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Critically reflect on an encounter with a service user in a health care setting

This essay aims to critically reflect on an encounter with a service user in a health care setting. The Gibbs’ Reflective Cycle will be used as this is a popular model of reflection. Reflection is associated with learning from experience. It is viewed as an important approach for professionals who embrace lifelong learning (Jasper, 2013). In general terms, reflective practice is the process of learning through and from an experience or activity to gain new understandings of self and/or practice (Bout et al., 1985; Jasper, 2013). This method is viewed as a way of promoting the personal and professional development of qualified and independent professionals, eventually stimulating both personal and professional growth (Jasper, 2013). Dating back to 1988, the Gibbs’ Reflective Cycle encompasses six stages of reflection which enable the reflector to think through all the phases of an activity or experience (Gibbs, 1998). The model is unique because it includes knowledge, actions, emotions and suggests that experiences are repeated, which is different from Kolb’s reflective model (Kolb, 1984) and thus, the model is wider and a more flexible approach in examining a situation in a critical light to enable future changes (Zeichner and Liston, 1996).

1. Description

The incident I will be reflecting on occurred whilst I was placed on the oncology ward during my first year of qualified nursing. We had an elderly service user on the ward, who had been admitted due to stomach cancer. Upon his arrival, we read his notes which highlighted that he had significant learning difficulties, meaning that he also had problems with verbal communication. The main areas of reflection are how both myself and the other nurses used communication to calm the patient and show compassion, as well as how we adapted our care to address their individual needs. A nurse came onto the ward with three members of the public, who were viewing the ward as part of a job advertising process. When the nurse entered the patients bay, she informed the members of the public that the service users in that bay were currently receiving radiotherapy treatment. Upon hearing the nurse’s words, the service user became overtly distressed and began crying, shrieking and hitting his head backwards against his pillow –it took time; however, another nurse managed to calm him down by talking in a soothing manner.

2. Feelings

Prior to the incident occurring, I was mindful that the nurse was showing the three members of the public around the oncology ward, as part of a job advertising process. At the time of the incident, I had only been working on the oncology ward for six months so still felt slightly unsure of my position within the team. Ultimately, I did not feel confident or experienced enough to deal with this situation independently. I think that my increased level of anxiety meant that I struggled to intervene, however it is still clear that both my colleagues and myself should have intervened more quickly to ensure that the patient was dealt with effectively. Moreover, I was very surprised when the nurse failed to take into consideration the individual needs of the service user during the visit of the ward, as the distress caused to both the service user and the members of the public was very unnecessary.

3. Evaluation

In hindsight, the experience had both good and bad elements which have led to an increased understanding of the service user experience and my role as a nurse practitioner within the oncology team. My role was to give physical examinations and evaluate the service user’s health, prescribe and administer medication, recommend diagnostic and laboratory tests/read the results, manage treatment side effects, and provide support to patients – this includes acting in their best interests. I feel that I did not fulfil the latter responsibility completely. This duty to protect service user’s full confidentiality and ensuring that the nurse who was showing the members of the public around the ward was aware of the service user’s communication difficulties and resulting anxiety was not fulfilled. Our failure to act as a team, by sharing information and stepping in before a situation escalated, shows that there was a low level of group cohesiveness (Rutkowski, Gruder and Romer, 1983).

4. Analysis

According to the Nursing Times Clinical (2004), people with learning difficulties often have a struggle with adapting to new situations, which means that there is a potential for problematic behaviour when dealing with something outside of their comfort zone. Nevertheless, as suggested by the Nursing Times Clinical (2004), healthcare staff should be aware of how to effectively interact with people who have a learning disability and this can be aided through regular and valuable reflection. Prior to admission into the hospital, it is advised that professionals find out about the patient's communication and their likes and dislikes; address any potential fears either through discussion or by allowing the patient to visit the ward to meet the nursing staff (Nursing Times Clinical, 2004). Moreover, the day to day communication towards patients with learning difficulties should involve patient-centred/holistic care in addressing patient needs, which incorporates both verbal and non-verbal forms of communication. Therefore, professionals should make eye contact, look and listen, allocate more time for the patient, be interactive and communicative, remain patient and in some cases, enable any professionals who may have had experience with people with a learning difficulty to care for the patient (Nursing Times Clinical, 2004).

