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Reflective Essay About Group Work Camps

Abstract

This article describes some of the experiences of a small group of second year adult nursing students during an optional module – Student Community Engagement (SCE), at the School of Health Sciences, University of Brighton.  Their experience was reflected on in the context of being a volunteer and working with socially excluded groups of children and young people. Their reflections are discussed in relation to the importation of new skills into their wider course work and are interpreted using educational and communication theory.

Introduction

In year two of the BSc Nursing undergraduate curricula students are able to choose between a range of optional modules.  Students electing to participate with the SCE module are then invited to a ‘matching event’ which is jointly coordinated by staff from the Active Student Volunteering Service, based with University of Brighton’s Careers Service.  Local voluntary organizations are invited to discuss potential learning opportunities within their organizations and to attract motivated volunteers.  Significantly, many of the volunteering placements are not for profit organizations with a social care orientation, this offers the students a distinct change from their usual health based organizations.

Early in the placement students are asked to complete a Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis and a learning agreement which are later reflected upon.  One of the key aims of the module is the recognition and importation of transferable skills and knowledge back into their existing repertoire of professional nursing skills.   The module’s summative assessment constitutes a short report describing the host organization and its function, an account of how they have spent their time, an impression of their effectiveness in their volunteering role, the benefits of their activity to the community and the skills and attributes developed while volunteering within the organization.  The module is supported by six theoretical sessions looking at volunteering, active citizenship, relevant social policy and project planning.   Two action learning sets are facilitated by senior lecturers, making use of narratives, story-telling and the use of reflective dialogue.

The Volunteering Learning Opportunity

At our matching event a range of volunteering options was presented, including the opportunity to volunteer with CCHF – All About Kids (previously Children’s Country Holiday Fund).   As students training in the adult branch of nursing we rarely get to work with directly with children, this experience was viewed as an opportunity to broaden our skill-set with this specific group and to challenge ourselves by working with children from disadvantaged backgrounds with potentially difficult behavior.

CCHF was established in 1884 and is a registered charity.  It aims to give disadvantaged children respite and residential breaks in order to improve their quality of life and to help them to recognize their own potential (CCHF 2013).  It focuses on children aged seven to eleven living mainly within London or the immediate surrounding areas; it relies totally on donations from the public and corporate partners to fund their activities. Children can be referred by anyone who works with disadvantaged children such as teachers and social workers; their eligibility is then assessed against the CCHF criteria.  This criteria includes a range of factors such as poverty, abuse, low self-esteem, children that care for a family member, or other family factors such as having a parent who abuses substances or who has a mental health issue.  Each child is gently monitored for the duration of the camp due to their circumstances.  CCHF works closely with statutory organizations in order to address any issues or concerns encountered throughout the duration of the camp.  As such the experience represented our first opportunity to patrol the tensions of a safeguarding role.

It is estimated that of the 1.1million families living on low income in London in 2010 / 11; 60% could not afford to take their children away for a week’s holiday (London’s poverty profile, 2011). Cummins et al (2013) suggest that children that are brought up in poverty can be at greater risk of suffering from low self-esteem. This is one of the key areas that the charity works to improve. Their annual report demonstrates that many of the children that arrive on camp with low self-esteem and leave feeling much happier and far more confident (CCHF All About Kids, 2013).

The wider community also benefits from those accessing the opportunity as children with greater confidence and self-belief are more likely to have better health and are also less likely to engage in criminal activities (Chen et al 2013).  Knapp et al (2011) supports this notion by suggesting that individuals who suffer from low self-esteem in childhood are likely to have worse economic prospects in adulthood.  Conversely research by the Child Poverty Action Group (2013) using Department of Education data, suggests that children receiving free school meals attain an average of 1.7 grades lower than wealthier students.

A King’s Fund report (Buck et al 2013) suggests that in our modern society volunteers are sometimes under appreciated and used instead of paid workers – however this was found not be the case at CCHF where they have always relied upon the goodwill of volunteers to enable their existence.  The role of the volunteer in society has become ever more important as a result of reforms put in place by the Health and Social Care Act, 2012, (Naylor et al 2013).  As such, volunteering is now a key part of the current governmental strategy, and is included in their ‘Big Society’ vision. This aims to encourage people to participate in local projects, by giving them more power to influence the running of services and facilities in their community (Cabinet Office 2010).  It believes that the inhabitants of communities understand the needs of the local area most, and this will help create “attractive and thriving” neighbourhoods.

