Posted: August 20th, 2023
Essay 3000 Words Assessment
Cohort 01/21 BSc(Hons) Nursing – Mental Health
Assessment(s) Category Type Scope
1 Coursework Essay 3000 Words
Summative Assignment – 3,000-word essay
Weighting: 100% of grade achieved
Submission Date: Monday, 07 August 2023 at 12:00
Assessment Title: A critically reflective and critically analytic examination of an episode of care
This assessment addresses all module Learning Outcomes.
Write a 3000-word semi-structured, critically reflective, and critically analytic essay examining an episode of care from your own nursing experience. The episode must involve complex care that you were personally involved in, where there was a risk to be managed, and where you can debate what the quality nursing care should have been. Write in the first person.
Structure the assignment using the following headings, indicated topics, and approximate word count:
Introduction (300 words: 10%)
Introduce your episode of care and how you will meet the objectives of the assignment.
State in what capacity you were involved in the episode of care.
Briefly summarize what happened.
Explain why you have chosen this episode.
State what the risk was in this episode.
State what nursing care you are going to examine in the assignment.
Evidence-based holistic nursing assessment (600 words: 20%)
Consider the person who is receiving nursing care.
Describe their thoughts, feelings, and behaviors.
Explain how they experienced the episode of care.
Give a bio-psycho-social assessment of the person.
Briefly discuss relevant history, experiences, environment, and life journey.
Discuss how those features were possibly presenting in their current thoughts, feelings, and behaviors.
Consider the role of their family, friends, carers, dependants, or significant others and the possible impact upon their current thoughts, feelings, and behaviors.
Justify assessment of the risk they were presenting with and what nursing care they needed.
Critical reflection on self (600 words: 20%)
Critically reflect on your experience of the episode of care.
Explore and analyze your thoughts, feelings, and behaviors you remember at the time.
Explore and analyze how people responded to you and how you responded to others.
Explore and focus on your impact on this episode of care.
Critical appraisal of evidence (600 words: 20%)
Apply theory to explain the episode of care.
Analyze what the clinical guidelines and evidence tell you should be the correct care for someone with this kind of presentation.
Apply the evidence to your episode of care.
Critically appraise the underpinning theory and research.
Examine the quality of the evidence.
Consider the research you have identified in this section and provide a debate on if it would be effective for this particular episode of care, justify your opinion.
Evidence-based nursing interventions (600 words: 20%)
Evaluate if the risks were managed appropriately.
Evaluate if the nursing care was effective.
Analyze the quality of the care given.
Debate what factors would increase the quality of the care given.
Analyze what improvement mechanisms would be useful.
Evaluate if those mechanisms would be effective in this case, considering the wider context this care is delivered in.
Conclusion (300 words: 10%)
Summarize your recommendations for this kind of episode of care.
Summarize your findings.
State the recommendation you have identified in this assignment for this kind of episode of care.
In-depth Assignment Guidance:
We are inviting you to consider a difficult experience that challenged you and to analyze this. Please be aware that if you disclose things in this assignment that are criminal, abusive, or negligent either in your own practice or about practice you have witnessed, we will have an obligation to act on this information. This may include sharing information with practice partners, standards boards, or external organizations up to and including the police.
Therefore, we would ask you NOT to consider an episode of care that is a serious incident currently under investigation or a current safeguarding concern. The case you discuss should be completely anonymized, including the identity of the person, location of the care delivered, and the professionals involved. Please do not disclose unreported criminal behavior or confess to any previously undisclosed practice that would trigger fitness for practice considerations.
DO’S and DON’TS
Use the first person, e.g., “In this essay, I will….”
Give the service user in your episode of care a pseudonym, e.g., “I will refer to the person in this episode of care as ‘Dave,’ not his real name.”
Make it clear the context of your experience, e.g., “I was a student nurse on an acute inpatient unit.”
Identify risks and nursing care, e.g., “This essay will examine the management of violence in an inpatient setting and the barriers and opportunities for maintaining a therapeutic relationship in this context.”