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MENCAP states that one of the most common problems when accessing healthcare for people with learning disabilities is poor communication (n.d). This can be aided by offering the service user an advocate to communicate on their behalf and by providing information in a variety of ways including visual. They further this with the notion that healthcare professionals should equally value all people, adapt their service so that it meets different needs and understand that each individual will have different needs (MENCAP, n.d). The Nursing and Midwifery Council (NMC) (2015) further this in 'The Code', which states that all registered nurses and midwives must abide by the professional standards which are to: prioritise people, practise effectively, preserve safety and promote professionalism and trust. Therefore, the incident whereby another nurse did not take into consideration the individual needs of the patient does not abide by the professional code of conduct; ultimately, they did not recognise when the patient was anxious or in distress and respond compassionately, paying attention to promoting the wellbeing of the service user and making use of a range of verbal and non-verbal communication methods (NMC, 2015). Compassion is one of the '6cs' introduced in 2012 - which are the values and behaviours that are viewed as the quality markers of a health and care service - these being: care, compassion, competence, communication, courage and commitment (Department of Health, 2012). The 6Cs carry equal weight and should be a part of all service delivery - ensuring that patients are always placed at the heart of the provision (DoH, 2012).

5. Conclusion

From this experience, I am now more mindful of the importance of being assertive and exert professionalism in practice (and not feel as though I cannot do something because of my position within the team or length of experience) if similar situations were to arise in the future. The insight I have gained from this experience means that I am now more aware of the implications of not acting immediately and the importance of acting in the best interests of the patient, even when this may take courage. Strong working relationships between healthcare professionals should also be given a greater emphasis within the oncology ward, so to increase levels of group cohesiveness (Rutkowski, Gruder and Romer, 1983).

Action Plan

In the future, I aim to be more proactive in dealing with a situation face on regardless of my role within the team or level of experience; this includes dealing with a stressed service user, ensuring that information is passed on to the relevant staff and intervening when I believe that is a risk to a service user’s health or mental wellbeing. Moreover, I will address the needs and alter how I approach a patient with learning difficulties in the future by ensuring that I use the different methods of communication and undertake some independent research on their specific needs; the information of which I can use in my nursing practice.

I will not assume that other members of staff will always be aware or mindful of the individual needs and/or triggers of a service user, and I will not presume that other members of staff will always act in a wholly professional way. I will continue to undertake regular professional reflective practice, using the on-going model proposed by Gibbs (1988). I also aim to consistently and confidently implement the principles and values as set out by the National League for Nursing, relating to the individual needs of service users, these being:

These are furthered by the National Health Service (NHS), which was created out of the ideal that quality healthcare should be available to all and should meet the individual needs of everyone.

Reference List

Boud, D., Keogh, R. and Walker, D. (1985) Promoting reflection in learning: a model. In D. Boud, R. Keogh and D. Walker (eds.) Reflection: turning experience into learning. London: Kogan Page.

Department of Health (DoH). (2012) Compassion in Practice. London: Department of Health.

Gibbs G (1988) Learning by Doing: A guide to teaching and learning methods. Further Education Unit. Oxford Polytechnic: Oxford.

Jasper, M. (2013) Beginning Reflective Practice. 2nd edition. Andover: Cengage.

Kolb, D. (1984). Experiential learning: experience as the source of learning and development. New Jersey: Prentice Hall.

MENCAP. (n.d) Communicating with people with a learning disability. Online. Available at: https://www.mencap.org.uk/sites/default/files/2016-12/Communicating%20with%20people_updated%20(1).pdf

National Health Service (NHS). (2015) Principles and values that guide the NHS. Online. Available at: http://www.nhs.uk/NHSEngland/thenhs/about/Pages/nhscoreprinciples.aspx

National League for Nursing. (2017) Core Values. Online. Available at: http://www.nln.org/about/core-values

Nursing and Midwifery Council (NMC). (2015) The Code. London: Nursing and Midwifery Council.

Nursing Times Clinical. (2004) Managing the needs of people who have a learning disability, Nursing Times 100 (10) pp. 28-29.