Volunteering is traditionally associated with the concept of altruism (Haski-Leventhal 2009) – the motivational selfless desire to increase the wellbeing of others.   Alternatively, Carpenter and Myers (2010) argue that the main drive for volunteering is not altruism, but the perceived benefits, whether these are career benefits or purely self-satisfaction.  Sigmund and Hauert (2002) take this point further, suggesting that any act in which both parties gain is more co-operation than altruism, as both the volunteer and the organization benefit from the partnership. CCHF utilize this sense of co-operation in their organization; the vast majority of the workforce is made up from volunteers.   Most of them are students who are hoping to both enjoy the experience and improve their future career prospects.

Personal Reflections

Amy’s reflection  Before camp I had little experience of working with children or even managing large groups of people.  At one point I managed a group of 15 challenging children for an hour with another first time volunteer.  The children were well behaved, safe and actually enjoyed themselves, and at no point did I find myself worrying or panicing.  Later on in the day, the senior leader praised at CCHF this activity, which helped to build my confidence for future situations on camp. Although these individuals were children, my confidence in leading larger groups of adults has definitely improved and this has made a noticeable difference in clinical practice, for example, when managing a bay of patients in a ward.

A potential weakness that I discovered during the camp that I had not previously identified in the SWOT analysis was my hesitance when trying to find the words to set and enforce interpersonal boundaries with the children and young people.   As the week progressed I began to see the consequences of not doing so, I therefore realized that I needed to take some advice from our senior leader, who encouraged a certain amount of careful risk taking.  This gave me the confidence to gradually experiment by trying different approaches within the interaction’s, in doing so I eventually over-rode my fears of causing offence or humiliating myself.  I found that upholding boundaries did not alter the relationship that I had with the child, nor reduce their respect for my position; it was mostly accepted and often helped to harmonize power structures in the group.  Reflecting on this process has helped me in subsequent nursing roles, for example, at timely moments I am more confident when offering health promotion advice, such as advice to reduce smoking, drinking or other harmful activities that I anticipated I would be perceived in an authoritarian or negative light.

One of the most significant experiences that occurred to me during the camp was dealing with a disobedient child and their parents.  A particular child had consistently demonstrated aggressive behavior towards others in the early days of the camp.   Bullying is not tolerated and so it became my responsibility to liaise with the parent about the child’s behavior and return them to home ahead of schedule. The parents were understandably upset and concerned when I contacted them; I myself felt awkward and did not want to exacerbate the situation further.   I tried to remain calm, be professional and listened attentively to the parents; eventually we came to a mutual agreement.   The way in which I dealt with this situation and the camp as a whole, reinforced my own ‘self-efficacy’, this is the belief in one’s own capabilities to produce a desired effect by one’s own actions (Lopez and Snyder 2011).

Laura’s reflection  Although quite personal, my experience and subsequent reflections have helped me to surface, confront and alter some unconscious attitudes, raising my self-awareness in the process.  The demographics of children on the camp was incredibly diverse as was their range of ethnicities and socio-economic backgrounds.  This was in contrast to my own quite stable upbringing and I felt a little under confident in my abilities to engage and relate to them.  One of the competencies for entry to their register, the NMC requires that:

“All nurses must practice in a holistic, non-judgmental, caring and sensitive manner that avoids assumptions, supports social inclusion; recognizes and respects individual choice; and acknowledges diversity.” (NMC 2013)

At first I found the encounters quite difficult, I just wasn’t consciously judging the children and young people, just uncertain as whether they would accept me and how the interactions would go.  However, after I had spent some time with the children I realized that most of my pre-conceived fears were in fact unfounded, and by the end of the camp my I sensed that my confidence had changed.  During my nursing career I will encounter people from all walks of life; this episode forced me to think about  my own attitude and values.   I believe this realisation equates to a shift in values which will stay with me for years to come.

I feel that working with children that may be distressed or upset during the camp has improved my communication skills, insight and confidence in clinical areas where I might encounter and treat children on a regular basis.  Having not previously worked with children, I found being able to interact and to make appropriate interventions, a valuable leap for me which in turn forms a valuable part of a child’s development.