Break confidentiality, e.g., “I was in Highcroft Hospital…” or “I was caring for Fred Smith…”
Start giving definitions, e.g., “Critical reflection is the process of retrospectively examining your actions…”
Evidence-based Holistic Nursing Assessment:
Give the perspective of the person, e.g., “Dave was angry because he thought we were laughing at him.”
Demonstrate an understanding from the person’s perspective and why they behaved in the way they did, e.g., “Dave was newly admitted and did not know staff members; he was surrounded by strangers and was realizing for the first time he couldn’t leave the ward because he was detained.”
Explore the person’s bio-psycho-social needs and link them to how they are being expressed in the episode, e.g., “Dave’s difficulty in trusting others reflects a pattern common amongst those who have experienced….”
Use relevant evidence to support your assessment, e.g., “Children who survive physical abuse are much more likely to have low self-esteem, anxiety, self-destructive behavior, suicidal behavior, and a lack of trusting relationships as adults (Gilbert et al., 2007).”
But ensure they remain focused on the person you are discussing, e.g., “For Dave, alcohol was the key to managing his low self-esteem and anxiety.”
Give a medicalized description, e.g., “Dave was agitated because he has antisocial personality disorder.”
Give a service-focused context, e.g., “Dave was treated with medication because he was detained under the mental health act which allows it.”
Give a service perspective of his care, e.g., “Dave was angry because he was paranoid and impatient, staff were busy.”
Give general definitions of key terms without reference to the episode, e.g., “Holistic assessment involves considering a person’s circumstances and history as an important part of their current presentation.”
Critical Reflection on Self:
Say specifically what you said and did, e.g., “Dave kept asking for his medication, but I was waiting for the qualified nurse to return, so I asked him to wait while I found them.”
Demonstrate and name what you did well or what didn’t go well, e.g., “I could see Dave was getting agitated, so I lowered my voice and sat down, which de-escalated the situation.”
Reflect on what knowledge and personal values influenced what you did and where they came from, e.g., “I could see Dave’s hands were shaking; I think other people thought he was angry, but I wrote about alcohol dependence in an essay in the second year, and I was sure this was alcohol withdrawal.”
Demonstrate an ability to think about other people’s perspectives in relation to your own, e.g., “I could see Kevin the nurse looked worried; I think he thought Dave was going to be violent, so he spoke very firmly to him to control the situation.”
Include references when referring to specific theory or objective facts, e.g., “I had learned previously that low blood sugar was a common risk with alcohol withdrawal from the reading I did for my essay (Simpson et al., 2016).”
Organize this section with a specific reflective model unless that model is important to your reflective process, e.g., “I didn’t realize why I reacted that way until I used Brookfield’s (2017) model…”
Give yourself uncritical and unspecific general praise, e.g., “I have great communication skills; I have always had them; I used good communication skills in this episode of care.”
Try to use references for things only you experienced, e.g., “Dave was angry when he was told he couldn’t go out (Peterson, 2020).”
Talk generally about your nursing values and skills without reference to the episode of care, e.g., “I have always been a people pleaser; I’m very empathetic, and I like to help people; I have done volunteer work from an early age.”
Critical Appraisal of Evidence:
Use the module content to answer the question, e.g., “Dave’s suicide attempt makes sense in light of Joiner’s IPT model.”
Use the University library to find your evidence and use peer-reviewed evidence.
Apply the theory to the person, e.g., “Dave felt constantly guilty about not being there for his children; he felt the thwarted sense of belonging of not being part of the family unit and had the perceived sense of burdensomeness of every meeting going badly due to his drinking.”
Criticize the limitations of the theory, e.g., “Although the IPT model explains why Dave would feel suicidal, it didn’t help explain why he decided at that time to act on those thoughts…”
Critically analyze the evidence for the theory, e.g., “The IPT model has relied heavily on postmortem data on a national level; it does not account for regional factors such as higher rates of suicide in rural communities….”
