DOCSLIB.ORG

The Influence of Reflective Practice on the Case

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Influence of Reflective Practice on the Case THE INFLUENCE OF REFLECTIVE PRACTICE ON THE CASE CONCEPTUALIZATION COMPETENCE OF COUNSELOR TRAINEES by Vassilia Binensztok A Dissertation Submitted to the Faculty of The College of Education in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Florida Atlantic University Boca Raton, Florida May 2019 Copyright 2019 by Vassilia Binensztok ii THE INFLUENCE OF REFLECTIVE PRACTICE ON THE CASE CONCEPTUALIZATION COMPETENCE OF COUNSELOR TRAINEES by V assilia Binensztok This dissertation was prepared under the direction of the candidate's dissertation advisor, Dr. Len Sperry, Department of Counselor Education, and has been approved by all members of the supervisory committee. It was submitted to the faculty of the College of Education and was accepted in partial fulfillment of the requirements for the degree of Doctor of Philosophy. SUPERVISORY COMMITTEE: Len S~M~(/(;r;?< P~ul Peluso, Ph.D. ~Ad'#M £~ Carman Gill, Ph.D. Paul Peluso, Ph.D. Chair, Department of Counselor Education Apci \ ~. lotq Khaled Sobhan, Ph.D. Date Interim Dean, Graduate College iii ACKNOWLEDGEMENTS I would like to take this opportunity to thank everyone that has helped me on my journey through the doctoral program and seeing this dissertation to its end. First and foremost, I would like to express my appreciation to my advisor and committee chair, Dr. Len Sperry. I feel honored that you chose me to work on important projects with you. During these projects, I have learned not only how to be a scholar but also learned many lessons about myself. The assignments you gave me pushed me to explore the limits of what I could do and showed me I am capable of much more than I once thought I was. You have helped me gain the confidence to set out on my own ventures and attempt things I had not dreamed of before. I will be forever grateful not only for the academic opportunities you have afforded me but also for the opportunity to grow as a person and a thinker. I would like to thank my committee members Dr. Paul Peluso and Dr. Carman Gill. Dr. Peluso, thank you for taking the time to work with me and help me through my dissertation process. You bring a great presence to the Department and help the students feel supported through the program. Dr. Gill, you have inspired me in many ways, and I see you as a role model as both a scholar and a woman. I feel fortunate to have had the opportunity to learn from you and to have participated in so many meaningful class discussions with you. I would like to thank Dr. Jon Sperry for accommodating me in my research and for going to great lengths to help me collect my data. iv I want to acknowledge my family and friends, without whom nothing I have achieved would be possible. Thank you to my grandparents, Nina and David, may they rest in peace, who survived many hardships and eventually lived the American Dream and instilled this value in me. My grandfather, David, gave me his resilience, perseverance, and idealism. Thank you to my cousin, Sara, for always holding it down for me. I am doing my best not to live under the family spell, for all of us. Thank you to my great, great grandmother for watching over me, and thank you to my ancestors for the blessings. Thank you to my cousin, Joe, and my aunt and uncle Aviva and Leon, for supporting me and finally taking my side. Also, I would like to acknowledge my parents, who were right about some things, wrong about a lot of things, but, for better or worse, helped make me who I am. Thank you to my friends Lexie, Allison, and George. You are my fans, my support, and my confidantes. I love you, and I don’t know where I would be if it weren’t for you. I can’t wait to get out and finally see more of you now that I’m done with all this work! Thank you to the most amazing Ph.D. friends anyone could ask for —The Outliers Ali and Tiffany. You have helped me navigate one of the most turbulent times, and I hope that I have done the same for you. I will be forever grateful to you and the thread. The further I got into this dissertation, the more I realized how fitting norepinephrine was. Finally, last but not least, I would like to thank and dedicate my dissertation to all the students I taught at Palm Beach State College from 2012 through 2018. My students changed my life. You believed in me so much that I started believing in myself. You v liked me so much I started liking myself. I might never have pursued this dream of earning a doctorate if it weren’t for you all. vi ABSTRACT Author: Vassilia Binensztok, M.S. Title: The Influence of Reflective Practice on the Case Conceptualization Competence of Counselor Trainees Institution: Florida Atlantic University Dissertation Advisor: Dr. Len T. Sperry Degree: Doctor of Philosophy Year: 2019 The purpose of this quasi-experimental, longitudinal study was to measure the effects of reflective practice coaching on 35 participants, as compared to participants who did not receive coaching. Data was collected over a period of eight weeks. A secondary purpose was to examine the effects of a standardized case conceptualization training lecture on 84 participants. A third purpose was to examine the relationships between counselor trainee demographic variables, their attitudes towards evidence-based practice, disposition towards reflective reasoning, and competence in writing case conceptualizations. This was the first study to contribute to the reflection in counseling literature. A convenience sample of N = 84 participants participated in two standardized case conceptualization training lectures. An intervention group (N = 35) received an additional