In healthcare, implicit bias can affect patient care, communication, and trust. This underscores the critical need for ongoing training in cultural competence and diversity. Nurses must be equipped not only to recognise their own biases but also to respond appropriately to patients who may act out of prejudice. This is particularly important when dealing with aggressive or difficult patients who may be reacting from their own unconscious biases.

As I transition into my role as a new graduate nurse, I am committed to continuously adhering to NMBA Standard 2 in my practice. I will actively listen to patients, respect their autonomy, and involve them in care planning to ensure they feel heard and valued. By fostering a compassionate, person-centered approach, I will aim to create an inclusive environment that supports their mental health recovery. Additionally, I will seek opportunities for collaboration with interdisciplinary teams, ensuring a comprehensive approach to care that upholds the patient's dignity and rights at all times. Lastly, I think being empathetic to patients is crucial to building therapeutic relationship. It because it helps me understand where the patient is coming from and what they are feeling. During my PEP experiences, I think I adhere to NMBA standard 2 naturally. I am always empathetic towards the patients, therefore I also help make a healthy, safe and non-judgmental environment for them.

In my future practice as a new graduate nurse, I will ensure that I continue to adhere to NMBA Standard 6.1 by actively respecting patients' rights in every aspect of care. This includes involving patients in decision-making processes, educating them about their treatment options, and encouraging them to voice their concerns or preferences. By doing so, I will create a care environment that supports autonomy, safety, and person-centered care. Additionally, I will strive to continuously assess and reflect on my practice to ensure that the care I provide is both responsive and aligned with patients' individual needs, while also fostering a sense of dignity and respect throughout their healthcare experience. In my previous PEP experiences, nurses always showed me the importance of informed decision making and why patients must always be included in discussions of their treatment plans. This is because they are a person who has the right to decide for themselves and who are the experts in the experiences of their own life.

During my placement, I encountered a patient who had previously experienced the loss of two pregnancies and was returning to the hospital for a check-up as she was expecting for her third attempt. The patient was extremely anxious and worried that her past experiences might repeat. Without a referral to a psychologist or therapist, it would have been very difficult to support her emotional well-being and help her achieve a positive outcome in her pregnancy. This patient did not just need the assistance of nurses and her GP, but she also required mental health support from an expert. This aligns with NMBA Standard 7.3, which emphasises the importance of determining and communicating further priorities, goals, and outcomes with relevant team members such as the mental health care team. This highlights the necessity of cooperation and communication within the healthcare team to improve patient outcomes.

To adhere to NMBA Standard 7.3 in future clinical practice, I plan to actively engage in multidisciplinary meetings and discussions to ensure that all necessary professionals are involved in the patient's care. I will take the initiative to communicate with relevant team members, such as psychologists, social workers, and medical staff, to prioritise the patient's holistic needs. Additionally, I will continuously assess the patient's progress and promptly raise any concerns that may require adjustments in care, ensuring that care plans are tailored to evolving patient goals. This collaborative approach will help ensure comprehensive and patient-centred care, promoting the best possible health outcomes.

During my recent PEP placement, I witnessed the importance of this collaboration firsthand. We had a patient who had undergone a right foot amputation and was understandably anxious about his recovery. Recognising the need for multidisciplinary support, we involved a social worker, occupational therapist, diabetes educator, and physiotherapist to provide comprehensive care tailored to his physical, emotional, and practical needs. By working together, we ensured that his rehabilitation plan addressed not only his immediate medical concerns but also his long-term recovery and well-being.

This scenario ties directly to NMBA Standard 4, which emphasises the need for comprehensive assessments, and Standard 6, which highlights the importance of effective communication and accurate documentation. Strategies I could adopt in future practice include ensuring that I always gather and document thorough patient information, even under pressure, and practicing concise, clear handovers. Regularly participating in simulation exercises and shadowing experienced nurses during handovers will help me build these skills and confidence.

In one of my placements, I encountered a similar situation where I observed that a patient’s handover was incomplete, leading to confusion during care. The nurse team had to backtrack to gather critical details, which slowed down care delivery. This experience reinforced the importance of detailed handovers and the need to consistently document all relevant patient information, ensuring smooth transitions between healthcare providers and timely patient care.

