Reflective writing is a useful approach for nurses to learn from experience. In nursing, personal reflection is essential to recognize one's own strengths and limitations and to initiate the changes needed in the future to improve the situation and for professional development. I selected Gibb's thought cycle to reflect the incident because it helps express both the events and the feelings generated by the experience. Say no to plagiarism. Get a tailor-made essay on “Why Violent Video Games Should Not Be Banned”? Get the original essay During my placement, I was responsible for completely caring for 4 patients in a surgical department at Umum Hospital Sarawak under the supervision of a senior nurse. The registered nurse on the night shift informed us that one of our postoperative patients had an indwelling catheter (IDC) that had been removed the night before and that the patient had been drained after the IDC was removed. The nurse reported that the patient's incontinence aid was moderately wet at night, but the patient was still complaining about not being able to urinate, which made the nurse think the patient was confused. After receiving the transfer, I went to check on my patients and discovered that this patient was agitated and when asked, she stated that she had a lot of pain in her lower abdomen. A cursory physical examination revealed distension of the lower abdomen. After reviewing her clinical notes, I noticed that the patient was receiving PRN analgesia (as needed) for abdominal pain early that morning, but no further investigations or interventions were performed for the pain. Additionally, I assessed the patient and found that she was well oriented to time, place, and person as there was no significant history of confusion or delirium in her clinical notes. At that time, I felt that the situation was not right and immediately reported to my mentor. She appreciated my initiation and asked me to perform an ultrasound of the bladder. Ultrasound of the bladder revealed a residual volume of 998 ml of urine in the bladder. I immediately noticed my mentor and the junior doctor working in the field who examined the patient and ordered immediate intervention. insertion of IDC.While I was inserting IDC under the supervision of my mentor, I delegated to the Nursing Staff Assistant (PPK) working in the field to closely monitor the rest of my patients and attend to their needs . When the IDC was inserted, the urine output was 1650 ml within a few minutes and the patient reported feeling much more comfortable. The patient thanked us for not ignoring her complaint of pain, not dismissing her as confused, and taking prompt action to put her at ease. In my opinion, the night nurse changed her incontinence aid which was quite wet, thinking the patient was confused when she said she can't cancel. The patient may have incomplete bladder emptying or overflow incontinence, which the night nurse might have considered the patient emptying normally. Later, my mentor told the night nurse about the incident and asked her to either attend a bladder exam or inform the main nurse or attending team of the situation. The nurse said she was very busy and didn't think about it. My mentor explained to him how important it is to witness a complete and accurate assessment of the patient rather than making his own judgment. My mentor discussed the legal obligation of nurses to fulfill their duty of care andhow negligence can harm the patient. The night nurse assured my mentor that she would never ignore the needs of patients and would always fulfill her duty of care in the future. The Australian Nursing and Midwifery Council (ANMC) has defined the competencies of nurses to provide safe and competent nursing practice, within the legal and ethical framework. The ANMC competency for registered nurses requires nurses to perform a complete and accurate assessment of the patient before performing any intervention (NMBA, 2006). In this scenario, the night nurse should have performed a full assessment (physical assessment and bladder scan) when the patient complained of abdominal pain and discomfort. It is the responsibility of nurses to fulfill their duty of care to their patients. Based on the ANMC Competency Standards, reflecting on this impact has enhanced my understanding of the importance of duty of care, the role of nurses in advocating for their patients, critical thinking and analysis, comprehensive and systematic nursing assessment to identify actual and potential health problems and care needs. effective communication and coordination of care with a multidisciplinary team to achieve an optimal level of health. Moreover, with this incidence, I also learned that while providing care to the patient, the nurse must understand their own personal value and their attitudes should never dictate the care they provide to their patients. .Reflecting on this incident, I feel like I performed quite well, but I should have acted much sooner to alleviate my patient's suffering. I now realize that if I had ignored the incident thinking the patient was confused, I would have put his well-being at risk. Retention of more than 800 ml of urine in the bladder increases the risk of bladder distention injury (Nguyen et al, 2016). Likewise, there are many other complications associated with acute or chronic urinary retention, which can include infection, flaccid bladder, kidney damage from reflux, and the development of a diverticulum or bladder pouch (Casey, 2011). Therefore, if the appropriate action had not been initiated on time, the situation could have been worse. Looking back on this incident, in addition to fulfilling their duty of care, I realize that nurses are legally required to recognize and respond quickly to unsafe and compromised care. Therefore, by keeping patients' well-being at the forefront, I also learn to question my colleagues' practice if their practice puts the patient's health at risk. Additionally, this incident helped me understand the importance of a comprehensive patient assessment to identify actual and potential health problems. By carrying out a patient assessment, the exact cause of the problem could be notified and, with the involvement of a multidisciplinary team, the problem was easily resolved. This incidence gives me insight into the importance of holistic patient-centered care, effective communication and teamwork skills for a smoother transition as an entry-level registered nurse. Nurses are responsible for providing safe and competent nursing care (NMBA, 2008). National competency standards enabling registered nurses to fulfill their duty of care and recognize and respond to unprofessional and unsafe practices. Through this impact, I learned to carefully fulfill my