Oxford Brookes University. (2017) Reflective writing: About Gibbs reflective cycle. Online. Available at: https://www.brookes.ac.uk/students/upgrade/study-skills/reflective-writing-gibbs/

Rutkowski, G. K., Gruder, C. L., & Romer, D. (1983). Group cohesiveness, social norms, and bystander intervention, Journal of Personality and Social Psychology, 44(3), pp.545-552.

Zeichner, K. and Liston, D. (1996) Reflective Teaching: an introduction. New Jersey: Lawrence Erlbaum Associates.

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Gibbs Reflective Cycle Sample Essay By an Expert(2022)

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Critically reflect on an encounter with a service user in a health care setting -Gibbs Reflective Cycle

This essay aims to critically reflect on an encounter with a service user in a health care setting. The Gibbs’ Reflective Cycle will be used as this is a popular model of reflection. Reflection is associated with learning from experience. It is viewed as an important approach for professionals who embrace lifelong learning (Jasper, 2013). In general terms, reflective practice is the process of learning through and from an experience or activity to gain new understandings of self and/or practice (Bout et al., 1985; Jasper, 2013). This method is viewed as a way of promoting the personal and professional development of qualified and independent professionals, eventually stimulating both personal and professional growth (Jasper, 2013). Dating back to 1988, the Gibbs’ Reflective Cycle encompasses six stages of reflection which enable the reflector to think through all the phases of an activity or experience (Gibbs, 1998). The model is unique because it includes knowledge, actions, emotions and suggests that experiences are repeated, which is different from Kolb’s reflective model (Kolb, 1984) and thus, the model is wider and a more flexible approach in examining a situation in a critical light to enable future changes (Zeichner and Liston, 1996).

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1. Description -Gibbs Reflective Cycle

The incident I will be reflecting on occurred whilst I was placed on the oncology ward during my first year of qualified nursing . We had an elderly service user on the ward, who had been admitted due to stomach cancer. Upon his arrival, we read his notes which highlighted that he had significant learning difficulties, meaning that he also had problems with verbal communication. The main areas of reflection are how both myself and the other nurses used communication to calm the patient and show compassion, as well as how we adapted our care to address their individual needs. A nurse came onto the ward with three members of the public, who were viewing the ward as part of a job advertising process. When the nurse entered the patients bay, she informed the members of the public that the service users in that bay were currently receiving radiotherapy treatment. Upon hearing the nurse’s words, the service user became overtly distressed and began crying, shrieking and hitting his head backwards against his pillow –it took time; however, another nurse managed to calm him down by talking in a soothing manner.

2. Feelings -Gibbs Reflective Cycle

Prior to the incident occurring, I was mindful that the nurse was showing the three members of the public around the oncology ward, as part of a job advertising process. At the time of the incident, I had only been working on the oncology ward for six months so still felt slightly unsure of my position within the team. Ultimately, I did not feel confident or experienced enough to deal with this situation independently. I think that my increased level of anxiety meant that I struggled to intervene, however it is still clear that both my colleagues and myself should have intervened more quickly to ensure that the patient was dealt with effectively. Moreover, I was very surprised when the nurse failed to take into consideration the individual needs of the service user during the visit of the ward, as the distress caused to both the service user and the members of the public was very unnecessary.

3. Evaluation -Gibbs Reflective Cycle

In hindsight, the experience had both good and bad elements which have led to an increased understanding of the service user experience and my role as a nurse practitioner within the oncology team. My role was to give physical examinations and evaluate the service user’s health, prescribe and administer medication, recommend diagnostic and laboratory tests/read the results, manage treatment side effects, and provide support to patients – this includes acting in their best interests. I feel that I did not fulfil the latter responsibility completely. This duty to protect service user’s full confidentiality and ensuring that the nurse who was showing the members of the public around the ward was aware of the service user’s communication difficulties and resulting anxiety was not fulfilled. Our failure to act as a team, by sharing information and stepping in before a situation escalated, shows that there was a low level of group cohesiveness (Rutkowski, Gruder and Romer, 1983).

