Self-assessment, in the nursing context, is moment-to-moment self-monitoring. This directly refers to one’s ability to observe his or her own actions and correctly judge the effects of those actions (Epstein, Siegel, and Silberman 2012). Brown and Harris (2013) also gave their definition of self-assessment as an evaluative and descriptive act that is carried out by a nurse as relates to their own work. These definitions include the assessment of one’s abilities, products, and processes as they are all subject to the influence of one’s feedback.
Mechanisms of Self-assessment
There are many sides to a formative assessment in the clinical field. Basically, in the course of my earlier assessment, the areas I discovered that needed some level of improvement are my difficulty to pay attention to details due to poor concentration abilities and poor level of compassion towards patients, which also has to do with concentration issues. As stated by Hawe and Parr (2014), the main reason for self-assessment is to help participants grow in their respective fields and take central roles in the improvement aspect.
The Position of Compassion in the Clinical Care
As captured in the work of Crawford, Brown, Kvangarsnes, and Gilbert (2014), there is a global concern over the deficit of compassion across the nursing profession. This development is evident in the contemporary literature that has fairly tilted towards addressing this deficit (Dewar Adamson, Smith, Surfleet, King 2014). Noticeably, most cases of poor exhibition of compassion toward patients are from nurses who also have self-compassion issues (Dewar et al., 2014). “For someone to develop genuine compassion towards others, first he or she must have a basis upon which to cultivate compassion, and that basis is the ability to connect to one’s own feelings and to care for one’s own welfare. Caring for others requires caring for oneself” (Crawford et al., 2014). Statistics have given the indication that compassion for patients is one of the factors that motivates people who join nursing because nursing itself is synonymous with compassion. Unfortunately, at a point and through my previous self-assessment, I realized that I was one of those whose level of compassion towards patients has been declining. According to Izhaki, Treacy, Phaladze, Romeu, Vernon, Marshall, Fealy, Ehrenfeld, Larkin, McNamara, Dignam, Rollins-Ganz & Nelson (2015), there is evidence that a lack of compassion can limit the proficiency of a nurse in delivering care to patients. This is why (Klopper 2010) it is constantly important that nurses take the necessary measures towards optimizing their compassion for patients.
Earlier Measure of My Compassionate Disposition towards Patients
This measuring was done using a psychometric scale known as the Likert Scale. My choice for the Likert Scale is due to the fact that it can be easily interpreted by the prospective audience. This scale was used to find out what people (both patients and co-nurses) think about my compassionate disposition. In order to get a sincere opinion of what people really think, a questionnaire was distributed to them and they were allowed to maintain anonymity in getting their responses across to me. In the practical version of the questionnaire, I used my real name to help the respondents know who was been referred to. Here, however, I will refer to myself as nurse A.
The questionnaire came in the following versions:
S/N question disagree disagree disagree agree disagree agree
Despite any possible personal challenges, nurse A. is seen at all times showing good concern for both co-workers and patients.
Nurse A. is known to emotionally connect to the world of others especially patients.
Nurse A. is known to identify with patients by earnestly working to relieve their pains.
Nurse A. is always aware of the patient's needs by paying detailed attention to them.
Nurse A. hardly gets angry even when there is a reason to.
Nurse A. is always responsive to the patients even when doing so leads to abandoning personal tasks.
Nurse A. is always a very good source of encouragement to patients.
The overall results gotten from the questionnaire shows that I have not been doing very well in terms of compassion in the course of discharging my duty. Using 4 points Likert Scale, the results are summarized as follows:
The summary of my personal assessment of compassion, using 4 points Likert Scale
The scale indicates that my earlier self-assessment on compassion was on average on a scale of 4 options. This was a pointer that my performance in that aspect needed to be thoroughly examined and improved.
On the other hand, paying good attention to details is critical for effective care to patients. This, also, was another area in that I found myself performing poorly. Prior to my earlier assessment, it was practically difficult for me to pay attention to details in the course of offering care to patients. This, I could say, was largely due to my inability to concentrate when I should. As Saarikoski, Ekaterini, Pérez, Tichelaar, Tomietto, and Warne (2013) stated, for nurses, paying good attention to details is a powerful component of mindful practice. One of the differences between effective delivery care is the ability of the nurse or caregiver to pay good attention to little details that have to do with the patient in question (Saarikoski et al., 2013). To do this appropriately, internal discipline is required. Some of the many qualities of paying attention are listening, taking actions that change the course of events, and noticing details. In other words, this involves staying alert and being ready and prepared for the unexpected in order to take quick actions that are necessary (Kajander-Unkuri, Salminen, Saarikoski, Suhonen, and Leino-Kilpi, 2013). For nurses, not being vigilant or paying good attention when one should has been associated with concerns over patients’ safety because this could lead to a number of problems including poor infection control and medication errors (Kajander-Unkuri 2013).