three one-on-one reflection coaching sessions. The comparison group (N = 49) received the training lectures and no coaching. Participants from both groups attended two 3-hour training lectures, which taught the integrative case conceptualization model vii developed by Sperry (2010). Intervention group participants took part in three additional one-on-one reflection coaching sessions. Pre- and post-training lecture case conceptualization skills were assessed using the Case Conceptualization Evaluation Form (CCEF) 2.0. Levels of reflective thinking were measured with pre-, post-, and post-post- administrations of The Reflection in Learning Scale (Sobral, 2005). Variance in case conceptualization competence was analyzed using a MANOVA. Intervention group participants’ mean CCEF 2.0 scores were significantly higher than those of the comparison group (M = 72.64 and M = 46.81, respectively). Reflective thinking was determined not to be a mediating or moderating variable. Mean CCEF 2.0 scores from the first training lecture increased from the pre-test to the post-test (M = 11.20 and M = 24.10, respectively) for all participants. Mean case CCEF 2.0 scores also increased from the pre-test to the post-test in the second training lecture (M = 21.33 and M = 52.29, respectively) for all participants. Additionally, a paired sample t-test showed improvement on the Reflection in Learning Scale (Sobral, 2005) between the post-test and post-post test for the intervention group. Results were significant (|t| = 1.91, df 34, p < .001, one-tailed). viii THE INFLUENCE OF REFLECTIVE PRACTICE ON THE CASE CONCEPTUALIZATION COMPETENCE OF COUNSELOR TRAINEES List of Tables ................................................................................................................... xiii List of Figures .................................................................................................................. xiv I. Introduction ..................................................................................................................... 1 Statement of the Problem .............................................................................................. 5 Need for standardized training of case conceptualization skills. .......................... 10 Purpose of the Study ................................................................................................... 11 Research Questions and Hypotheses .......................................................................... 11 Definitions of Key Terms ........................................................................................... 13 Study Design ............................................................................................................... 16 Organization of the Dissertation ................................................................................. 17 Summary ..................................................................................................................... 17 II. Literature Review ......................................................................................................... 19 Case Conceptualization ............................................................................................... 19 Significance of Case Conceptualization ..................................................................... 21 Practitioner Expertise .................................................................................................. 23 Case Conceptualization Training ................................................................................ 25 Types of Case Conceptualization Models ................................................................... 27 Context and organizational models. ...................................................................... 27 Research models. .................................................................................................. 27 ix
Load more

Recommended publications
  • Reflective Practice: an Introduction
    01-Bolton 3e-3948-Ch-01:Bolton 3e-3948-Ch-01 24/11/2009 5:33 PM Page 1 SECTION 1 REFLECTION AND REFLEXIVITY: WHAT AND WHY 01-Bolton 3e-3948-Ch-01:Bolton 3e-3948-Ch-01 24/11/2009 5:33 PM Page 2 01-Bolton 3e-3948-Ch-01:Bolton 3e-3948-Ch-01 24/11/2009 5:33 PM Page 3 CHAPTER 1 REFLECTIVE PRACTICE: AN INTRODUCTION Chapter 1 introduces and describes reflective practice, outlining its political and social responsibility. Reflection and reflexivity are defined and explained. The particular nature of through-the-mirror writing is introduced, its relationship to mindfulness, and the way it can tell the truth while accepting the impossibility of objectivity. We do not ‘store’ experience as data, like a computer: we ‘story’ it. (Winter 1988, p. 235 ) You understand how to act from knowledge, but you have not yet seen how to act from not-knowing. (Chuang Tsu 1974, p. 68) I’m no longer uncertain about being uncertain: uncertainty is now my mantra. (Reflective practice student ) Reflection is a state of mind, an ongoing constituent of practice, not a technique, or curriculum element. Reflective Practice can enable practitioners to learn from experience about themselves, their work, and the way they relate to home and work, significant others and wider society and culture. It gives strategies to bring things out into the open, and frame appropriate and searching questions never asked before. It can provide relatively safe and confidential ways to explore and express experiences otherwise difficult to communicate. It challenges assumptions, ideological illusions, damaging social and cultural biases, inequalities, and questions personal behaviours which perhaps silence the voices of others or otherwise marginalise them .
