The Impact Of Guided Reflection On Self-Care Behavior

Throughout personal professional development reflection is essential, allowing health care professionals to self-develop by revisiting events and analysing areas in which improvements and learning would ensure a positive impact on their future practice. The Nursing and Midwifery Council, (NMC, 2010) notes that all health care practitioners must be self-aware in their own values and principles which could affect their practice. Ensuring they maintain personal and professional development while learning through supervision, feedback and reflection.

Dorthea E. Orem’s self-care model emphasizes both a patient 's ability and responsibility to care for themselves. Self-care as defined by Orem as “the practice of activities that individuals initiate and perform on their own behalf to maintain life, health, and well-being” (Catalano, 2015, p. 58). Since individuals function at varying levels, Orem has identified three levels of nursing care: wholly compensated care, partially compensated care, and supportive developmental care. This theories goal is to help each individual reach his or her maximum level of function and to take responsibility for his or her health (Catalano, 2015). Self-reliance is also core value in my own personal life. I believe that a person who is capable of performing any part of their own self-care should be encouraged to do so because it will help them become independent, improve their psychosocial status, and promote self worth at a time when they rely so heavily on other people for their care. Orem’s theory matches my own belief of the importance of independence and self-reliance because the main goal is to help patients become as self-reliant as possible in their healthcare. This theory emphasizes the important role of education in nursing in order to enable them to take control of their own health. Because of health deficits, some individuals may require more assistance from care providers. However, even these patients should be encouraged and allowed to do whatever they are able to do for

Rawlinson, (1990) defines self-awareness as a conscious process in which we consider our understanding of ourselves. Having self-awareness and the ability to reflect means you can assess your own knowledge, skills and behaviours (NCL, 2014). In order to improve the quality of care and develop skills and confidence, one must reflect on their self-awareness experiences, to reach their full potential of practise. To define reflection Duffy (2008) describes reflective practise as an active and deliberate process to critically examine practice. Through self-awareness individuals can get to know more about what they do and what limits their abilities (Ghaye and Lillyman, 2001). Thus improving the quality of care provided to service users, as nurses have the responsible for providing care to the best of their ability to patients and their families.

Reflection is a process of exploring and examining ourselves, our perspectives, attributes, experiences and actions / interactions. It helps us gain insight and see how to move forward (Nursing Times 2018). I believe reflection is particularly important when it comes to Nursing, as medicine is constantly changing/ improving and us ourselves medical professionals must adapt with the changes in medicine. I find that reflection is extremely useful in doing this as we can look over procedures or experiences that we have had, how that made us feel, whether we would change anything, then in the future we can see the changes that may have been made, whether this has changed our feelings and opinions on medical practice.

This essay will demonstrate an understanding of the theory of reflective practice within healthcare and nursing. Furthermore, the essay will identify and analyse the different models of reflective practice, the effectiveness of the models and how healthcare professionals can apply this within their profession. Also, the barriers that may prevent a healthcare professional from reflecting will be discussed in this essay and how it will impact the quality of care delivered to patients.

Reflective practice in nursing is the process where we examine our nursing ability’s and practice in order to critically think and analyze the way we work and think about the views of others in our practice, what we could have done and we could have achieved a greater result by doing this also allows us as nurses to include best practice and use our own judgment in patient care to show the factors that either aid and hinder nurse to patient relationship. (Lowenstein, Bradshaw and Fuszard, 2001) described reflecting in nursing practice “the nurse must first come to understand what he or she defines as ideal practice”.

Reflection is defined by Howatson-Jones (2013), as “a way of examining your experience in order to look for the possibility of other explanations and alternative approaches to doing things” (p. 6). The practice of reflection is important for numerous reasons. As stated by Hargreaves and Page (2013), reflections promote good practice and in the occurrence of a difficult or challenging situation, they can help to identify where things went wrong and how to improve the outcome for future incidents. As identified by Jasper, Rosser and Mooney (2013), reflection offers benefits to both the patient and the practitioner. Practitioners are more likely to avoid routine practice, continuously develop their knowledge and identify faults to improve on. Patients are more likely to receive higher standards of safety and better quality of care

Reflection is an important tool for all health care practitioners. It can improve our skills and help us understand the choices we make while in practice. Williams (2001) states that “Reflective learning involves assessment and re-assessment of assumptions and critical reflection occurs whenever

Gustaffson and Fagerberg point out that reflective practice has relevance for clinical practice as by understanding the contents of nurses’ reflections, it is also possible to understand the advantages of reflective practice and how and when such measures should be used by the nurses for further professional development.