4. Analysis -Gibbs Reflective Cycle

According to the Nursing Times Clinical (2004), people with learning difficulties often have a struggle with adapting to new situations, which means that there is a potential for problematic behaviour when dealing with something outside of their comfort zone. Nevertheless, as suggested by the Nursing Times Clinical (2004), healthcare staff should be aware of how to effectively interact with people who have a learning disability and this can be aided through regular and valuable reflection. Prior to admission into the hospital, it is advised that professionals find out about the patient’s communication and their likes and dislikes; address any potential fears either through discussion or by allowing the patient to visit the ward to meet the nursing staff (Nursing Times Clinical, 2004). Moreover, the day to day communication towards patients with learning difficulties should involve patient-centred/holistic care in addressing patient needs, which incorporates both verbal and non-verbal forms of communication. Therefore, professionals should make eye contact, look and listen, allocate more time for the patient, be interactive and communicative, remain patient and in some cases, enable any professionals who may have had experience with people with a learning difficulty to care for the patient (Nursing Times Clinical, 2004).

MENCAP states that one of the most common problems when accessing healthcare for people with learning disabilities is poor communication (n.d). This can be aided by offering the service user an advocate to communicate on their behalf and by providing information in a variety of ways including visual. They further this with the notion that healthcare professionals should equally value all people, adapt their service so that it meets different needs and understand that each individual will have different needs (MENCAP, n.d). The Nursing and Midwifery Council (NMC) (2015) further this in ‘The Code’, which states that all registered nurses and midwives must abide by the professional standards which are to: prioritise people, practise effectively, preserve safety and promote professionalism and trust. Therefore, the incident whereby another nurse did not take into consideration the individual needs of the patient does not abide by the professional code of conduct; ultimately, they did not recognise when the patient was anxious or in distress and respond compassionately, paying attention to promoting the wellbeing of the service user and making use of a range of verbal and non-verbal communication methods (NMC, 2015). Compassion is one of the ‘6cs’ introduced in 2012 – which are the values and behaviours that are viewed as the quality markers of a health and care service – these being: care, compassion, competence, communication, courage and commitment (Department of Health, 2012). The 6Cs carry equal weight and should be a part of all service delivery – ensuring that patients are always placed at the heart of the provision (DoH, 2012).

Gibbs reflective cycle

5. Conclusion -Gibbs Reflective Cycle

From this experience, I am now more mindful of the importance of being assertive and exert professionalism in practice (and not feel as though I cannot do something because of my position within the team or length of experience) if similar situations were to arise in the future. The insight I have gained from this experience means that I am now more aware of the implications of not acting immediately and the importance of acting in the best interests of the patient, even when this may take courage. Strong working relationships between healthcare professionals should also be given a greater emphasis within the oncology ward, so to increase levels of group cohesiveness (Rutkowski, Gruder and Romer, 1983).

Action Plan -Gibbs Reflective Cycle

In the future, I aim to be more proactive in dealing with a situation face on regardless of my role within the team or level of experience; this includes dealing with a stressed service user, ensuring that information is passed on to the relevant staff and intervening when I believe that is a risk to a service user’s health or mental wellbeing. Moreover, I will address the needs and alter how I approach a patient with learning difficulties in the future by ensuring that I use the different methods of communication and undertake some independent research on their specific needs; the information of which I can use in my nursing practice.

I will not assume that other members of staff will always be aware or mindful of the individual needs and/or triggers of a service user, and I will not presume that other members of staff will always act in a wholly professional way. I will continue to undertake regular professional reflective practice, using the on-going model proposed by Gibbs (1988). I also aim to consistently and confidently implement the principles and values as set out by the National League for Nursing, relating to the individual needs of service users, these being:

To respect the dignity and moral wholeness of every person without conditions or limitation.

To affirm the uniqueness of and differences among people, their ideas, values and ethnicities. (National League for Nursing, 2017, n.d).

These are furthered by the National Health Service (NHS), which was created out of the ideal that quality healthcare should be available to all and should meet the individual needs of everyone.

Reference List -Gibbs Reflective Cycle

Related FAQs -Gibbs Reflective Cycle

1. What are some examples of reflective writing?

Examples of Reflective Writing

2. What is the Gibbs Reflective Cycle definition?

Gibbs Reflective Cycle is a self-reflection and management tool that help people to think clearly and systematically about the different experiences they have gone through during specific activity or similar situation and draw conclusions.

