Reflection as well as conducting myself in a

Reflection has been identified as an
essential skill for midwives to learn as well as an

component of professional practice (Kirkham 1997). Therefore,
as a student

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midwife, I intend to use this mechanism to
further develop my knowledge and clinical skills

(Mezirow, 1981). Throughout this module, I
have had the opportunity to gain various

insights into new ways of communicating, both
verbally and non-verbally (Baughan, J. 

Smith, A. 2013), as well as conducting myself
in a professional manner throughout (The

NMC Code: 15, Section 20). In this essay, I will
use the Gibb’s (1988)

model of reflection to analyse the
development of my communication and professional

skills in the task of ‘Hollie’ and ‘Grandma,
remember me’. The thought-provoking aspect of

these tasks along with the way in which they
highlight the true significance of

communication and professionalism are the key
reasons why I chose to analyse these



Within the
healthcare system, there is a necessity for health workers to communicate

effectively and ethically; as the NCM standards for pre-registration nursing

states: ‘..All
nurses must build partnerships.. through safe, effective and non-discriminatory

and must take account of individual differences.’ (Nursing and Midwifery

Council England,
2010: 15). Thus, recognising diversity is key for the patient to be able to

make an informed
decision (Communication in Nursing and Healthcare: 1, 2012). As

Goffman (1963) noted, the impact of a patient’s socio-economic
status among other factors

– religion,
culture, language, gender – is integral to consider when administering care to

patient. For example,
when a midwife is looking after a lady who is a practicing Jehovah’s

witness, it must
be considered how religion will influence the care given to the patient pre-

birth, during
and post. For instance, how an emergency blood transfusion would

affect the patient
in question, ensuring respect at every stage of care of her rights as well as

choices she has
made. Effective midwife-patient communication is, therefore, essential in

order for messages
not to be lost, preferences noted and rights upheld (Morris and Morris,



The integrality
of communication was also evident in the task of ‘Hollie’. This task allocated

each student
into a group with the objective of caring for the virtual patient and

required four
people within each time slot to log onto the system to ensure Hollie received

her full care


During the task,
a breakdown in my team’s communication became apparent. This was

highlighted by
two members administering medical treatment to Hollie within the same

time slot which,
inevitably, put Hollie’s health in jeopardy. Conversely, others were also

missing their
slot and not taking accountability for their roles within the team which, not   

only disregarded
previous communication but also strained future communication (Belbin,



Consequently, as
a team member, I became more introverted within the group discussion

due to fear of
being ignored because of the unwillingness of some members of my team.

As a result, roles
within the team became blurred and leadership was lost. Hunter (1997)

points out that the more roles a
team has within its members, the more successful a team

will become. Therefore, I think
more delegation and established roles were needed within

my team as well as clearer
communication before the task commenced. Dougherty

Lister, (2011)
also notes that a breakdown in inter-professional communication and

professionalism is
a failure to not only the patient but also to their families. Thus, it is a

component of any
health practitioner’s role.


The breakdown in our teamwork (Belbin, 2012) caused Hollie’s
health to suffer, which

reflects the problematic consequences of communication and
professionalism. A similar

case in failed communication was exposed through the Francis report (Francis,
2013). This

enquiry highlighted that ‘people must be treated as individuals and their

(NMC, 2015: 4). However, these standards of care were not upheld at all times

the task of ‘Hollie’, and as the Francis Report illustrated, this can have a
detrimental effect

the patient.


Although, at times, the task made me feel frustrated
and stressed, I also recognise


the importance of not ignoring issues, speaking up
and not letting small issues escalate into


larger ones (Belbin, 2000). The downfalls of the task have taught me the
importance of


acting more assertively with colleagues, but also, the importance of encouragement and


within a team (Dinkins,
2011). Thus, I feel I could have
improved the team’s


through imparting drive, evaluating options and organising the slots more


(Belbin, 2000). Also, I feel this task has taught me that I need to have more


in delegating tasks, working closer with colleagues and giving more


where it is lacking. Although I regret that I was not more vocal towards the


the task, I am pleased that Hollie’s health remained in a good condition and at
a high




the second part of my reflection, I will focus on the play of ‘Grandma,
Remember me’.

The play follows the story of Lily and her
family. As the play progresses, the deterioration of

Lily’s grandma’s mental health as a result of
dementia becomes evident through her

loss of memory, recognition and altered behaviour.
The core theme throughout the play is

the knock-on effect of Grandma’s illness upon
the family relationships as well as the family

members’ psychological, emotional and
physical well-being.


When watching the play, my initial thoughts
and feelings were of frustration, sadness and


helplessness for Lily, her family members’
and her grandmother. This feeling of sadness


enabled me to look at the disease of dementia
not just as an isolated subject, but to see the


story and person behind it; the suffering and
helpless position family members


find themselves in. As Reynolds (2005) notes, health-professionals
‘must be receptive to


another’s communication’ and ‘put him/herself in the
other’s place’. Therefore, I feel


this play especially taught me how crucial
compassion and care is towards patients.



Throughout the play, relationships between family
members became strained due to


confusion and lack of communication. This
aspect of the play compelled me, as a student


midwife, to think of ways I could help a
patient who is struggling to come to terms with


changes in their body, mentality and
well-being. Gault et al (2013) acknowledged


communicative behaviour is the outward expression of
health professionals’ internal


attitudes and values. Thus, it is our duty, through
communication as well as compassion,


understanding and care to diagnose patients
correctly, as well as to offer the most effective


treatment and care post-diagnosis, unlike that
which Grandma experienced in ‘Grandma,


remember me’. In the practice of midwifery, supporting
and guiding mothers throughout


their pregnancies help reduces stress and
anxiety and encourages healthy relationships


within their existing support network.



As NMC (2010) noted professional
practitioners must possess highly sophisticated


communication skills to provide compassionate care
to the people they look after. From


watching ‘Grandma, remember me’, I have learnt how important
sign-posting as well as


active listening is. For example, if a woman’s
safety in my care is in question, I would have a


responsibility to take the correct measures in order
to safeguard her and any other children


in her care.


In conclusion,
throughout this module, I have had the opportunity to re-evaluate the

significance of
communicating holistically to both the patient as highlighted in ‘Grandma,

Remember me’ and
inter-professionally in the task of ‘Hollie’. It has not only ensured I

recognise the
centrality and complexity of communication within the healthcare system but

also, the
measures in which we, as health professionals, must take to overcome these


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