As the nurses who participated in a study (Jones & Cheek, 2003) overwhelmingly advised, there is no such thing as a typical day for a nurse. Nurses face new situations everyday and it is important that they can adjust their knowledge and skills accordingly. Critical thinking and reflection are essential skills because they can enhance nurses’ ability to solve problems and make sound decisions. Critical thinking skills enable nurses to identify multiple possibilities in clinical situations and alternatives to interventions; weigh the consequences of alternate actions; and make sound judgement and decisions (Brunt, 2005). Through reflection, nurses can examine their practice, explore feelings and reactions and connect new meanings to past experience (Brunt). Reflection can enhance self-awareness, foster professional satisfaction and growth and increase the possibility for change and improvement in nursing practice and therapeutic relationships (Thorne & Hayes, 1997).

Reflective practice is often defined as when practitioners engage in a continuous cycle of self observation and self evaluation in order to understand their own actions and reactions they prompt in themselves and in learners (Brookfield, 1995; Thiel, 1999). The goal is not necessarily to address a specific problem or question defined at the outset, as in practitioner research but to observe and refine practice in general on an ongoing basis. (Cunningham 2001). Reflection on practice is a key skill for nurses. Engaging in regular reflection allows practitioners to manage the personal and professional impact of addressing their patients’ fundamental health and wellbeing needs daily (Oelofsen, 2012)

In recent years, reflection and reflective practice have become well-known term with in the health care arena. They are words that have been debated and discussed with in the health care setting (Tony and Sue 2006). Reflective practice is essential for nurses, as nurses are responsible for providing care to the best of their ability to patients and their families (NMC, 2008). Reid (1993) states reflection is a process of reviewing an experience of practice in order to describe, analyse, evaluate and so inform learning about practice. Johns (1995) notes that reflection enables practitioners to assess, understand and learn through their experience. Reflective practice, therefore, offers nurses an opportunity to review their decisions and

Schon (1987) identified two types of reflection that could be applied in the nursing practice. He described “refection-on-action” that involves assessing and analyzing an action while performing the action and “reflection-in-action” which involves going back to previous actions and situations and analyzing them to gain new insights and to improve the nursing practice (Schon 1987). Schon further argued that for reflection to take place there should be a commitment to action as there is to results. Coined in 1970, Borton’s theory on the other hand, proposes the use of three stem questions in the reflective practice (Borton, 1970). These questions were originally proposed by John Driscoll who described the experiential learning cycle (Driscoll, 1994) where practitioners are able to learn from their experiences to improve their practice. According to Driscoll (1970) these trigger questions could be used to complete the experiential learning cycle leading to a practitioner gaining new information and insights on how to improve their practice (Driscoll, 1994). The importance of Driscoll’s three stem questions in improving practice reflection among nurses cannot be underestimated. By answering these stem questions, nurses develop a better insight into the situation regarding how and why it occurred and identifies the next courses of action in case the situation recurs.

Personal reflection in nursing is essential and critical as it allows for continuous development and re-assessment of skills whilst working within a health care setting (Reflective practice: a tool to enhance professional practice 2011, pp.1-3). Personal reflection is important as reflective practice allows for the ability for one to reflect and examine their actions and experiences which overall will increase and enhance their clinical knowledge, as well as developing and improving their practice (Reflective practice: a tool to

The Self-Care Deficit Theory of Nursing impacts modern health as well as nursing more than expected during the theory’s creation and evolution. The Institute of Medicine (IOM, 2001) demanded the need for health care to shift from acute care setting management of disease. Consequently,