3. How do you write a Gibbs reflective cycle?

Read More -Gibbs Reflective Cycle

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Gibbs’ Reflective Cycle Essay

Introduction.

Gibbs’ Reflective Cycle is a powerful model that encourages people to think critically and systematically about their experiences, specific events and occurrences. This approach makes it easier for them to identify the major causal factors and adjust their actions or behaviours accordingly. This model also supports the concept of lifelong learning. The purpose of this paper is to apply Gibbs framework to an incident that happened in midwifery practice.

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Description of the Incident

The selected scenario for this discussion revolves around educating pregnant women about the importance of getting vitamins and iron supplements. The background of this incident is that a specific woman gave birth to a child with extremely low weight. The baby developed breathing problems and was immediately diagnosed with infant respiratory distress syndrome. This kind of medical condition occurs when an individual has immature lungs (Hassmiller & Reinhard, 2015). Unfortunately, this newborn baby died two days after birth. A detailed inquiry into this happening revealed that the mother was not taking the recommended supplements during her pregnancy. This example was a clear indication that many women were not taking the issue of nutrition into consideration, thereby exposing themselves and their unborn babies to numerous health challenges or risks.

Application of Gibbs’ Cycle and Discussion

Gibbs’ Reflective Cycle is an evidence-based self-reflection tool that can help people to examine their experiences and identify new measures for improving them and acquiring additional ideas (see Figure 1). This framework has become essential in the fields of nursing and healthcare delivery (Doolen, 2017). It encourages people to identify both the negative and positive aspects of any given eventuality and learn from it.

Gibbs’ Cycle of Reflection

Description

During the first stage, the involved individual will give a detailed description of the event without presenting any conclusions or personal insights (see Figure 1). The presented incident occurred when a newborn baby died two days later due to a respiratory condition triggered by or associated with low birth weight (Doolen, 2017). Those involved provided adequate support to the baby after birth and the mother. All caregivers, practitioners, physicians and midwives were part of the process to ensure that the child received adequate oxygen.

As part of the team involved in the midwifery process, I was moved by this event and sympathised with both the baby and the mother. I felt traumatised since such an incident could have been controlled or prevented. This becomes a learning point for all pregnant women and every person planning to have a child (Hassmiller & Reinhard, 2015). My teammates, the mother’s family members and clinicians were unhappy because of this loss. They still maintained that such an event could have been avoided.

This midwifery incident occurred because the targeted woman had not appreciated the importance of vitamin and iron supplements during pregnancy. However, all participants and clinicians provided adequate and timely support throughout the period. They ensured that high-quality services were available to the newborn baby. Personally, I provided adequate care and guidance to the mother after she gave birth. I also updated her family members and relatives continuously. All other stakeholders ensured that the baby got timely medical attention. From this event, I have learnt that the issue of nutrition is something that all people should never ignore. Childbearing women should go further to receive adequate supplements and vitamins if they are to give birth to healthy babies (Wain, 2017). This knowledge will encourage me to empower, educate and sensitise more individuals about such an event and how to prevent it.

Although this incident resulted in the death of an innocent baby, it can become a powerful model for guiding health professionals in the field of midwifery and public health experts to educate more women about the importance of vitamin and nutrient supplements during pregnancy (Howatson-Jones, 2016). In future, I will always sensitise and inform every pregnant woman about the benefits of getting the right minerals and food materials. I will have to engage in lifelong learning in an attempt to learn more about the best nutrients that are appropriate for women during pregnancy. This knowledge will make it easier for me to prevent similar events.

Action Plan

The recorded incident has become a powerful model for ensuring that more women give birth to babies with average weights. The best action plan entails the implementation of a program that educates women about the importance of taking vitamin supplements during birth. The campaign should be designed in such a way that it encourages all beneficiaries to inform their friends, neighbours and relatives (Howatson-Jones, 2016). Similar programs should be available to all women seeking prenatal health services. The introduction of evidence-based measures will prevent the reoccurrence of a similar incident.