    [Show full text]
  • Becoming a Reflective Practitioner Prof
    Becoming a reflective practitioner Prof. David Brigden, Adviser for Postgraduate Medical and Dental Education Mersey Deanery (University of Liverpool/NHSE) Professor of Professional Development, Faculty of Health Sciences, University of Cape Town;Mr Nigel Purcell, Senior Education Advisor Higher Education Acadamy, Subject Centre, School of Medical Education Development, Newcastle University; Introduction Reflection and reflective practice are two of the key buzzwords in professional and education practice at present. But what exactly do we mean by these terms and how can we develop our capacity for reflection? This article focuses on how to become more reflective in your professional practice whether as a clinician or educator. In it we define what we mean by reflection, identify the key stages in reflective practice and outline the main reflective practice skills. Reflection on current practices Before bringing about a change to current practices, the clinician needs to reflect on what is currently being practiced and what changes are required. A key factor in determining whether change is needed is the ‘evidence base’ relevant to the situation under consideration. One of the most difficult tasks for educators is to help learners to relate theory to practice and reflection is one of the most important factors in achieving this synthesis. Unless this link is made then simply reading up on the evidence base is of little practical value. ‘Evidence based practice needs to retain a practical focus and to build on reflective practice’ (1). This process is referred to as ‘reflection on action’ that is, it takes place after an event. Another aspect to reflective practice is ‘reflection in action,’ a more immediate reflection that takes place during the action.
    [Show full text]
  • Understanding Reflective Practice
    CONTINUING PROFESSIONAL CPD DEVELOPMENT Understanding reflective practice NS842 Nicol JS, Dosser I (2016) Understanding reflective practice. Nursing Standard. 30, 36, 34-40. Date of submission: September 28 2015; date of acceptance: January 9 2016. Abstract Aims and intended learning outcomes This article aims to increase the nurse’s The Nursing and Midwifery Council (NMC) requires that nurses and knowledge and understanding of reflective midwives use feedback as an opportunity for reflection and learning, practice and assist them to develop a portfolio to improve practice. The NMC revalidation process stipulates that of evidence for revalidation (Nursing and practitioners provide examples of how they have achieved this. To reflect Midwifery Council (NMC) 2015a). After in a meaningful way, it is important to understand what is meant by reading this article and completing the time out reflection, the skills required, and how reflection can be undertaken activities you should be able to: successfully. Traditionally, reflection occurs after an event encountered in Define reflection and explain its role in practice. The authors challenge this perception, suggesting that reflection professional practice. should be undertaken before, during and after an event. This article Describe two different models of provides practical guidance to help practitioners use reflective models to reflection. write reflective accounts. It also outlines how the reflective process can Discuss how self-awareness is integral be used as a valuable learning tool in preparation for revalidation. to reflection. Discuss how reflection can be used as a Authors learning tool. Jacqueline Sian Nicol Lecturer, Edinburgh Napier University, Edinburgh, Prepare several examples of reflection Scotland. to support the NMC revalidation process.
    [Show full text]
  • Reflective Practice’ Is Much Used and Little Understood
    Career Guidance Today, Institute of Career Guidance Vol. 10(6). 2002 The Guidance Practitioner: Technician or Artist? Going Beyond Technical Competence Liane Hambly The term ‘reflective practice’ is much used and little understood. It is not the ability to describe one’s feelings about one’s experience. Rather, it is the ability to reflect on one’s experiences, to analyse what happened, why it happened and the learning gained. But it can even mean more than this – according to Schön1, reflective practice is the ability to conduct such reflection, not only at the end of an experience, but mid- process. He calls this ‘Reflection-in-action’ - the ability to think on one’s feet, to understand what is happening and why, and to deal with the uncertainties of practice in situ. In terms of interviewing, this takes us beyond mere technical competence into the realm of what Schön calls the ‘artistry’ of practice. It is this I want to explore – how to create guidance practitioners who are artists, practitioners who are able to respond creatively to the uniqueness of each guidance interview, who are able to move through and beyond what they have been taught whilst preserving the principles and ethics of the profession in which they operate, not only in their evaluations but whilst they are face-to face-with clients. Clients are unique. Their needs are unique. The way they engage in the guidance process is also unique. Yet how often do we say ‘this particular solution works best with this type of client’? How dangerous is it to teach students a predisposed set of responses and constructs of what clients are like and how best to deal with them? No wonder so many clients smile politely and say ‘thank you’ but upon leaving say to their friends that ‘she/ he didn’t listen’.
