conclusion
As her peers asked for more information about the client's economic resources for food and the toddler's other developmental patterns, the nurse began to feel angry. She had many years of home visiting experience, and of course, had assessed these areas with the client. She then realized that she was feeling as angry and frustrated as her client must have felt when she told her nurse that " the pediatrician told me that I'm not feeding my child right" and "the WIC educator said that I should stop giving her the bottle." As the discussion proceeded, the supervisor suggested they break and watch a video that used principles of motivational interviewing to see whether the latter might offer new approaches to the situation.
Action plan. Using the motivational interviewing principles demonstrated in the video, the team strategized with the nurse about potential communication techniques that she could use on her next visit with this client. It was suggested that when the client said "they told me that I'm not feeding my child right,"
a good response might be "That must be really hard to hear that. You have tried so hard to help your child to eat well and gain weight? Do you want to talk more about it?" Other suggestions included asking the client: " Are there times when the child has less difficulty eating? What is different about those times? What kinds of things have you tried that have been successful."
Supervisor summary of case conference
Supervisors working within the NFP are encouraged to elicit feedback from nurses at the close of the case conference about the discussion. The nurse who shared her case expressed relief that her feelings and concerns had been respected and stated that she was energized by having a solid plan to use with the client at the next home visit. Her peers also noted that it had been a learning experience for them as they thought of ways to use motivational interviewing techniques with their own clients.
Joint home visits
Lastly, another component of reflective practice that the NFP model encourages is joint home visits by the nurse and the supervisor conducted quarterly. Time spent in reflective supervision in individual sessions with the nurse and during case conferences builds the trust between the supervisor and the nurse that is necessary for the nurse to feel comfortable having her supervisor join her on home visits. Joint visits provide the supervisor with the opportunity to evaluate the nurses' practice skills in the context of a nurse-client interaction.
The following client scenario illustrates how a supervisor used her observation of nurse-client interaction during a joint home visit to help a nurse step back and reexamine her practice following the visit. The visit involved a young client who had struggled to reenroll in school after the birth of her baby.
Nurse : " How's school going?"
Client : " It was too hard, I dropped out..... I'll get my G.E.D later."
Nurse : " I'm so disappointed, you've worked so hard. You can't drop out. Let's call the principal right now and get you back in."
Client : " No ,
I can't go back now."
The supervisor sensed the tension between the nurse and the client for the rest of the visit. Following the visit, she used the reflective cycle to process the visit with the nurse. The nurse was able to recognize that her immediate response in suggesting that they call the principal to get the client back in school had shut down communication,and therefore,the client did not reveal the details of her decision. Moreover,by reflecting on the incident,the nurse also realized that there was probably more to the story and factors that contributed to the client's decision than were shared once the client sensed the nurse's disappointment. In thinking about what she might have done differently,the nurse identified that she could have responded using a solution-focused response such as " I know that finishing school is very important to you. You must have really put some thought into this decision. Will you tell me about it?" The nurse and the supervisor visit to engage the client in discussing her progress toward her goal.
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ช่วยแปลบทความอังกฤษให้หน่อยค่ะ เรียบเรียงแล้วงง ^^
As her peers asked for more information about the client's economic resources for food and the toddler's other developmental patterns, the nurse began to feel angry. She had many years of home visiting experience, and of course, had assessed these areas with the client. She then realized that she was feeling as angry and frustrated as her client must have felt when she told her nurse that " the pediatrician told me that I'm not feeding my child right" and "the WIC educator said that I should stop giving her the bottle." As the discussion proceeded, the supervisor suggested they break and watch a video that used principles of motivational interviewing to see whether the latter might offer new approaches to the situation.
Action plan. Using the motivational interviewing principles demonstrated in the video, the team strategized with the nurse about potential communication techniques that she could use on her next visit with this client. It was suggested that when the client said "they told me that I'm not feeding my child right,"
a good response might be "That must be really hard to hear that. You have tried so hard to help your child to eat well and gain weight? Do you want to talk more about it?" Other suggestions included asking the client: " Are there times when the child has less difficulty eating? What is different about those times? What kinds of things have you tried that have been successful."
Supervisor summary of case conference
Supervisors working within the NFP are encouraged to elicit feedback from nurses at the close of the case conference about the discussion. The nurse who shared her case expressed relief that her feelings and concerns had been respected and stated that she was energized by having a solid plan to use with the client at the next home visit. Her peers also noted that it had been a learning experience for them as they thought of ways to use motivational interviewing techniques with their own clients.
Joint home visits
Lastly, another component of reflective practice that the NFP model encourages is joint home visits by the nurse and the supervisor conducted quarterly. Time spent in reflective supervision in individual sessions with the nurse and during case conferences builds the trust between the supervisor and the nurse that is necessary for the nurse to feel comfortable having her supervisor join her on home visits. Joint visits provide the supervisor with the opportunity to evaluate the nurses' practice skills in the context of a nurse-client interaction.
The following client scenario illustrates how a supervisor used her observation of nurse-client interaction during a joint home visit to help a nurse step back and reexamine her practice following the visit. The visit involved a young client who had struggled to reenroll in school after the birth of her baby.
Nurse : " How's school going?"
Client : " It was too hard, I dropped out..... I'll get my G.E.D later."
Nurse : " I'm so disappointed, you've worked so hard. You can't drop out. Let's call the principal right now and get you back in."
Client : " No ,
I can't go back now."
The supervisor sensed the tension between the nurse and the client for the rest of the visit. Following the visit, she used the reflective cycle to process the visit with the nurse. The nurse was able to recognize that her immediate response in suggesting that they call the principal to get the client back in school had shut down communication,and therefore,the client did not reveal the details of her decision. Moreover,by reflecting on the incident,the nurse also realized that there was probably more to the story and factors that contributed to the client's decision than were shared once the client sensed the nurse's disappointment. In thinking about what she might have done differently,the nurse identified that she could have responded using a solution-focused response such as " I know that finishing school is very important to you. You must have really put some thought into this decision. Will you tell me about it?" The nurse and the supervisor visit to engage the client in discussing her progress toward her goal.
ขอบคุณมากนะค่ะ