To ascertain my level of performance in the area of paying attention to details in the course of delivering my duty as a nurse, I also conducted a survey, using questionnaires that are tailored towards getting revealing questions in this regard. The questionnaire came with the following content:
S/N question
How was I at Poor fair good very good excellent
Giving patients the opportunity and needed time to fully tell the stories surrounding their illnesses by themselves without interruption.
Really listening to what the patient is saying without showing signs of distraction like looking at my notebook?
Identifying with patients and colleagues by earnestly working to relieve their pains.
Being aware of the patient's needs through paying detailed attention to them.
Being warm and friendly to patients and treating them with respect?
Being genuinely interested in the patient and asking relevant questions that will positively engage them.
Being a good source of encouragement to the patient?
These questionnaires were distributed amongst patients and my co-workers and they were allowed to return their opinions anonymously to encourage sincere responses. 5 point Likert Scale was used in the opinion collection and the result is shown below.
The summary of my personal assessment on paying attention to details, using 5 points Likert Scale
The collected opinions indicated that I had a poor attitude toward paying attention to details.
My New Skills
The knowledge of the following assessment came to me like a shock. I had never anticipated anything as poor as that. This, however, spurred me to enroll in a number of programs that helped me develop the needed skills. On my own, I felt I was improving because my relationship with patients and colleagues were changing for good. Not relying on this, I ran another self-assessment to truly get people’s opinions on the new improvement. The result was quite encouraging. This was a repeat of the first process with the same questionnaires:
The above questionnaire was sent out to participants during the second phase of my self-assessment to ascertain how well I have improved in the area of compassion towards patients.
The summary of the second phase of my self-assessment on compassion, using 4 points Likert Scale
Also, I ran another assessment to ascertain my level of improvement in the area of attention to detail, using 5 points Likert Scale
The summary of the second phase of my self-assessment on paying attention to details, using 5 points Likert Scale
The results show a significant improvement in the skills. During the first assessment, I was “average” on compassion and “poor” on paying attention to details. On the second attempt, however, I went from “average” to “excellent” on compassion and from “poor” on attention to detail to “good”. This shows that, although more efforts to gain additional knowledge in those areas might be required, the effort made so far has shown significant improvement.
Future Impacts on My Nursing Profession
The new skills are part of the knowledge I need to continue in the continuously dynamic medical profession. Things are changing in the medical field and it is only important that nurses strive to acquire new skills to better position them professionally and in caregiving. The new skills will help me to effectively give care to patients from different backgrounds.
References
Brown, G. and Harris, L. (2013). Student self-assessment, in Sage Handbook of Research on Classroom Assessment, ed J. H. McMillan (Los Angeles, CA: Sage), 367–393. doi: 10.4135/9781452218649.n21
Epstein, R., Siegel, D. and Silberman, J. (2012). Self-monitoring in clinical practice: a challenge for medical educators. J. Contin. Educ. Health Prof. 28, 5–13. doi: 10.1002/CHP.149
Hawe, E. and Parr, J. (2014). Assessment for learning in the writing classroom: an incomplete realization. Curr. J. 25, 210–237. doi: 10.1080/09585176.2013.862172
Crawford, P., Brown, B., Kvangarsnes, M., Gilbert, P. (2014), The Design of Compassionate Care. J. Clin. Nurs., http://dx.doi.org/10.1111/jocn. 12632.
Dewar, B., Adamson, E., Smith, S., Surfleet, J., King, L. (2014), Clarifying Misconceptions about Compassionate Care. J. Adv. Nurs. 70 (8), 1738–1747, http://dx.doi.org/10.1111/jan.12322.
Izhaki, M., Treacy, M., Phaladze, N., Rumeu, C., Vernon, R., Marshall, B., Fealy, G., Ehrenfeld, M., Larkin, P., McNamara, M., Dignam, D., Rollins-Ganz, N. & Nelson, J. (2015). A five-country partnership to measure the perception of nursing staff caring for self, burnout, and compassion fatigue. Interdisciplinary Journal of Partnership Studies, 2(1), 1-20 http://pubs.lib.umn.edu/ijps/
Klopper, H. (2015), Opening Plenary Address. Sigma Theta Tau International 26th International Research Congress, San Juan, Puerto Rico, 23-27 July
Saarikoski, M., Ekaterini, P., Pérez, R., Tichelaar, E., Tomietto, M. and Warne, T. (2013), Students' experiences of cooperation with nurse teacher during their clinical placements: An empirical study in a Western European context. Nurse Educ Pract; 13(2):78-82. doi:10.1016/j.nepr.2012.07.013.
Kajander-Unkuri, S., Salminen, L., Saarikoski, M., Suhonen, R. and Leino-Kilpi, H. (2013), Competence areas of nursing students in Europe. Nurse Educ Today; 33(6):625-632. doi:10.1016/j.nedt.2013.01.017.