    [Show full text]
  • Implementation of an Integrated Reflective Practice Model in Higher Education Pedagogy Within the Context of a South African Tertiary Institution
    ©2018 Scienceweb Publishing Journal of Educational Research and Review Vol. 6(6), pp. 84-93, November 2018 doi: 10.33495/jerr_v6i6.18.136 ISSN: 2384-7301 Research Paper Implementation of an integrated reflective practice model in higher education pedagogy within the context of a South African tertiary institution Petronella Jonck* • Riaan De Coning Research and Innovation, The National School of Government, 70 Meintjies Street, Sunnyside, Pretoria, South Africa. *Corresponding author. E-mail: [email protected]. Tel: 071 2995 162. Accepted 29th October, 2018. Abstract. Reflection as educational tool to improve practice has gained impetus and is deemed critical within the context of culturally relevant pedagogy. This article provides an example of a practitioners’ reflection on applied educational practices within the context of a South African tertiary institution based on the Comprehensive Assessment Method in Psychology (CAMP). A qualitative, phenomenological research design was implemented. The CAMP model was found to be useful ascribed to the ability thereof to distil and integrate the key academic focus areas with student feedback. In addition, the researcher reflected on underlying beliefs and assumptions which guide internalised interest and practice in the field of education. The significance of the study underscores the value of reflection for current or prospective career academics in terms of aligning with institutional strategic intent. Moreover, it gauges the measure of potential misalignment as well as identifying developmental areas for educators. Keywords: Educational policy, higher education, institutional alignment, reflection. INTRODUCTION Reflection as a tool for improving educational practice learners are endowed with internalised attitudes, beliefs has gained prominence over the last decade.
    [Show full text]
  • Reassess - Realign - Reimagine: a Guide for Mentors Pivoting to Remote Research Mentoring
    Reassess - Realign - Reimagine: A Guide for Mentors Pivoting to Remote Research Mentoring Christine Pfund1,2,7, Janet L. Branchaw3, Melissa McDaniels2, Angela Byars-Winston4, Steve Lee5, and Bruce Birren6 1Institute for Clinical and Translational Research, University of Wisconsin–Madison, Madison, WI 2Wisconsin Institute for Science Education and Community Engagement and Department of Kinesiology, University of Wisconsin–Madison, Madison, WI 3Wisconsin Center for Education Research, University of Wisconsin–Madison, Madison, WI 4Department of Medicine and Center for Women’s Health Research, University of Wisconsin– Madison, WI 5School of Humanities and Sciences, Stanford University, Stanford, CA 6Broad Institute of MIT and Harvard, Cambridge, MA 7Corresponding author Keywords: mentor, mentoring, graduate, advisor, psychosocial Abstract Maintaining your research team’s productivity during the COVID-19 era can be a challenge. Developing new strategies to mentor your research trainees in remote work environments will not only support research productivity, but also help to keep your mentees’ academic and research careers on track. We describe a three-step process grounded in reflective practice that research mentors and mentees can use together to reassess, realign and reimagine their mentoring relationships to enhance their effectiveness, both in the current circumstances and for the future. Drawing on evidence-based approaches, a series of questions for mentees around documented mentoring competencies provide structure for remote mentoring plans. Special consideration is given to how these plans must address the psychosocial needs and diverse backgrounds of mentors and mentees in the unique conditions that require remote interactions. Introduction An unprecedented situation requiring remote research mentorship from faculty and research group leaders has emerged from the COVID-19 health crisis.
