This essay will examine the importance of reflective practices and methods of reflection in the healthcare environment, particularly for Registered Nurses who are primarily responsible for the holistic care of a patient. For the best patient outcome, nurses are required to consistently review and improve their knowledge and skills to be able to function in the evolving healthcare setting (Mann et al, as cited in Usher & Holmes, 2017, p.112).
Reflection is the mental examination of previous events to re-examine the need for improvement of patient care delivery or to simply reflect on personal and professional progress. Reflective practice is the means of using these encounters to improve nursing practices, communication, and ensuring that the holistic needs of a patient are always prioritised (Jacobs, 2016, p.62). Critical reflection allows the impassive evaluation of clinical performance, decision making, and processing emotional carnage related to an event.
Reflection-on-action, making changes at the time of practice, and reflection-in-action, reflecting on the details after the event, are two forms of reflection that improves patient care (Usher & Holmes, 2017, p.114). Rolfe et al (as cited in Usher & Holmes, 2017) claims reflective writing is unique and assists in gaining a better perspective of the event (p.118), unravelling knowledge gaps or discrepancies in applied clinical processes. Journaling, a form of reflective writing, is often written in first person enabling the writer to be personal with their own thoughts and feelings of experience. Critical incident analysis is a more formal strategy of written reflection that involves intense evaluation to identify the inadequacies in relation to the incident with more focus on the actions within the event. Rees (as cited in Usher & Holmes, 2017, p.121), argues that nurses have a better emotional grasp on similar future events when they reflect on distressing situations. Sharp (2018) introduces the well-known model, Gibbs’ reflective learning cycle which contains six phases. The description of the event, thoughts, and feelings of the event, positive and negative evaluation, perception of the situation, what could be done differently, and what to do if it were to happen again (p.48). Reflective practice in nursing can be difficult, especially after an adverse experience but self-awareness and self-monitoring are important in the prevention of reoccurrences.
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Self-awareness allows a nurse to view what affect they had on the situation and what affect the situation had on them (Atkins, as cited in Usher & Holmes, 2017. p.122) Reflective practices enhances self-awareness and clinical reasoning (Glynn & Rigby et al, as cited in Goulet et al, 2016. p.143), aiding the development of emotional engagement with patients, a core characteristic in clinical practice (Morrison & Symes as cited in Goulet et al, 2016. P143). Pitt et al (2013. p.46-47) explores the nursing qualities set out by the Australian Nursing and Midwifery Council (ANMC), which are the foundation of becoming a Registered Nurse. Caring, kindness, and compassion, being a team player, enhancing knowledge and skills, self-motivation, critical thinking, problem solving, applying theoretical frameworks and knowledge, acknowledging boundaries, applying knowledge, and acting within the scope of practice are the foundations of nursing.
The healthcare environment is always changing therefore nurses must review their skills and knowledge to perform their role accurately and to ensure mistakes are not repeated. Reflective practice is integral for a nurse’s professional refinement, both in clinical knowledge and application of practice. The ANMC’s standards for nursing set the need to constantly review the need for refinement of skills and knowledge which leads to improved patient care, critical thinking, effective communication, and increased self-awareness. There are many strategies to ensure that reflection becomes a habitual process to support the prompt exposure of inadequacies in knowledge and practice that might lead to poor patient care.
Below I have outlined my career action plan using the Smart goals strategy.
- Specific: My career goal is to become a Registered Nurse and gain employment in a Hospital setting where I will work in as many specialties as possible until I find my passion then I will pursue any extra training that I need to.
- Measurable: Will assist me to complete and pass my Diploma by the end of trimester three, 2020. Then at the start of 2021, transition on to Bachelor of Nursing where I will pass all my courses and graduate at the end of 2022. I will need to ensure I have an impeccable record and skills to be considered for employment at the Hospital.
- Attainable: I will I attend all lectures and complete all assigned work. I will also use my ability to apply my knowledge to pass all assessments and exams, using my critical thinking to ensure adherence to the formatting guidelines.
- Realistic: I will implement my time management skills to fit in study which include while my children are at school, after lectures, in the afternoon, around extracurricular activities, and on weekends. I will remain self-aware to ensure that I complete my work on time.
- Time: My determination and compassion for people will see me complete my goal within the next 3 years. Once I graduate in 2022, I will aim to apply for a position at the hospital.
- Jacobs, S, MN, MA, Ed, RN. (2016). Reflective learning, reflective practice. Nursing, 46(5), 62-64. doi:10.1097/01.NURSE.0000482278.79660.f2
- Sharp, L. (2016). Reflective practice: Understanding ourselves and our work [online]. Nursing Standard, 30(36) p.48. AustralianNursing.libraryproxy.griffith.edu.au/documentSummary;dn=536752761070430;res=IELHEA> ISSN: 2202-7114.
- Usher. K, Holmes, C. (2017). Reflective Practice: What, Why, and How. In J. Daly, S. Speedy, D. Jackson, Contexts of Nursing (5th ed. pp.112-127). Elsevier
- V. Pitt, D. Powis, T. Levett-Jones & S. (2013). Can an existing personal qualities measure be used to examine nursing students’ professional and personal attributes? Focus on health professional education: a multi-disciplinary journal 15(2), p.41-50. https://opus.lib.uts.edu.au/bitstream/10453/117356/4/201588.pdf