Sam’s reflection  By the end of the camp I felt proud to be a part of each child’s accomplishments and saying goodbye to them was one of the hardest things that I experienced.  As a caring professional it is vital to maintain healthy relationships with the patients and people that you work with.    Making use of attachment theory Skovholt and Trotter-Mathison (2011), helpfully describe the ‘caring cycle’ as consisting of four stages: Empathetic Attachment, Active Involvement, Felt Separation and finally, Re-creation.  I related this model to the time with the children and it is directly transferable to the relationships I form in my nursing practice.

Knowledge and use of the model has helped me to think differently about the process of attachment.  Failure to reach the recreation stage of the caring cycle may indicate an unwanted level of attachment or unprofessional attitudes.  My belief is that I will now be able to take part in further camps, being able to recreate healthy, professional relationships again and again.

My experience of volunteering has brought to the fore many considerations into my own education as a student nurse and responsibilities as a future health care practitioner and leader.   Due to the personal circumstances of the children at CCHF, I became more aware the importance of safeguarding practices, namely remaining vigilant for possible signs abuse and malnourishment.  Being responsible for a group of children meant observing for any issues and reporting them immediately; this aspect of social care applies more broadly to nursing and the responsibility nurses have to the wellbeing of their patients. I have found this experience correlates with my current placement in a Community Nursing Team as we regularly see vulnerable adult patients in their own homes.

Facilitator’s reflection  Having supported the students during other academic sessions over the previous year I felt I understood the students well enough to sense the impact that volunteering had on them personally and on their learning.  Their sheer enthusiasm evoked a positive sense of dissonance which inspired me to try and capture and analyse their experiences.  In our action learning set I probed their narratives, asking what it was about the experience that so differed to other experiences on their course.  My overriding sense was that it was the immersive nature of the summer camp combined with their interactions with the young people that had helped to transform their attitudes towards themselves, their practice and their ability to form and maintain relationships.
To interpret the students’ experience I have found it helpful to locate their experience on a two dimensional map of ‘reality’ and ‘learning outcomes’, created by Morgan and Burrell, (1979, cited by Brockbank and McGill, 2006).  It is my view that their collective experience moved the group away from the objectivism and towards the subjectivism end of the reality dimension, and from the equilibrium towards the transformation end of the learning outcomes dimension.
Arguably, much of the learning taking place on the adult pre-registration nursing programme, such as clinical skills or anatomy and physiology, depends heavily on notions of an objective reality and maintaining the equilibrium of power structures, as per the conceptual dimensions.   Such learning reflects ‘imposed objectives, based on perceived objective reality’ (Brockbank and McGill, 2006).   At the ‘equilibrium’ end of the dimension, the status quo and ‘taken for granted’ ideas go unchallenged and are therefore upheld by the prevailing discourses and scripts.

My analysis is, the summer camp experience nudged the students towards the subjectivist end of the continuum as they were immersed in a new social world and a common language became ‘understood and continuously reconstructed, reproduced and transformed through interaction’ with the children and young people, (Brockbank and McGill, 2006).   The students’ perspectives appear to have been altered as a consequence of the developmental experience, pushing them away from the stability of the equilibrium element towards the transformative end of the scale.

This is consistent with a symbolic interactionist perspective on perceptions of self and on developing relationships.  Symbolic interactionism can be defined as ‘a theory of human communication that can account for the process by which everyday nursing situations become defined and redefined’, (Stevenson, Grieves and Stein-Parbury, 2004). Symbolic exchanges occurred during their interactions and these appear to have shaped understandings and cemented social relationships.  For a short time they had been thrown off their usual student nurse ‘script’ (Stevenson, Grieves and Stein-Parbury, 2004), into a completely different domain and the students had adapted to the challenge and risen to the responsibility.  In doing so they had achieved new understandings by being part of the young people’s world, using their language, interpreting and making meaning of their communication.

Conclusion

Johnson and Webb (1995, cited by Stevenson, Grieves and Stein-Parbury, 2004) found that ‘nurses do judge the social worth of people and that such judgments do have moral consequences’. However, in our students’ case we have seen these relatively negative evaluations were negotiated and renegotiated throughout their interactions.  Once such attitudes are brought into awareness through the process of reflection, corrective thoughts were assumed.   In thinking about the collective experience of the group, all three students have processed their experience and engaged with their inner dialogue to make meaning of what occurred in their week with CCHF.  Significantly, by processing the subjective cues that occurred, small and hopefully lasting shifts and transformations of attitude occurred impacting on their outlook and learning.