    [Show full text]
  • Reflective Practice Farrell
    Reflective Practice for Language Teachers THOMAS S. C. FARRELL Framing the Issue There is a longstanding recognition in the field of language education that teach- ers must continually reshape their knowledge of teaching and learning (Farrell, 2007). This knowledge is developed initially in teacher education programs, and then becomes part of teachers’ education throughout their careers when they engage in reflective practice (Farrell, 2015). Indeed, many years ago Dewey (1933) noted that teachers who do not bother to reflect on their work become slaves to routine because their actions are guided mostly by impulse, tradition, and/or authority rather than by informed decision making. This reliance on routine and daily repetitive actions eventually leads to burnout. However, if teachers engage in reflective practice they can avoid such burnout because they take the time to stop and think about what is happening in their practice to make sense of it so that they can learn from their experiences rather than mindlessly repeat them year after year. Dewey’s ideas were further developed by his PhD student Donald Schön (1983) when he suggested that teachers should not only reflect on their action after stepping back from it, but also reflect during and while doing the action, which he called reflection-in-action. For example, Schön (1983) wondered what would happen when a teacher’s established routines did not work because an unforeseen event occurs and the teacher must experiment in some manner while in the midst of the action in order to cope. In such a manner Schön’s reflec- tion-in-action built on Dewey’s reflection-on-action and the result of both can be used to direct a teacher’s future decisions (or reflection-for-action).
    [Show full text]
  • The Virtual Professor and Online Teaching, Administration and Research: Issues for Globally Dispersed Business Faculty
    ISSN: 2292-8588 Vol. 32, No. 2, 2016 The Virtual Professor and Online Teaching, Administration and Research: Issues for Globally Dispersed Business Faculty Rick K. Ladyshewsky Abstract: Changes in the manner in which universities are delivering education are revolutionary. Learning spaces are changing, online learning is increasing, the demand for more flexible learning continues to grow, and the skill set for academics is expanding. Recruitment and retention of academic staff to work in this type of context creates a range of challenges for universities. With a global shortage of quality academic staff, an ageing academic workforce and a younger cohort of casual academic staff looking to leave the sector, institutions may need to consider other ways of attracting staff beyond the traditional manner of resident faculty. One staffing model involves having permanent academic staff positions that are virtual. This case study reports on the experience of a professor in a university’s business faculty working remotely in a foreign country. The experience of working virtually was successful across teaching, research and administrative dimensions. Reasons for this success related to the intrapersonal competencies and work preferences of the professor and the technology rich environment of the university. Maintaining communication richness with colleagues were noted challenges. Educational management and administration of these staffing arrangements offer new ways for universities interested in internationalizing their business. Keywords: Virtual Faculty, Online Teaching, Telework, Internationalization, Distance Education Résumé : Les changements dans la manière dont les universités offrent l'éducation sont révolutionnaires. Les espaces d'apprentissage changent, l'apprentissage en ligne augmente, la demande pour l’apprentissage plus flexible continue de s’accroître, et l'ensemble des compétences pour les universitaires est en pleine expansion.
    [Show full text]
  • Preventing Violence, Harassment and Bullying Against Health Workers Second Edition Disclaimer
    Best Practice Guideline JULY 2019 Preventing Violence, Harassment and Bullying Against Health Workers Second Edition Disclaimer These guidelines are not binding on nurses, other health workers, or the organizations that employ them. The use of these guidelines should be flexible and based on individual needs and local circumstances. They constitute neither a liability nor discharge from liability. While every effort has been made to ensure the accuracy of the contents at the time of publication, neither the authors nor the Registered Nurses’ Association of Ontario (RNAO) gives any guarantee as to the accuracy of the information contained in them or accepts any liability with respect to loss, damage, injury or expense arising from any such errors or omission in the contents of this work. Copyright With the exception of those portions of this document for which a specific prohibition or limitation against copying appears, the balance of this document may be produced, reproduced and published in its entirety, without modification, in any form, including in electronic form, for educational or non-commercial purposes. Should any adaptation of the material be required for any reason, written permission must be obtained from RNAO. Appropriate credit or citation must appear on all copied materials as follows: Registered Nurses’ Association of Ontario (RNAO). Preventing violence, harassment and bullying against health workers. 2nd ed. Toronto (ON): RNAO; 2019. Funding This work is funded by the Ontario Ministry of Health and Long-Term Care. All work produced by RNAO is editorially independent from its funding source. Conflict of Interest In the context of RNAO best practice guideline development, the term ‘conflict of interest’ (COI) refers to situations in which an expert panel member’s financial, professional, intellectual, personal, organizational and/or any other relationship may compromise their ability to independently conduct panel work.
