Self Assessment and Reflection Essay - Special Academic Support

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Role Play Scenario

Jack is a 13-year-old boy who has just been told by the specialist nurse that he will have to start taking insulin every day for his diabetes. Jack is angry and upset, he does not want to be different from his friends. He is worried that his friends will find out that he has diabetes and will make fun of him. He is worried that having to take injections will affect him, his life at school, and his friendships.

In this assignment, I am going to reflect on a clinical role play using Gibbs’ Reflective model. The role play involved four first-year student nurses acting out the given scenario. The roles comprised of a nurse, Jack (a young teenage boy), Jack’s mother, and an observer. The roles were rotated so everyone could experience the nurse’s roles. The role play took place in a classroom of approximately twenty-two adults. Each of the groups took their turn to perform their chosen role play in front of their peers, program director, and service user.

I felt nervous for all involved in the role play. Performing in front of others can be a daunting experience especially as this task formed part of an assessment. As the role-play progressed, I became more relaxed as my focus was on the nurse’s performance. Every group member listened to each other and took account of what was said before replying. They supported each other and there were no awkward silences or any obvious signs that the group was feeling flustered. I felt that the scenario gave a glimpse of how the nurse might respond in a real-life situation even though this was an engineered environment.

The student nurses began by introducing themselves to both Jack and his mother. There were obvious signs of nervousness as they spoke at a fast pace. As the role-play progressed, they slowed down the pace and relaxed into the role. They portrayed a caring attitude, spoke in a reassuring voice asked if both Jack and his mother were warm enough, and offered refreshments. Offering refreshments although showing kindness should be avoided especially for a patient diagnosed with diabetes with unknown sugar levels. Jack and his mother were visibly put at ease by the gesture. The student nurse was friendly and looked directly at the person they were talking to. There was good use of silent periods as Jack was angry and upset. It allowed Jack to think about what he wanted to ask next. The role play flowed as the student nurse used open-ended questions and listened carefully to the answers before giving the necessary information. They asked for clarity before moving on. Making promises is to be avoided. Jack should have been encouraged to tell his friends rather than promising that he didn’t have to tell his friends if he didn’t want to. Peer support could have been offered. The student nurse did pay attention to the needs of the mother as well as to Jack. They asked if they needed any advice on diet and were referred to the dietician. There was a good rapport between the student nurse, patient, and carer. The role play came to a satisfactory conclusion with all concerns being addressed. Jack and his mother left with an information leaflet and were advised if they had any further concerns to get in touch and were assured help was available. Jack was no longer angry and left content.

The role play situation was not true to life as in a ward or office there would only be the necessary people present. There would be no audience present or formal assessment taking place. This can be stressful and inhibit performance. However, role-play situations can be beneficial as rehearsing and practicing the scenario builds confidence so if faced with a similar situation in nursing practice participants feel ready and confident to address the situation successfully. (Role-Playing: Preparing for Difficult Conversations and Situations, 2021). (Blake and Blake, 2019) concur as they found in their study that student nurses’ self-efficacy in their therapeutic communication skills was improved using a simulation experience. Practicing skills improves performance and raises self-confidence.

The importance of good communication skills is included in the RCN Code (2018). To practice effectively nurses and midwives must be able to communicate clearly. (McMahon, 2021) shows the importance of good communication both verbal and non-verbal communication, and are central to building up relationships. This is similar to (Kim and Sim, 2020). They found that good communication skills could also help student nurses understand the medical conditions of their patients and help to develop problem-solving skills. Further investigation into this area is needed.

The student nurse built up a good rapport with the patient. Jack was central to the conversation. Not every healthcare professional involves children in decision-making (Quaye, 2019). They listened carefully to Jack and his mother’s concerns and addressed each one carefully giving advice when needed in an unbiased manner thus showing that they were prioritizing the patient. Prioritizing people means treating everyone with dignity and respect (The Code: Professional Standards of Practice and Behaviour for Nurses, midwives, and nursing associates – The Nursing and Midwifery Council, 2018). (Research recommendations | Diabetes (type 1 and type 2) in children and young people: diagnosis and management | Guidance | NICE, 2021) requires that the emotional well-being of the child should be taken into account. This was the case in the roleplay. The student nurse demonstrated a good understanding of the situation, and the condition of diabetes and gave excellent advice ensuring that Jack and his mother had a positive experience.

The role play would have been better placed at the end of placement as being on a ward and gaining the experience of the hospital environment has given me more confidence and better insight into the role of the nurse in patient care. My role-play performance would have benefitted from this first-hand experience.

Roleplays can be nerve-racking and to reduce stress levels could be performed in a more relaxed setting with just the observers present and not peers. The feedback from the assignment showed that I talked over my colleagues. This could be attributed to nerves. I was not aware that I had done so and have been cautious not to do so now when on placement. The dangers of making promises have been highlighted in the roleplay so I can now apply the new learning to further practice.

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