Warren Stewart Senior Lecturer School of Health Sciences, University of Brighton, Laura Brown Adult Nursing BSc (Hons) student, Sam Harris Adult Nursing BSc (Hons) student and Amy Isaac Adult Nursing BSc (Hons) student

References

Brockbank A and McGill I, (2006) Facilitating Reflective Learning Through Mentoring and Coaching. Kogan Page, London. Page 10.
Burrell G and Morgan G (1979). Sociological paradigms and Organisational Analysis, Heinemann, London.

Buck, D., C. Mundle., C. Naylor., L. Weaks. 2013. Volunteering in health and care Securing a sustainable futures. from:http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/volunteering-in-health-and-social-care-kingsfund-mar13.pdf [Accessed 06/09/13]

Cabinet Office. 2010. Big Society Programme.[Online]. Available from: www.gov.uk/government/uploads/system/uploads/attachment_data/file/78979/building-big-society_0.pdf  [27th August 2013].

Carpenter, J. and C. Myers. 2010. Why volunteer? Evidence on the role of altruism, image and incentives. Journal of Public Economics. 94 (11): 911-920.

CCHF. 2013. CCHF All About Kids [Online]. Hassocks: CCHF All About Kids. Available from: http://www.cchf-allaboutkids.org.uk/welcome.htm . [4th September 2013].

Chen, H., R. Chen., P. Cohen., Y. Huang., S. Kasen., L. Maldonado. 2013. Impact of Early Adolescent Anxiety Disorders on Self-Esteem Development From Adolescence to Young Adulthood. Journal of Adolescent Health. 53(2): 287-292

Child Poverty Action Group. 2013. Child poverty facts and figures. [Online]. Available from: http://www.cpag.org.uk/child-poverty-facts-and-figures#footnoteref6_ablz1rj   [Accessed 04/01/13]

Cummins, S., S.E. Curtis., J.H. Fagg., A. Quesnel-Valléee., S.A. Stansfeld. 2013. Neighbourhood deprivation and adolescent self-esteem: Exploration of the ‘socio-economic equalisation in youth’ hypothesis in Britain and Canada. Social Science and Medicine. 91: 168-177

Haski-Leventhal, D. 2009. Altruism and Volunteerism: the perceptions of altruism in four disciplines and their impact on the study of volunteerism. Journal for the Theory of Social Behaviour. 39 (3): 271:383.

Knapp, M., D. King., A. Healey., C. Thomas. 2011. Economic outcomes in adulthood and their associations with antisocial conduct, attention deficit and anxiety problems in childhood. Journal of Mental Health Policy and Economics. 14 (3): 137-147

London’s poverty profile. 2011. Key facts. [Online]. Available from:http://www.londonspovertyprofile.org.uk/key-facts/ [Accessed 05/09/13]

Lopez, S. and C. Snyder. 2011. The Oxford Handbook of Positive Psychology. 2nd ed. New York: Oxford University Press.

Naylor, C., C. Mundle., L. Weaks., D. Buck. 2013. Volunteering in health and care. Securing a sustainable future. [Online]. Available from: www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/volunteering-in-health-and-social-care-kingsfund-mar13.pdf [27th August 2013].

NMC. 2010. The code: Standards of conduct, performance and ethics for nurses and midwives. [Online]. Available from:http://www.nmc-uk.org/Publications/Standards/The-code/Introduction/  [Accessed 06/09/13]

Nursing and Midwifery Council. 2013. Competencies for entry to the register – Adult Nursing. London: Nursing and Midwifery Council.

Sigmund, K. and C. Hauert. 2002. Altruism. Current Biology. 12 (8): 270-272.

Skovholt, T, and M. Trotter-Mathison. 2011. The Resilient Practitioner. 2nd ed. New York: Routledge.

Stevenson, C., Grieves, M., and Stein-Parbury, J. (2004). Patient and Person, Empowering Interpersonal Relationships in Nursing. Elsevier, Oxford.

I’m sure that most students find it difficult to answer their teacher when posed with the question ‘what have you learn so far?’ At the very least it is for me. No teacher wants to hear that your ADD usually gets the better of you and that some lectures the only new information you’ve walked away with was the number of dots on the third ceiling panel from the left. If put on the spot that’s how I might have answered the question, but when I take a deep breath and think back to everything that Professor Sheard and Jason White conveyed to us the murky water gets a little bit clearer.