    [Show full text]
  • Person-Centred Practice Across Cultures
    futures UPFRONT Workbook 1.4 Person Centred Practice Across Cultures Reflective Practice - why different points of view matter July 2016 This workbook has been developed for National Disability Services by: Barbel Winter, Managing Director, futures Upfront and Maria Katrivesis, Consultant and Trainer First published (July 2016) © futures Upfront For more information and for permission to reproduce please contact: futures Upfront email: [email protected] web: www.futuresupfront.com.au Produced by NDS NSW Level 18, 1 Castlereagh St Sydney, NSW 2000 Funded by NSW Department of Family and Community Services. © This publication is copyright All rights reserved. Except as provided in the Copyright Act 1968 (Commonwealth), no use of this work, which is within the exclusive right of the copyright owners, may be made. Contact NDS 02 9256 3100 [email protected] www.nds.org.au About National Disability Services National Disability Services is the peak body for non-government disability services. Its purpose is to promote quality service provision and life opportunities for people with disability. NDS’s Australia-wide membership includes more than 1000 non-government organisations, which support people with all forms of disability. NDS provides information and networking opportunities to its members and policy advice to state, territory and federal governments. Table of Contents 1. Preface ...................................................................................................................... 2 1.1 How to use this workbook?
    [Show full text]
  • California Elementary School District Superintendents' Perceptions
    CALIFORNIA ELEMENTARY SCHOOL DISTRICT SUPERINTENDENTS’ PERCEPTIONS REGARDING PROFESSIONAL DEVELOPMENT SUPPORT AND REFLECTIVE PRACTICE IN THE SUPERINTENDENCY by Julie Ann Graves B.A. (California State University, Bakersfield) 1977 M.A. (California State University, Bakersfield) 1984 A dissertation submitted in partial fulfillment of the requirements for the degree of Doctorate in Education Doctoral Program in Educational Leadership at Fresno State Kremen School of Education and Human Development California State University, Fresno 2017 ii Julie Ann Graves December 2017 Educational Leadership CALIFORNIA ELEMENTARY SCHOOL DISTRICT SUPERINTENDENTS’ PERCEPTIONS REGARDING PROFESSIONAL DEVELOPMENT SUPPORT AND REFLECTIVE PRACTICE IN THE SUPERINTENDENCY Abstract This dissertation examined perceptions of elementary district superintendents regarding professional development in the superintendency. The current challenges of the superintendency require superintendents to be more prepared than ever before and to serve as effective leaders of school districts. Specifically, this research identified what professional development activities provide effective support in the superintendency, and additionally identified the value of linking professional standards with professional development. This study also focused on the connection between reflective practice and professional development in the superintendency. The three research questions that guided this study were: In what structures of support and professional development do elementary school district
    [Show full text]
  • Bullying in the Nursing Profession
    Bullying By Mary Pat Szutenbach ROOTS,in RATIONALES, Nursing: AND REMEDIES 3.0 contact hours ABSTRACT: Bullying and incivility are sadly, far too common in today’s healthcare work- places. This article reviews early to current literature, identifies types of bullying, offers four root causes, and suggests responses to impact these causes using Gibbs’ Reflective Cycle, biblical Scripture, and an allegory “How to Swim with Sharks.” KEY WORDS: bullying, Gibbs’ Reflective Cycle, incivility, lateral violence, nursing 16 JCN/VolumeJCN / Volume 30, 30,Number Number 1 1 journalofchristiannursing.com Copyright © 2013 InterVarsity Christian Fellowship. Unauthorized reproduction of this article is prohibited. “Her statements became increasingly aggressive and she ultimately told me to ‘go slide down a razor blade.’” A SADLY COMMON STORY in the baby’s right hand, taped on a started shouting at me. I convinced ess than a year after graduation padded board with the board pinned her to move our interaction into the from nursing school I was com- to the mattress. I checked the IV and medication room, where we could talk Lmissioned in the military and it was patent and showed no signs of in private. Brenda continued to yell at assigned to a combined adult and pe- malfunctioning, so I reset the pump me and told me never to touch her diatric unit in a small hospital. While in and returned to the nurses’ station. patients. Her statements became increas- orientation I was asked to provide one- A little later it alarmed again. When ingly aggressive and she ultimately told to-one care for a critically ill child who I went in the second time, I noticed me to “go slide down a razor blade.” could not be placed in in- I left the interaction tensive care.
    [Show full text]