Integrate your analysis with national frameworks and clinical guidelines, e.g., “NICE Guidelines for suicide prevention (NICE, 2019) recommend reducing access to means in custodial settings; acute wards are designed to achieve this through a high level of monitoring and by creating an environment that minimizes the risk of things like ligature points….”
Generally describe research or clinical guidelines, e.g., “NICE (2022) Guidelines on the treatment of depression in adults say that when offering a person medication for the treatment of depression, discuss and agree on a management plan with the person. Including the reasons for offering medication, the choices of medication (if a number of different antidepressants are suitable), the dose, and how the dose may need to be adjusted.”
Use websites designed for use by members of the public to support your points, e.g., “MIND (2018) confirms that SSRI medication is appropriate for depression…”
Use Google to find your evidence.
Use websites like Cite This For Me.
Copy and paste sections of the evidence you have chosen and change a few words around.
Use other students’ essays as the basis for your own.
Find sample essays from essay mills and then use them as a template for your essay.
Evidence Based Nursing Interventions:
Tell us what nursing care was actually given, e.g., “Kevin asked Dave if he could join him when his mother came to visit that evening.”
Analyze if the care that was given matches the evidence you have explored, e.g., “Involving people’s family and significant others is identified as important in the NICE guidelines around suicide prevention (2019) and depression (2022) and has been shown to facilitate a recovery-oriented approach to care (Barker, 2013).”
Give your opinion on if the care was safe, effective, and high quality, e.g., “The care was safe and effective as Dave’s impulsive attempt was caught by the person on observations, but it could have been of higher quality if someone had seen his attempt coming earlier and prevented it entirely.”
Suggest what could have been done differently based on your reading, e.g., “Although Dave was kept safe and given the medication he needed, that interaction could have been used for a one-to-one conversation about how he was feeling, which might have led him to reveal signs of an imminent attempt, for example, his sense of hopelessness and feeling trapped on the ward along with his impulsivity (O’Connor, 2019).”
Suggest if this was realistic and if not what improvements are needed to achieve this, e.g., “The evidence suggests nursing shifts are understaffed, and a lack of resources reduces the quality of assessment and ability to provide bespoke care (RCN, 2021), but my feeling is that if Kevin had identified those risks at the time and had responded to Dave then, it would have saved time later on, but this relies on Kevin spotting the signs. This kind of reflective practice can be facilitated through clinical supervision (Clarke, 2020).”
Generally describe an intervention or tool, e.g., “When Dave was agitated, the staff should have used de-escalation.”
Generally introduce a multi-factor model as if it was an intervention, e.g., “The care would be better if they used Safe Wards.”
Describe general nursing values as interventions, e.g., “Staff should be empathetic.”
State staff need unspecific training without stating why or in what way they should be trained or how this would help, e.g., “Train staff to do de-escalation right.”
Give a realistic recommendation for what you would do if you saw a similar incident in practice, e.g., “In cases like Dave’s, I would give the medication to calm his agitation, but I would also use that time to do a brief one-to-one and find out how he is feeling.”
Give a realistic recommendation for your own personal development, e.g., “I need to work on listening to how people feel and be less focused on tasks.”
Introduce whole new arguments or areas of discussion.
Contradict what you have already said.
Submission point 1: 7/8/2023
Submission point 2 (In Year Retrieval): 2/10/2023
Submission point 3 (Resubmission point): 27/11/2023
The module includes the following formative opportunities to support you with your assignment submission:
Group tutorials will be offered on a weekly basis throughout the module.
Student case studies will be used in module seminars throughout the module to explore module content.
The final week of the module will include classroom writing workshops where students will work on their assignment under the direct supervision of teaching staff.
Students will have the opportunity for a one-to-one tutoring session with a member of the module team through a booking page.
Students who are not successful on the first attempt will receive a group tutorial prior to the IYR.
Students who did not submit (DNS) at the first attempt or students who have not achieved the 40% threshold on the first and second attempt will have access to 1:1 tutorials.