Reflection Using Kim’s Model

Please always refer to the following resources when writing your reflection:
o Instructions for Reflective Journaling Sheet
o Acceptable resources list
o APA referencing guidelines
o Note your refection should be approximately 200 words
Descriptive Phase (Clinical Script) – your narrative: What happened?
As the leader for the day, I had the duty of assigning patients and making sure tasks were
delegated correctly. One of my coworkers raised a concern after I allocated a patient with a
chest tube, who also had diagnoses of HIV and HCV. The coworker was apprehensive about
the potential risks and complications involved in caring for someone with these conditions,
especially regarding the stigma associated with HIV and HCV. They expressed worries about
how other team members might view the patient, fearing that potential biases could influence
the quality of care provided. I took the opportunity to address these worries, offering
reassurance and highlighting that the patient's health issues should not affect the standard of
care delivered.

Reflective Phase – reflection and analysis: What knowledge guided your actions and what
does the research say? (Include citation of evidence here)
In responding to my colleague's worries, I utilized my knowledge of patient-centred care
principles and ethical standards. Both HIV and HCV are chronic illnesses, yet they should not
determine the quality of care provided to a patient. I was influenced by the necessity of
upholding an impartial, non-judgmental stance since studies indicate that stigma can
adversely affect the treatment of individuals with HIV and HCV, so I used a textbook to gain
information about viral infection like HIV (Human Immunodeficiency Virus) targets CD4 T
cells, resulting in immune system suppression and, if not treated, can advance to AIDS. It
spreads through sexual contact, blood, and from mothers to their children. Diagnosing HIV
involves tests for antibodies, viral load measurements, and CD4 cell counts, with treatment
centred on long-term antiretroviral therapy (ART) to keep the virus under control. Preventive
measures like pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) are
available to reduce transmission risk. Hepatitis C (HCV) predominantly impacts the liver,
causing inflammation that can lead to cirrhosis and liver cancer. It is spread through blood-to-
blood contact and sexual interactions. The diagnosis of HCV includes tests for antibodies,
RNA detection, and assessments of liver function, while treatment relies on direct-acting
antivirals (DAAs) to eliminate the infection. Co-infection with HIV and HCV heightens the risk
of liver disease, necessitating careful management that includes ART for HIV and DAAs for
HCV. Monitoring liver health, viral loads, and possible drug interactions is crucial, and
patients should be informed about the importance of adherence, prevention strategies, and
regular follow-up to effectively manage both infections (Harding et al., 2023). Furthermore, I
referenced infection control guidelines for treating patients with chest tubes and
communicable diseases, ensuring my colleague comprehended the correct procedures.
Leadership in healthcare also involves proactively addressing issues and assisting team
members in delivering compassionate care, particularly in delicate situations such as these
By promoting an open conversation about the stigma linked to HIV and HCV, I aimed to
mitigate any adverse effects on patient care.
Also, Nurses share in collaborative decision-making like recommended ART or DAAs so the
nurse can effectively manage the switching of antiretroviral therapy (ART) for patients with
HIV/HCV coinfection by identifying potential drug interactions between ART and direct-acting
antivirals (DAAs), conducting thorough patient assessments, and providing education about
the importance of adherence to treatment plans (Starbird et al., 2019). It is crucial to minimize
 ART modifications whenever possible, as changes can negatively impact treatment
outcomes; however, if a switch is necessary, temporary modifications should be implemented
with careful monitoring (T1, T2). Nurses should also ensure regular follow-up visits to assess
the patient's response to the new regimen and stay updated on the latest clinical guidelines to
provide the most effective care (T4, T5). By employing these strategies, nurses can enhance
treatment outcomes and improve the quality of life for patients undergoing therapy for HIV
and HCV coinfection.

Critical / Emancipatory Phase: What would you do next time if you faced the same situation?

In the future, I would include a short team meeting or huddle prior to assignments to address
any concerns related to patient care, especially in sensitive situations involving HIV or HCV.
(Harding et al., 2023) This would create a space for team members to voice their concerns
and clarify any uncertainties about protocols, expectations for patient care, or infection control
measures. I would also think about implementing educational sessions aimed at reducing
stigma in the workplace, ensuring that all team members feel at ease delivering equitable
care to patients, regardless of their health status. Promoting open communication and
offering emotional support for the staff when handling sensitive cases could improve the
team’s approach and the quality of care provided.

Reference/s: Use APA system – if you have a citation you must also include a full reference
and vice versa! (Remember your evidence must come from an acceptable source. Please
submit your evidence with your clinical pack )
 Starbird, L. E., Hong, H., Sulkowski, M. S., & Farley, J. E. (2019). Management of the
Patient With HIV/Hepatitis C Drug Interactions. Journal of the Association of Nurses in
AIDS Care, 1. doi:10.1097/jnc.0000000000000144

 Harding, M., Kwong, J., Roberts, D., Hagler, D., & Reinisch, C. (2023). Lewis's
Medical-Surgical Nursing E-Book: Assessment and Management of Clinical Problems,
12th edit. Elsevier Health