HIntroduction: The purpose of this essay is to reflect on the skill I have learned during my 6 weeks clinical placement in Palliative Ward of Greenwich Hospital. In this essay, I will explain how I succeeded in my learning goal. I made a set of learning goals and discussed and got approval from my assessor during the 2nd week of placement. My goal was to be able to perform a PCOC assessment on the patients by the end of my placement. PCOC assessment is a very important tool in palliative care and for evidence based improvement of patient outcome (Eagar et. al 2010). So, I felt PCOC assessment would be the most significant learning outcome to learn and reflect on. I will be using Gibb’s Reflective cycle (Gibb, 1988) to explore my goal in this essay. Furthermore, I will be highlighting and correlating to different NMBA Standards throughout the reflection (NMBA 2016 RN Standards for practice). Body: PCOC is a standardized clinical assessment tool to measure patient outcomes in palliative care. Care and management of palliating patients is based on the clinical assessment (Eagar et. al 2010). As I was in palliative unit for 6 weeks, I speculated the importance of performing the PCOC assessment and prioritized this goal over other. This importance encouraged me to pursue the goal of becoming efficient in PCOC assessment and contributing to the care. As Standard 4 of NMBA requires registered nurses to comprehensively conduct assessments (NMBA 2016), I took the opportunity to learn the skill. The first step was to customize myself with the different aspect of assessment form such as different phase, RUG score, AKPS scale and symptom assessment scale. To familiarize with those aspect, I researched about the assessment tool and went through related articles and videos. Doing so I have followed Standard 3 which instructs to maintain the capability for practice (NMBA 2016). To guide my practice, We read the facility policies and procedures related to PCOC assessment. Then, I observed the supervising RN perform the PCOC assessment. I realized that the RNs were using two different approaches to do the assessment. Some preferred to do it as an interview whereas some rated it according to the observations and information they had gathered through conversation with the patient throughout the shift. I used the combination of both approaches, as I thought while interviewing is still the most effective data collection method sometimes it is not practical in a palliative care setting. I did simulated practice with my RN before filling the PCOC chart. We performed the assessment on my 2 allocated patients on week 1 building up to 4 patients on week 2. I practiced under supervision for next 2 weeks and seek feedback from the supervising RN and incorporated feedback into practice. Feedback has a crucial role in driving and directing learning (Boud & Molly, 2013). At one time, I had a disagreement with one of the RN regarding the assessment. We had scored my patient according to my understanding of the PCOC assessment and the symptom severity of the patient. But the RN did not agree to what I had scored and changed it to the minimum score which was 0 for this aspect. To me this was a case of underrating the severity of the problem which affects the care of the patient as well as the time and resource allocated for care. It also made me question my understanding about the assessment. It was very confronting for me as my profession asks me to advocate for my patient and report any notifiable conduct of health professionals. I did so and reported it to the nurse educator. I think I acted in respect to Standard 2.4, 2.5, 2.8 and 2.9 which emphasizes on engaging in therapeutic and professional relationships (NMBA 2016). With the educator, I had in-depth discussion regarding the situation and the assessment tool. He agreed that we had a valid point and assured me to consider the matter and take appropriate measures to ensure this does not happen in the future. This was a challenging situation for me but We took it as an opportunity to learnt.We feel by doing so we have met my standards of practice. My action was in alignment to Standards 1.1, 1.2, 1.5, 1.6 and 1.7 which focuses on thinking critically thinking and analyzing nursing practice (NMBA 2016). We reflected on my own performance and identified areas of improvement. I continued to reflect on practice and identify areas of improvement throughout my placement. Conclusion: This was a great learning experience for me and I am happy to acknowledge that we had succeeded in achieving this goal. We feel that We have taken all the possible measures to achieve my learning goal. Learning is a process and is much aided by our experiences. The disagreement with the RN has added much significance to my learning process. I may have much more to learn but I feel confident in undertaking a PCOC assessment which is evident by the number of assessments I have done during my placement and the feedback from the RNs and the Nurse Educator. In future if I get to work in palliative care setting I can correlate this goal to my practice. References: Boud, D. and Molloy, E. 2013. Rethinking models of feedback for learning: the challenge of design. Assessment & Evaluation in Higher Education. 38(6) Eagar, K., Watters, P. and David, C. 2010. The Australian Palliative Care Outcomes Collaboration (PCOC)- measuring the quality and outcomes of palliative care on a routine basis. Australian Health Review. 34(2), ProQuest Central pg. 186 Gibbs, G. 1988. Learning by doing: A guide to teaching and learning methods. Further Education Unit, Oxford Polytechnic, Oxford Nursing and Midwifery Board of Australia, Registered Nurse Standards for practice, 2016, viewed 5 June 2017 1 Rojina Shrestha 203082