Introduction
In this reflective essay, I aim to explore my experiences and decision-making processes during the Viva examination, focusing on the given scenario of assessing a 20-year-old university student experiencing depression. To guide this reflection, I have chosen Gibb’s Reflective Cycle, a model that encompasses the essential elements of reflection: description, feelings, evaluation, analysis, conclusion, and action plan. Gibb’s model provides a structured approach, facilitating a comprehensive exploration of my performance and allowing me to delve into both successful aspects and areas requiring improvement. The chosen model aligns with the assignment’s emphasis on critical examination and applying evidence and frameworks to nursing practice. The essay’s structure will comprise sections addressing the “What,” “So What,” and “Now What,” followed by a concise conclusion to encapsulate critical insights and takeaways from the reflective process.
What?
During the Viva test, I evaluated a 20-year-old university student, Edward, who was diagnosed with depression, and were his symptoms’ subject. The test demanded an in-depth understanding and application of social justice issues while balancing personal morality with the tenets of evidence-based practice, a central analysis theme.
Performing the Viva, I showed good judgment and briefly acquainted myself with Edward to ask his permission to conduct an assessment – one of the critical ethical elements of nursing practice (Villarroel & Terlizzi, 2020). Using the English translation and adaptation of the Italian Telephone-based Mini-Mental State Examination (Itel-MMSE) and the Short Test of Mental Status (STMS) based on the professional opinion of the associated author (Çebi et al., 2020, p. 453), I aimed to make systematic and focused MSE evaluation, maintaining thoroughness and This decision reflects the problems that were discussed in Schmidt and Brown’s literary work.
In terms of professional growth, I notice areas for improvement, including my flip-lecture delivery, which will be more persuasive and forthcoming if I boost my confidence and make myself clear and easily understood. This realization mainly comes from the comments, underlining the need for a better-emphasized presentation format. Martin et al. (2020, pg. 2) say one of the most essential things about conducting mental status examinations is communicating effectively: this reduces the possibility of misunderstanding among patients and the examiner.
On the other hand, the suggested admission duration of approximately 28 days for Edward’s stabilization was determined by considering his state of mental healthcare, which is a preventative measure like the risk mitigation strategies discussed in Dowding et al.’s study on infection risk identification by home care nurses where they stated (“Dowding et al., 2020”). However, for a broader understanding of nursing care from the patient’s point of view, the empathetic interview technique is an essential element in this process.
Having done the conclusive part of the Viva, it has been demonstrated that good evidence-based practice is being used. However, the reflection revealed improved communication, as the patient-centered approach should also be more effective (Wilcox et al., 2021, p. 129). By enriching my understanding with different points of view, it has been shown that there are different angles, and therefore, applying the information to clinical practice is constantly improving my clinical competition.
So, What (350 words)
The assessment of my presentation of evidence while undergoing the Viva examination carried my strong points and things capable of aiding my improvement in applying evidence-based practice and personal decision-making. The prime advantage of this strategy is a systematic application of mental state investigation instruments, in particular drawing on the Italian Telephone-based Mini-Mental State Examination (Itel-MMSE) and the Short Test of Mental Status (STMS) (Aiello et al., 2022). The employment of these validated scales was for a purpose that entailed a structured and potent evaluation of the symptoms of depression in Edward.
However, a careful analysis identifies a need to enhance how messages were communicated, which constituted my shortcoming as a sales representative. However, this demonstrates how the feedback confirms my knowledge and the need for a confident and clear communicator, as these skills are needed during the examination. This reiterates what Martin et al. (2020) emphasize: well-established communication skills in a mental status examination are highly valued. Literature highlights that clear communication is essential for the quality of care provided by the patient in terms of understanding and relationships.
In addition, a very detailed analysis of the reasons to suggest Edward’s admission for about 28 days is made; this analysis comprises the strengths and development areas. This chime is coherent with Dowding et al.’s professional protocols in their article and their nurse’s identification of infection risks involving comprehensive risk mitigation strategies (Dowding et al., 2020). Mental health stabilization is based on similar ideas of healthcare principles that maintain patient safety.
Thus, although the analytical gaze also reflects on the necessity of a more patient-centered model, it also calls into question data collection and privacy ethics. The literature recommends including more patient perspectives, for instance, using empathetic interviewing methods to enhance the assessment progress further (Thomson et al., 2020). Mental health nurses must identify with the lived experience of their patients for efficient and customized care according to the views espoused by Nyman et al. (2020, pg. 105)).
The data analysis shows that appropriate evidence-based techniques and measures were successfully added to the Viva case study. Nevertheless, an analytical standpoint shows the need for improvement in communication and patient-oriented. This decision-making line is being hodded by the modern conditions in mental health nurses, showcased in the latest studies. This analysis lays the foundation for the target strategies under the “Now What” section to be implemented in the subsequent strategies.
Now what (350 words)
To consider the listed improvement areas and keep the abilities high, which we saw during Viva, we have to create a strategic action plan. In the first place, it will be crucial to stress communication skills. Literature, like Martin et al. (2020), has long recognized the importance of communication in diagnosing mental health. In this regard, I plan to undertake communication workshops and training sessions using tutors and professionals from healthcare facilities and nursing organizations. Finally, getting into a relationship with a reputable mental health professional will offer the skills to fashion better communication approaches (Schmidt & Brown, 2024).