duty of care and significantly improved my assertiveness skills. Likewise, effective communication is an essential quality that a new graduate nurse shouldpossess. Taking the time to listen to the patient, recognize their unique need, and involve them in their own care promotes patient-centered care (Stein-Parbury, 2012). Regarding the incident, due to the lack of effective communication that the customer needs, it was neglected. Therefore, in order to successfully advance to the entry-level registered nurse level, I must develop competent communication skills. The transition from student to professional graduate is often confronting and requires a wide range of professional knowledge and skills. In order to successfully adapt to the professional role, new graduate nurses must prioritize care, manage workloads, make appropriate clinical decision, exercise leadership skills, and work as part of the interdisciplinary team. Other key skills required for a new graduate nurse are practicing in an evidence-based setting, mentoring, regularly monitoring patient progress, coordinating care, and patient advocacy. Apart from other skills, a novice practitioner must also possess skills such as leading, mentoring and delegating the task to other staff members based on their skills and scope of practice. Leadership skills are essential to the nursing profession. Upon completion of graduation, a new graduate nurse is also expected to lead a team based on the organization's policy and protocols. The new graduate nurse can demonstrate and develop leadership abilities by working within a small group of employees with different skills and abilities, such as an enrolled nurse and nursing assistants, to achieve a common goal (Thoms and Duffield, 2012). Leadership skills require a nurse to clearly delegate tasks to others, provide recurring feedback, communicate effectively within a team, and be involved in the professional development of self and others. Delegating a task to others is often difficult work for a new graduate nurse. Before delegating a task to others, it is essential to have a good understanding of the skills and abilities of other team members. Additionally, consistent supervision, support and mentoring are essential to ensure that the delegated task has been completed safely and accurately. Meanwhile, as a leader, it is also important to provide appropriate feedback to motivate team members. Therefore, reflecting on this incident helped me better understand my clinical practice, understand the importance of comprehensive assessment, assertiveness, holistic patient-centered care, and interdisciplinary teamwork . , lead mentoring and delegate within the team for a successful transition to the RN role. This reflection article focuses on the learning experience regarding dressing management during placement in aged care. The Gibbs thinking cycle is used, which will help to describe the incident, explore the feelings, make an evaluation, analyze the different components, finally conclude and develop an action plan by looking at what would be done differently if it happened again (Wain, 2017). The goal of reflection is to identify and use the strengths and weaknesses of the internship to guide learning. Dressing thinking is chosen because this skill is practiced more in elderly care during the first clinical placement. The dressing was performed on an elderly resident with a skin condition of bullous pemphigoid. The patient hadfluid-filled blisters on both legs. The registered nurse had asked the student nurse to help dress the wound. The student nurse helped the nurse remove the old dressing and clean the wound. She observed how the nurse cleaned the wound and changed the dressing. The registered nurse had used inadine as the primary dressing and then applied an appropriate secondary dressing on top. Additionally, the nurse showed him the different dressings used for wound care. The student nurse observed that the principles of infection control and hand washing were respected throughout the procedure. According to Standards 6.1 and 6.5, hand hygiene and social hand washing are considered important to ensure infection control and should be applied throughout the procedure (Nursing and Midwifery Board of Australia [NMBA], 2016 ). The student nurse had the chance to do the dressing on another leg under the supervision of the registered nurse. After the procedure, she documented notes that the legs were washed and straightened according to plan. Nursing documentation is important because it reflects nursing assessments, interventions, patient care records and provides a basis for communication between healthcare professionals (Alkouri et al., 2106). When the registered nurse removed the old dressing, the student nurse was very shocked to see the wound. This was the first major acute injury she observed during her placement. This led her to sympathize with the patient. She immediately wanted to help the registered nurse treat the wounds. She also felt anxious when the nurse asked her to bandage the back leg. The nurse helped her and she felt confident performing this skill. This gave him the feeling of improving his skills throughout the internship. Clinical skills showed positive results. The nursing student gained knowledge on tissue viability, wound healing, wound assessment and familiarization with different types of dressings. She followed the RN's instructions and performed the exercise using aseptic technique. She focused on aseptic principles of wound care and infection control. Aseptic technique is used to prevent the entry of microorganisms from infected areas to vulnerable areas (Denton & Hallam, 2020). She learned how the nurse established a relationship with the patient and provided patient-centered care. However, the negative aspect was that she lacked communication with the patient. She communicated with the patient before the dressing, but during the exercise she did not speak to the patient because she was focused on her work. Effective communication is the key element in the healthcare environment and can improve patient satisfaction, reduce anxiety, and build confidence (Negi et al., 2017). The overall learning experience in aged care was positive. The nursing student performed the dressing for the first time on a patient in a clinical setting. She learned about wound assessment and aseptic, no-touch dressing technique. Wound assessment should be performed before surgery. Evaluation of the wound is important in determining the diagnosis and appropriate treatment. Wounds should be assessed regularly to provide patient care. Wound assessment should focus on wound position, etiology, presence of blood, exudate, odor, color, wound size, and level of pain experienced.