Though this wasn’t part of my placement, I believe it aligns with NMBA Standard 6.1, which focuses on providing comprehensive, safe, and quality care that meets patient needs. In both scenarios, I see a similarity between myself and the mother, we both had to think critically and act swiftly to ensure our loved ones received the best care. Balancing emotional involvement with clinical decision-making adds an extra layer of pressure. To improve, I think I could benefit from trusting our colleagues and keeping a calm demeanor, as excessive stress can hinder the quality of care. Moving forward, I believe that practicing emotional regulation, fostering teamwork, and relying on collective expertise would enhance the quality of care we provide in such challenging moments. Lastly, continuous learning and self-reflection can strengthen our ability to navigate these dual roles effectively.

The RNs responded well by reviewing the medication chart, assessing her airway, performing a pain assessment using the Wong-Baker pain scale, and even checking her abdomen. They demonstrated effective communication by actively listening to both Yasmin and her mother and bending their knees down to Yasmin’s level to avoid intimidating her. After these evaluations, the RNs recognised that the situation needed to be escalated and called the MET team. The challenge in this scenario came from the overwhelming environment, lack of immediate medication availability, feelings of helplessness, and the complexities of conducting assessments on a child, which differ significantly from adult care. According to NMBA Standard 4, RNs must perform comprehensive and systematic assessments accurately, which ensures high-quality care and timely interventions.

To continuously adhere to this standard and improve in similar cases, several strategies can be employed. These include regularly practicing pediatric assessments in simulations, becoming familiar with pediatric pain scales, and enhancing communication skills to ensure effective interaction with both the child and their caregivers. It is also important to stay up-to-date on policies and protocols for pediatric emergencies and to build confidence in managing stressful situations. Reflective practice after each case can help identify areas for improvement and solidify learning experiences, ultimately enhancing the care provided to pediatric patients like Yasmin.

In the second video, we watched a female patient who wanted to go outside for a smoke but was prevented from doing so by two male healthcare workers. They repeatedly told her, "We will fix you," as if she were broken. One of the staff members followed her closely, making her even more uncomfortable. This situation clearly showed a disregard for her autonomy and personal space, and no consideration was given to how safe or comfortable she felt. If I were in her position, I would feel powerless and dehumanised, as if my choices and emotions were being ignored. This highlighted the critical need for a therapeutic environment where patient autonomy and safety are respected, ensuring they feel heard, valued, and treated with dignity.

As a soon-to-be graduate nurse, the experience was stressful, especially since I was managing the patient on my own without a buddy nurse, and my team leader was occupied. Reflecting on this scenario, I realised the importance of enhancing my skills in patient assessment, collecting accurate information, and working with the interprofessional team, particularly in handling deteriorating patients.

I believe that NMBA Standard 4, "comprehensively conducts assessments," is highly relevant in this scenario. It highlights the importance of gathering thorough and accurate patient data, conducting timely assessments, and recognising early signs of deterioration. I remembered my placement where I answered a nurse call bell and saw the patient struggling to breathe, I had to get myself together and perform vital signs to collect information and let my nurse what is happening. After we supplied oxygen and repositioning the patient and nothing was improving, we had to call the MET team and had to provide a detailed handover. Those information helped save and provide comfort to the patient's life that time. To adhere to this standard, I will focus on improving my clinical reasoning skills by engaging in more simulation training, which will help me become more confident in assessing and responding to changes in patient conditions. Additionally, I will work on improving my communication and collaboration with the healthcare team to ensure that I can escalate issues promptly and coordinate care effectively. Seeking feedback from senior nurses and participating in case discussions will further develop my ability to provide safe and comprehensive patient care.

NMBA Standard 6, which focuses on providing safe, appropriate, and responsive quality nursing practice, is essential in this context. It emphasises the importance of prioritizing care based on the patient’s condition and ensuring timely and appropriate interventions. Adhering to this standard helps ensure that the most critical patients receive immediate care, which can prevent complications and improve outcomes.