The above discussion has described how Gibbs’ cycle can guide medical professionals to address most of the problems that might occur during the delivery of health services. The described incident becomes a meaningful case study for overcoming various sentinel events in midwifery. Pregnant women should receive timely guidance and take the required minerals and vitamin supplements in order to give birth to healthy babies.

Doolen, J. (2017). Meta-analysis, systematic, and integrative reviews: An overview. Clinical Simulation in Nursing, 13 (1), 28-30. Web. Hassmiller, S. B., & Reinhard, S. C. (2015). A bold new vision for America’s health care system. Nursing Outlook, 63 (1), 41-47. Web. Howatson-Jones, L. (2016). Reflective practice in nursing (3rd ed.). Thousand Oaks, CA: SAGE Publications Inc. Wain, A. (2017). Learning through reflection. British Journal of Midwifery, 25 (10), 662-666. Web.

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COMMENTS

  1. Sample Essay Using Gibbs' Reflective Model - NursingAnswers.net

    The Gibbs’ Reflective Cycle will be used as this is a popular model of reflection. Reflection is associated with learning from experience. Reflection is associated with learning from experience. It is viewed as an important approach for professionals who embrace lifelong learning (Jasper, 2013).

  2. Gibbs’ reflective cycle - University of Cumbria

    Gibbs (1988, p.49) created his “structured debriefing” to support experiential learning. It was designed as a continuous cycle of improvement for a repeated experience but can also be used to reflect on a standalone experience.

  3. Applying the Gibbs Reflective Model

    Applying the GibbsReflective Model ‘It is not sufficient simply to have an experience in order to learn. Without reflecting upon this experience it may quickly be forgotten, or its learning potential lost. It is from the feelings and thoughts emerging from this reflection that generalisations or

  4. Gibbs' Reflective Cycle explained with lots of Examples.

    The Six Steps of Gibbs' Reflective Cycle 1. Description: Describe in detail the Situation in which you want to improve. A Negotiation, A Decision you made, a Discussion with your employees, etc. 2. Feelings: Reflect on How you Felt in that Situation, How you Coped with it. Did you feel Insecure? Did you feel Determined? Did you Hesitate? 3.

  5. Reflective practice Gibbs Model essay - EFFECTIVE ... - StuDocu

    I will use Gibb’s reflective cycle (Gibbs, 1988), which has 6 stages – Description, Feelings, Evaluation, Analysis, Conclusion and Action Plan – to structure this essay. This is an appropriate model to use as a student as it will encourage me to link theory and practice, and develop an action plan identifying specific learning needs and ...

  6. Reflective Essay On Patient Encounters Using Gibbs Cycle ...

    Reflective Essay On Patient Encounters Using Gibbs Cycle Nursing Essay. In this essay, I will reflect upon a experience which I had with a patient using the Gibbs cycle of reflection (Gibbs, 1998) to help to signpost my answer and help the reader to read this essay with ease.

  7. Gibbs Reflective Cycle Sample Essay By an Expert(2022)

    Gibbs Reflective Cycle Sample Essay By an Expert(2022) This article provides a sample essay written by one of our nursing professional writers about the Gibbs Reflective Cycle . The aim of the article is to provide nursing students with a blueprint to follow when writing their own essay.

  8. Gibbs' Reflective Cycle - 864 Words | Essay Example - Free Essays

    Gibbs’ Reflective Cycle is a powerful model that encourages people to think critically and systematically about their experiences, specific events and occurrences. This approach makes it easier for them to identify the major causal factors and adjust their actions or behaviours accordingly.

  9. Clinical Skills Reflection: Gibb's Model - UKEssays.com

    Clinical Skills Reflection: Gibb's Model Reference this Part of: Gibbs' Reflective Cycle Share this: Facebook Twitter Reddit LinkedIn WhatsApp The skill that I will reflect on in this essay is the administration of an intramuscular Injection (IM). An IM is an injection deep into a muscle (Dougherty & Lister, 2008).

  10. Sample Essay Using Gibbs' Reflective Model - /Services ...

    Sample Essay Using Gibbs' Reflective Model becoming the general society University Christian Service University College Course Taxation (B541) Uploaded by david frimpong Academic year2021/2022 Helpful? 30 Comments Please sign inor registerto post comments. Students also viewed