Peer Responses:

• Relate to another journal reading
• How I achieved my goals in the clinical setting 
• In my clinical experience at Palm Beach Medical Centre, I made significant progress towards my goal of understanding the balance between pharmacological and non-pharmacological interventions in chronic disease management. By actively engaging with patients with chronic conditions such as diabetes, hypertension, and chronic pain, I was able to apply the principles outlined in clinical practice guidelines such as the American Diabetes Association. This practical experiences, I have gained a deeper understanding of the nuances involved in chronic disease management, with the clinical guidelines providing a valuable framework. However, I also encountered some challenges that highlight the need for a more personalized approach. For instance, I encountered several cases of patients not responding to medications as expected, or some need a more complex treatment combination. These scenarios highlighted the complexity of chronic disease management, as individual factors like comorbidities, medication tolerance, and patient lifestyle, significantly impacted the effectiveness of the various interventions used (Lambrinou et al., 2019). In another example, I encountered a patient with chronic pain who was not able to tolerate certain medications. In this case, I had to carefully consider alternative treatment options that included referrals to pain management specialists and the incorporation of complimentary therapies. Nevertheless, this experiences highlight the importance of patient-centered care to chronic disease management, where as a healthcare provider, I must be willing to adapt and tailor my interventions to the unique needs and responses of each individual patient. 

A brief scenario of the most meaningful interaction 

One of the most meaningful interactions I can remember experiencing during my clinical term was with a patient who was struggling to manage their chronic pain. In this case, the patient was a 42 y/o middle aged man who had been dealing with persistent back pain for several years, and previous treatment approaches had not provided adequate relief. During the consultation, I could see the frustration and a sense of hopelessness the patient had, as they tried various medications and therapies without much success. Rather than prescribing another round of pain medications, I took time to listen to the patients concerns and circumstances through open questioning. Together with the patient, we discussed the patient’s daily activities, their coping strategies, and the overall quality of life. I was able to work with the patient collaboratively to develop a more comprehensive pain management plan (Wideman et al., 2019). This interaction was valuable in various ways. For instance, it helped me develop my interpersonal and emotional connection skills such that. By actively listening to the patient, showing empathy, and involving them in the decision making process, I was able to build trust and established a stronger therapeutic relationship. The one experience that was lacking in this rotation was the opportunity to work with more diverse patient population. While the clinical setting serves a demographically diverse community, my caseload was predominantly focused on chronic disease management. In future, I hope to gain more experience in areas such as preventive care, mental health, and women health, as this will broaden my clinical knowledge and skills.

Review of literature on reflection in nursing 

The literature on reflection in nursing and healthcare places more emphasis on the importance in enhancing professional practice, especially in the development of necessary skills and competencies for healthcare professionals. Reflection is recognized as a process that assists nurses in developing their skills, which is crucial for effective and person-centered professional practice (Errasti-Ibarrondo et al., 2023). Personally, I engage in reflection outside of classroom requirements, and this process has significantly changed my practice by allowing me to critically analyze my experiences and identify areas for growth. The process helped me develop a deeper understanding of the complexities involved in chronic disease management and the importance of patient-centered care. However, while I personally engage in reflection, there were some barriers that were eminent to most of the healthcare providers. Some of this barriers included lack of time, support, and energy for a constructive reflection, as well as pressure to prioritize EBP education over reflection education. To overcome these barriers, it was important to promote a culture that values reflection and provides the necessary support and resources for healthcare professionals engage in reflective practice.