), pp.260-264

Bradshaw, A. (2016). An analysis of E ngland's nursing policy on compassion and the 6 C s: the hidden presence of M. S imone R oach's model of caring. Nursing inquiry, 23(1), 78-85.

Burns, A. and Danyluk, P., 2017. Applying Kolb’s model to a nontraditional preservice teaching practicum. Journal of Experiential Education, 40(3), pp.249-263.

Conceição, C., Guedes, M.J., Rosa, S., Martins, V., Figueiredo, M.C., Godinho, C., Spínola, A. and Ferreira, S., 2019. P14 Therapeutic communication in nursing centered in the informal caregiver: a scoping review. European Journal of Public Health, 29(Supplement_2), pp.ckz095-011.

Cox, A.M., 2020. Nurse or Psychotherapist? Using Nursing Skills in Therapeutic Relationships and Psychotherapies. In Nursing Skills for Children and Young People's Mental Health (pp. 139-154). Springer, Cham.

Donovan, L.M. and Mullen, L.K., 2019. Expanding nursing simulation programs with a standardized patient protocol on therapeutic communication. Nurse education in practice, 38, pp.126-131.

Long, E.M. and Gummelt, G., 2019. Experiential service learning: Building skills and sensitivity with Kolb’s learning theory. Gerontology & Geriatrics Education, pp.1-14.

MacLean, S., Kelly, M., Geddes, F. and Della, P., 2017. Use of simulated patients to develop communication skills in nursing education: An integrative review. Nurse education today, 48, pp.90-98.

Miniano, C.M.B. and Rui, X.Y., 2020. Kolb’s Learning Styles and Managerial Concern for People and Task: A Reflective Measurement Model.

Morris, T.H., 2019. Experiential learning–a systematic review and revision of Kolb’s model. Interactive Learning Environments, pp.1-14.

Percy, M. and Richardson, C., 2018. Introducing nursing practice to student nurses: How can we promote care compassion and empathy? Nurse education in practice, 29, pp.200-205.

Turner, T., 2018. Dementia care: an overview of available non-pharmacological therapies. Stroke, 13, p.57.

Winter, L.A., 2017. Introducing therapeutic skills and clinical practice: the ‘basics’ of therapeutic practice? The SAGE Handbook of Counselling and Psychotherapy, p.64.

 

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