I can now think back to the beginning of the school year, me with my beliefs that freshmen classes would be fairly similar to an AP high school class many of which you could still sleep through and ace. This was probably my first detrimental trait to go as I quickly learned that there is no room for people who don’t apply themselves in college. Now I find myself sacrificing much of my free time in order to make sure I’m adequately prepared for the upcoming classes.And while it may mean missing out on the satisfaction of killing hordes of zombies, it does mean achieving a different feeling of satisfaction when I earn the grade that I wanted.

Other than just me realizing what needs to get done this class has also forced me into group environments that have instigated the realization of other objectives that are required of one’s self. When working within a group it forces you to do your best if not for your own goals but for the other members of your group. Even though it may allow for opportunities for members to lay back and let the group carry them, I still feel that teamwork through group projects were a useful tool used in professor Sheard’s freshmen inquiry class.

Adam Rose

Professor Sheard

Reflective Essay

The year is over. I’m finally done, for now. It went by faster than I ever would have thought. I find myself thinking back on everything I’ve accomplished over the past year and think ‘well done, you did it’. To be honest with you, the freshmen inquiry courses have been distasteful. They simply were not my usual work/school environment and for me being an architecture major they simply did not present me with subject matter that I truly wanted to engage in. But Professor Sheard already stated in the outline this essay is to discuss what I learn not what I liked, and so that’s what I’m going to discuss. There were four main categories in which students were supposed to grow: Communication skills in any and all medians, ethics and social responsibilities, critical thinking, and diversity of human experience.This is what I have learned in those four categories.

Communication skills, whether it be body language, written word, or public speaking, communication skills are a very essential part of life. All successful people know how to properly communicate their goals. And it is one of my desires to be successful so I may as well learn it sooner better than later. I have always been good at talking to people in small groups and in large ones, even though public speaking is one of the biggest fears of the majority of the public. So our class presentations were good practice because there is always room for improvement. My writing skills have always been lacking, especially my spelling, but I realize this and I have been working to improving it. In high school I took advanced placement English three out of my four years to help improve on my writing capabilities. But high school standards don’t really match up to those that are enforced on college writing assignments which is why I’m glad I got to expand on them when writing our term papers. Like I said there is always room for improvement.

Ethics and social responsibilities are a bit harder to grow and expand on. It has always been my believe that morals are really just a made up idea in order to make feel bad when they sway to far from the path of religious and legal guidelines. What I mean is everyone knows right from wrong, but what is right for some may not be for others. There is no way to have a widespread ethical standard. So really the only solid black line for people to derive and ethical standard for is not what is right and wrong but rather what is legal and illegal. But that too has more than a few grey areas. Yes everyone knows murder and theft is wrong but I’m sure there are a million and one standpoints on speeding. But it is much easier to look back on ones history to see if they have wrong anyone or even ones nation’s history. This is one thing I was able to do when we visited the internment camp monument.

Critical thinking is far less of a touchy subject than morality. This is really just anything that can get the light bulb to turn on, the gears to turn, or to wind up the little clockwork symbol banging monkey, regardless of however frustrating that it may be.This past term we had to do three large programming projects in a programming language I have never even heard of before. And we had to write them in a program that kept locking up. Frustrating to say the least. However, I did manage to completely them and I am willing to admit that I did learn a thing or two from this experience and should I ever have to do anything similar in the future, then I’m covered.

Lastly we come to the diversity of human experience, which is something that we can all see on a daily basis.I have a very different experience from here at PSU then the next person and I imagine that they have a very different experience from someone else and so on. The point is no two people are the same, each with different stories. I have been fortunate enough to travel around the world seeing first hand different peoples and cultures. I’ve been in nine different countries on four different continents so I’ve seen a thing or two and it has affected me. I live my life based on things I’ve learned abroad. I understand not everyone has been able to do this, in fact most have never even left the states which personally I feel is a shame. But I can’t tell them what to do or how to live their lives so even if I don’t like them or what they do or how they think I can’t do anything about it. So it’s to each his own I guess.

Well the school year is over. It’s finally time to relax and let out a nice long sigh of relief. And more likely than not forget a thing or two we just learned just learned, after all we got to make sure there is plenty to do next year. Well I really don’t have much to say, a whole year has gone by and I don’t even have some snappy closing statement for the conclusion of the last paper I’ll be writing a long while. But I guess that’s important what’s important is that I made it through my freshmen year of college and more importantly I actually got something out of it. Anyways farewell Bridger and Professor Sheard it was a pleasure.


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