We also need a unified commitment to moving to a more patient-centered way of making decisions. To this end, using the empathetic interviewing tips discussed by Thomson et al. (2020) and assimilating them into my day-to-day practice becomes necessary. This translation involves listening actively, being compassionate, and, in turn, including the patient in the shared decision processes. That self-reflection is a powerful process that, together with peers’ feedback, allows for an accurate assessment of the outcomes of the implemented changes.
Moreover, it is essential to read the research and follow the mental health nursing news to provide evidence-based practice. Continually updating areas related to literature, attending conferences, and involvement in online forums will be key to my professional development (Schmidt & Brown, 2024). The continuous professional development of healthcare professionals through educational and training programs will be undertaken, and efforts will be put in place to refine the application of evidence-based instruments, such as MSE instruments, to fit the underlying standard best practices (Aiello et al., 2022).
Eventually, to ensure effective use of the action plans, a structured self-assessment schedule and regular appraisals by the supervisors and colleagues will be the solution. Continually revisiting and revising this revised iterative procedure is consistent with the principles of lifelong learning and constant improvement in nursing practice (Schmidt & Brown, 2024). It is paramount to understand that these modifications in behavior carry not only the personal and professional development of healthcare personnel but also the standard of the delivered care to the patients and the service concern of the healthcare system.
The following section, “Now What,” presents a thorough action plan incorporating the empirical knowledge obtained from the literature with real-life strategies to address every identified area of improvement. By attending to the precise learning opportunities, implementing a patient-centered system, and equipping myself with the current evidence-based information, I plan to contribute to transforming my mental health nursing skills.
Conclusion
In conclusion, this reflective journey that followed my Viva has been firing me with new knowledge, which has let me see both my proficiency and some flaws in my mental health nursing practice. Through an assessment of my performance, I have understood that healthcare communication, decision-making involving the patient’s centeredness, and continuing education are all essential. Inspired by understanding, my action plan is designed to improve communication, create communities where patients have input into the decision-making process, and initiate lifelong improvement by continuing through learning. The tips and evidence-based interventions explained in the “Now What” section are the foundations for my transformation into a holistic and inclusive mental health nurse. This reflective writing prompts me to get the foundational knowledge required to learn how to make vital decisions in evidence-based practice and patient-centered and holistic care in the hectic field of mental health nursing.
References
Aiello, E. N., Esposito, A., Pucci, V., Mondini, S., Bolognini, N., & Appollonio, I. (2022). Italian telephone-based Mini-Mental State Examination (Itel-MMSE): item-level psychometric properties. Aging Clinical and Experimental Research, 1-7.
Çebi, M., Babacan, G., Öktem Tanör, Ö., & Gürvit, H. (2020). Discrimination ability of the Short Test of Mental Status (STMS) compared to the Mini-Mental State Examination (MMSE) in everyday cognition, mild cognitive impairment, and probable Alzheimer’s disease dementia: The Turkish standardization study. Journal of Clinical and Experimental Neuropsychology, 42(5), 450-458.
Chen, F., Zheng, D., Liu, J., Gong, Y., Guan, Z., & Lou, D. (2020). Depression and anxiety among adolescents during COVID-19: A cross-sectional study. Brain, behavior, and immunity, ]88, 36.
Dowding, D., Russell, D., Trifilio, M., McDonald, M. V., & Shang, J. (2020). Home care nurses’ identification of patients at risk of infection and their risk mitigation strategies: a qualitative interview study. International journal of nursing studies, 107, 103617.
Hansen, J. R., Gefke, M., Hemmingsen, R., Fog-Petersen, C., Høegh, E. B., Wang, A., & Arnfred, S. M. (2020). E-library of authentic patient videos improves medical students’ mental status examination. Academic Psychiatry, 44, 192-195.
Martin, A., Jacobs, A., Krause, R., & Amsalem, D. (2020). The mental status exam: an online teaching exercise using video-based depictions by simulated patients. MedEdPORTAL, 16, 10947.
Nyman, M., Hofvander, B., Nilsson, T., & Wijk, H. (2020). Mental health nurses’ experiences of risk assessments for care planning in forensic psychiatry. International journal of forensic mental health, 19(2), 103-113.
Østervang, C., Geisler Johansen, L., Friis‐Brixen, A., & Myhre Jensen, C. (2022). Experiences of nursing care for patients who self‐harm and suggestions for future practices: The perspectives of emergency care nurses. International journal of mental health nursing, 31(1), 70-82.
Sampaio, F., Sequeira, C., & Teixeira, L. (2021). Impact of COVID-19 outbreak on nurses’ mental health: A prospective cohort study. Environmental Research, 194, 110620.
Schmidt, N. A., & Brown, J. M. (2024). Evidence-based practice for nurses: Appraisal and application of research. Jones & Bartlett Learning.
Thomson, L. J., Morse, N., Elsden, E., & Chatterjee, H. J. (2020). Art, nature and mental health: assessing the biopsychosocial effects of a ‘creative green prescription ‘ museum programme involving horticulture, artmaking and collections. Perspectives in public health, 140(5), 277-285.
Villarroel, M. A., & Terlizzi, E. P. (2020). Symptoms of depression among adults: United States, 2019 (pp. 1-8). Hyattsville, MD, USA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.
Wilcox, G., Fernandez Conde, C., & Kowbel, A. (2021). Using evidence-based practice and data-based decision making in inclusive education. Education Sciences, 11(3), 129.
write