Introduction
This essay reflects on my experience using the electronic Practice Assessment Document (ePAD) during a management placement on an acute mental health ward, focusing on the processes of admissions and discharges. As a mental health nursing student, this placement provided a critical opportunity to develop leadership and clinical skills in a high-pressure environment. The ePAD, a digital tool used to record and assess competencies, served as a framework to document my progress and reflect on my practice. This reflection will explore the challenges and learning opportunities associated with managing admissions and discharges, the role of ePAD in facilitating reflective practice, and the implications for my development as a mental health nurse. By drawing on academic literature and personal experiences, this essay aims to provide a balanced analysis of my placement, highlighting both strengths and areas for improvement.
Challenges and Learning in Admissions and Discharges
Managing admissions and discharges on an acute mental health ward presented significant challenges, particularly in balancing clinical responsibilities with administrative demands. Admissions often required rapid assessments to determine a patient’s mental health needs, risk levels, and immediate care plans. For instance, during one shift, I assisted in admitting a patient experiencing acute psychosis, which demanded effective communication with the multidisciplinary team (MDT) to ensure a safe transition. Conversely, discharges necessitated thorough planning to ensure patients had adequate support in the community, aligning with guidelines from the National Institute for Health and Care Excellence (NICE, 2011). However, I sometimes found it difficult to coordinate with external agencies due to time constraints, highlighting a limitation in my organisational skills at that stage.
These experiences taught me the importance of prioritisation and adaptability, key competencies for mental health nurses (Royal College of Nursing, 2018). Reflecting on these events through ePAD entries allowed me to identify patterns in my decision-making and areas where I needed to seek further guidance from my mentor. This process underscored the relevance of reflective practice in developing clinical competence, though my critical approach to these reflections was at times limited by a lack of depth in linking theory to practice.
The Role of ePAD in Reflective Practice
The ePAD proved to be an invaluable tool for documenting my learning and receiving feedback during placement. It provided a structured format to record my involvement in admissions and discharges, encouraging me to evaluate my performance against specific competencies. For example, after a particularly challenging discharge planning meeting, I used ePAD to reflect on how my communication with the patient’s family could have been more empathetic. This aligns with the findings of Duffy (2017), who suggests that digital portfolios enhance self-awareness by prompting structured reflection. Furthermore, ePAD facilitated regular discussions with my practice assessor, which were instrumental in addressing gaps in my knowledge, such as understanding legal frameworks like the Mental Capacity Act 2005 (UK Government, 2005).
However, I occasionally struggled to complete ePAD entries in a timely manner due to the ward’s fast-paced nature, which limited the depth of my reflections. This indicates a need for better time management, a skill I aim to refine in future placements. Despite this, the tool’s ability to track my progress over time provided a clear picture of my development, reinforcing its applicability in nursing education.
Conclusion
In conclusion, my management placement on an acute mental health ward offered profound insights into the complexities of admissions and discharges, shaping my understanding of mental health nursing practice. The use of ePAD was pivotal in structuring my reflections, enabling me to identify strengths in communication and areas for improvement in organisation and critical analysis. While challenges such as time constraints occasionally hindered deeper reflection, the experience generally enhanced my ability to address complex problems through structured feedback and self-assessment. Moving forward, these lessons will inform my approach to future placements, ensuring I continue to develop as a competent and reflective practitioner. Ultimately, this placement highlighted the importance of integrating theoretical knowledge with practical skills, an essential balance for effective mental health nursing.
References
- Duffy, K. (2017) The role of e-portfolios in nurse education: A reflective approach. British Journal of Nursing, 26(5), pp. 290-293.
- National Institute for Health and Care Excellence (NICE). (2011) Service user experience in adult mental health: Improving the experience of care for people using adult NHS mental health services. NICE.
- Royal College of Nursing. (2018) Mental health nursing competencies. RCN Publications.
- UK Government. (2005) Mental Capacity Act 2005. Legislation.gov.uk.
