Note that you can take few days or time to work on the assignment as it is not urgent  The assi

Note that you can take few days or time to work on the assignment as it is not urgent  The assignment has 2 parts. The first is to write a reflective narrative using the LEARN format. The second is to clearly articulate a Learning Outcome using the SMART format. The reflective narrative will be based on one aspect of your health. During the reflection, you are to identify an aspect of your health that you are either satisfied with or feels need further development. Use the LEARN process to complete this reflection. After completing the reflection, you will then use the SMART process to develop the Learning Outcome/goal (for example, if after reflecting on your health, you have identified that there is room for improvement with your eating habits, your LO might be to eat more healthily including…. so that you can improve your heart health by the end of semester).  The attached documents are intended to provide further directions. They include the following: A summary of how to write a Reflective Note using LEARN; an explanation of the LEARN format; guidelines on how to develop a Learning Outcome; and finally, a summary of how the assignment is graded. Remember, this assignment has 2 parts- the reflective note and the learning outcome.   SAMPLE REFLECTIVE NOTEBased on L.E.A.R.N. FormatIssues Surrounding Bathing and Cognitively Impaired clientsLook BackWhen I reflect upon my two clinical experiences on this Continuing Care Unit, one issue continues to present itself repeatedly. I am surprised by the number of clients who become agitated and uncooperative when confronted with the idea of taking a bath or shower. Initially, I placed much of the blame on the staff, but on a second thought, I decided to explore the issue further.ElaborateMost of the clients on my unit suffer from some form of cognitive impairment due to Alzheimer’s disease, Parkinson or some form of brain damage. There were three incidents that brought the issue regarding bathing to my attention. On my first clinical day, I was asked to assist one of the staff members to dress a client who had just finished showering. When I arrived in the room, the client was partially dressed and sitting in a chair. In introduced myself to the client, explained what I was there to do, and asked if I could help him with putting his socks on. The client said ‘yes’, though he appeared tense and had an angry expression on his face. While I was putting on one of his socks, the client cried out claiming that I had hurt him. I immediately apologized, and told him that I would be gentler. I was surprised by the gentleman’s response because I was very careful and felt that his response was exaggerated. The nurse tried to comfort me by telling me that this man does not like showering and often yells while he is being showered. Later in the recreation room, I overheard another staff member asking one of the other clients if she would like a show before lunch. The client said “NO”. The third incident occurred on my second clinical day while I was assisting my client with her morning routine. When I asked her if she would like to wash her face, she replied, “Not really”. I was confused by how her demeanor seemed to change so quickly with the mention of merely washing her face. I noticed some lipstick in her side table draw, so I suggested that if she washed her face we could put some lipstick and go to breakfast together. I was so pleased that she said “OK” and we continued without any noticeable tension. In conclusion, I found it surprising that so many of the clients respond negatively to being bathed and wondered why it was occurring.AnalyzeWhile in post conference, I shared my experience with my group and asked if it could be because clients feel vulnerable during the bathing experience. My professor mentioned that vulnerability may very well be one of the issues, and that there is a lot of literature regarding what I witnessed. I thought the bathing experience would be therapeutic for clients, and that the warm water and their skin being massaged, would be refreshing. It also upsets me when I think of the emotional stress these clients are experiencing on a daily basis. I wondered why this was happening and what could be done to make this a more pleasant experience for both the clients and the caregivers. I decided to review some literature about Dementia and I soon realized that I was not adequately informed about the effects of Dementia and aging. From the research, I was reminded that Dementia affects a person’s memory, concentration, language, visual/spatial skills and ability to reason (Barrick & Rasin, 2004). In addition, another article stated older adults resist assistance with bathing for reasons such as physical pain, fatigue, weakness, confusion, embarrassment, and loss of autonomy (Rader, Barrick, Hoeffer, Sloane, McKenzie, Talerico, & Glover, 2006). I did not consider the possibility that bathing may cause fear and pain in the elderly, which can result from increased sensitivity to temperature changes, arthritis, and fear of falling (Barrick & Rasin, 2004). One recommendation included shifting the “focus from the task of bathing to the needs and abilities of the person being bathed, with an emphasis on comfort, safety, autonomy, and self-esteem” (Barrick & Rasin, 2004, p.30). some other tips for decreasing agitation during the bathing process are: bathing according to preference (bed/tub/shower), promoting flexibility regarding bath times, promoting a warm environment, eliminating excessive noise, promoting autonomy, moving limbs carefully, utilizing the unhurried approach, and assessing the need for routine analgesia or non-pharmacologic approaches (Rader et al., 2006).ReviseIn this situation, there are very few things for me to preserve. I should try to understand the reasons behind client behaviours and find ways to accommodate their needs and gain their cooperation. I should use the different strategies suggested in the articles to make bathing a more pleasurable experience for both the client and the staff member. I now realize that what these clients are experiencing is real to them and is not unusual. I learned from the articles that there are common problems associated with bathing cognitively impaired clients; and, there are ways to address these problems to reduce fear and discomfort in clients. I believe that it is possible to bathe clients in a therapeutic manner, and to understand that a client’s behavior is a result of them seeing the intervention as a threat. When caring for cognitively impaired clients, I will be able to accommodate the clients’ feeling/needs and find solutions that fit the clients’ needs.New Perspective/New TrialWhat could I do in the future in similar situations? I will get as much information as I can about my client’s health and related nursing care using the available resources. I would encourage my clients to participate in their care to gain their cooperation and to help them maintain their independence and dignity. Finally, I will share my knowledge with my colleagues so that they can see that a number of tips I research are feasible and will fit into a tight schedule. This will help to make the bathing experience less stressful for both clients and staff members.PLEASE NOTE: THIS IS JUST A SAMPLE LEARN REFLECTIVE NOTE Helpful Guide Development of Learning Outcomeslearning outcome is an A learning outcome is an identified goal that you wish to achieveThe learning goal is what you want to achieve. It is SMARTSpecific, Measurable, Attainable, Relevant and accomplished in a set TimelineDevelopment of Learning OutcomeDevelopment of Learning OutcomeThe learning outcome must include the specific activities you will do to gain:  A. KnowledgeB. SkillC. Judgment required to successfully meet your stated goalMeasurabilityRefers to what you have actually done or will do to demonstrate you have met your learning goalAttainable, RelevantNOTE: The Learning Outcome/goal has to be relevant to your reflection and realistic or attainable to your situation/lifestyle etc. Timeline A clear timeline for reaching the goal must be articulated. Action Verbs – Cognitive Domainwant to be able to:RecognizeDescribeExplainApplyDemonstrateIllustrateInterpretUsewant to be able to:AnalyzeAppraiseCompareContrastExamineDesignDevelopProposeAction Verbs – Affective Domainwant to demonstrate:Positive interactions with…Positive attitudes such as….Verbal communication skills such as…..attitude of interest, attentiveness when.Participation in…..Cooperation with others in…..Understanding of my…..Ways to Measure the GoalJournal/diaryPeer/family feedbackReflective narrative notesAnnotated bibliography Health Science Science Nursing NURSING NUR 101 Share QuestionEmailCopy link Comments (0)

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