The purpose of this essay is to reflect on my practical experience working with adults with physical and mental disabilities with a focus on risk. It was during my first year of adult nursing studies that I was posted to a residential home for adults with learning disabilities for a month. Ellis (2013) stated that the main goal of reflecting on previous experiences is to develop future practices when working with people with multiple needs. Reflection contributes to the development of evidence-based nursing practice, making it a valuable process for me once qualified. Firstly, I will talk about Ana (not real name), (for confidentiality reasons (NMC, 2002), an elderly lady with complex learning disabilities who does not communicate, is in a wheelchair with dementia, neck injury, seizure problems and with a nasogastric tube in place Secondly, I will discuss the risks Ana is vulnerable if the staff is not trained or has no knowledge to feed patients with swallowing problems. , as she poses a high risk of choking and falling I will use the 1988 Gibbs Model of Reflection, which was developed to help students engage in meaningful reflection and is frequently used in nursing contexts. educational and I find it helpful in identifying my learning and managing my developing feelings about the incident.Say No to Plagiarism Get a tailor-made essay on “Why Violent Video Games Should Not Be Banned”?Get it original essayThis framework for thinking includes. of six steps which are: Description, Feelings, Evaluation, Analysis, conclusion and Action plan. Confidentiality will be maintained throughout this reflection by not mentioning the real names of any person or organization (NMC, 2015). During my four weeks experience in a residence for residents with learning difficulties, I saw one of the residents choking. The incident happened while I was caring for a resident with dementia and epilepsy named Ana. Ana is unable to communicate, she is in a wheelchair and must be hoisted from bed to chair and vice versa. She has a nasogastric tube because she is unable to swallow due to her illness. During meals, the caregiver was continuously and carelessly feeding Ana orally with a dry sandwich cut into small pieces while chatting with other staff members and Ana started coughing. Instead of asking the team leader to give Ana something to drink through the tube, the caregiver simply yelled at Ana to swallow and stop coughing. I went to reassure Ana and offered to feed Ana and informed the team leader that Ana was coughing a lot. I stayed with Ana and the caregiver who fed Ana went to see another patient. I realized Ana was choking and the team leader quickly gave Ana a flush of water enterally. At the time of the incident, it was only my third day of learning disability placement. I didn't feel confident enough to deal with these circumstances. At first I felt terrible and my anxiety level increased, and I was afraid to intervene in the situation. Additionally, I could have helped feed Ana sooner because I knew she had a nasogastric tube and had better knowledge of anatomy and physiology. Instead of relying on the caregiver to feed Ana, the caregiver didn't seem to care and had limited knowledge of what was happening in Ana's reaction when she choked on a cough. I felt that I was responsible for ensuringAna's safety as she was vulnerable due to her complex needs and lacked the ability to communicate her feelings. Afterward, the team leader asked the caregiver who was feeding Ana to fill out an incident report. Then I documented it in the patient notes, countersigned by my mentor, emphasizing the need to be careful in Ana's diet. Additionally, they mentioned during each transfer what happened to Ana and how they can prevent her from choking. NICE (2015) guidelines support that anyone involved in the care of service users with learning disabilities should be aware of the risk involved and constantly document issues that may increase the risk. My mentor showed me Ana's record of past choking incidents over the past year and a care plan that was put in place. A referral to the speech therapy team was made a long time ago. Ana's care plan included a multifactorial assessment and treatment plan intended to address specific needs and precautions that could help her swallow more safely and manage her recurring choking. Various precautions include: sitting the patient upright when eating and drinking, taking small bites, taking your time, and ensuring that food does not come out of the patient's mouth. According to PHE (2018) Guidance Dysphagia (Swallowing Disorder), people with learning disabilities are more likely to suffer from dysphagia than other people. The National Patient Safety Agency (NPSA) (2004) has highlighted that choking is a significant health risk for people with learning disabilities. Dysphagia can cause choking and lead to death. Ana is an elderly person with swallowing problems, seizure problems and dementia, who is at high risk of choking due to her illness. She regularly takes painkillers like liquid ibuprofen, which makes her nauseous, and carbamazepine, an anticonvulsant that has side effects of drowsiness and fatigue. These are administered by nasogastric tube (BNF, 2017). Ana also underwent a falls assessment, as she has issues with seizures and immobility. I observed during my placement that staff members put some restrictions or limits on Ana because she had her seat belt in the wheelchair, but I know it is in her best interest to keep her safe. According to the Mental Capacity Act 2015, Deprivation of Liberty Safeguards (DoLS) is an act which is a specific method which has a list of orders intended to protect the adult deprived of rights and the course of action of which is also appropriate and in the best interest of the patient (Alzheimer Society, 2016). The Department of Health's (2015) guidance on DoLS maintains that local authorities, care providers and psychiatric learning disability consultants can make the verdict on whether or not to apply for DoLS. Ana requires, to prevent her from falling from her chair, due to the risks of falling and immobility, that she justifies the use of a seat belt. After the incident, the team leader asked me what happened and I explained it to him. I felt guilty that Ana was carelessly fed by the caregiver and should have recognized the signs of choking more quickly. The team leader was very supportive and explained to me that incidents happen all the time and she thanked me for staying and reassuring Ana. . The team leader also told me that I had acted and reacted well to the incident and that they also believed that they felt that I had done everything possible inthis situation. This experience was good because I learned from this incident, as it taught me the importance of acting quickly in any emergency situation, in order to protect patient safety. The downside of this experience is that the staff did not appear to follow the assessment made by the speech therapy team in providing additional care to Ana during feeding. This represents a risk because Ana has a swallowing problem and she has a nasogastric tube. According to the Department of Health (2007), the importance of referral to adult speech therapy (SALT) is important because people who use health and social services, carers, families, practitioners or Organizations perceive risk in a different way and as part of When assessing risk, it is essential to recognize possible risks related to patient care and a person-centered care plan should be considered. Support the individual and establish a critical understanding of ways of working with individual colleagues to encourage risk assessment and exercise to recognize and consider possible actions that may have harmful effects on service users with disabilities learning in the community and to comply with the legal duty under health and safety at work, it is important to document risk factors, appropriate transfer and recognition of person-centred care plans considered to reduce risks. Scarborough and Broussine, 2012) stated that health and social care staff need better training on how to support people with learning difficulties. During the time of the incident, I probably delayed my response and tried to manage and deal with the circumstances personally. But I had a strong feeling that something more serious was going on and I needed help. I may have ignored Ana and left, but for her well-being, I figured Ana wouldn't want to be left alone. When the team leader arrived, I could have walked back since other more experienced staff members were present, but as Ana was my patient, I felt I had a role to play in her recovery effective. My four week placement in the field of learning disabilities provides evidence and a chance to gain a concise understanding of different areas of practice. I have gained basic knowledge through this experience and learned about the policies and procedures, such as the DoLS in place to protect vulnerable adults and reduce the risks to them, and I also know the local rules and available online so that all staff can access them. also for the management of similar incidents. Having learned about local and national management rules and procedures, I have now learned how to respond professionally in the event of an incident. I now understand that I have learned: the value of recording risk factors, communicating with the team about the incident and resident care plans intended to reduce the dangers. Overall, I did well with my first experience seeing a resident choking and reacting quickly. to the incident, and I now feel like I have thought critically and confidently, to be even better prepared for the situation that may arise in my future nursing career. I will retain all the knowledge gained during my internship, such as safeguarding adults, risk assessment and management, incident management, the importance of communication, record keeping and teamwork (Barnes and Jenkins, 2015). Any incident must be.