Reflection On Critical Reflection In Nursing

Throughout my time on the Mother Baby Care Unit, I have faced many instances in which I have been able to reflect on both my patients and the care that I was providing them. One situation in particular that I found myself critically reflecting upon involved a new mother who was feeling slightly stressed about being discharged as her newborn son would not be going home with her. For confidentiality reasons, this patient will be given the pseudonym of Kayla for the remainder of this reflection.

The nursing practise has continually evolved and can be described as autonomous due to the significant involvement of nurses in patient care. This then necessitates critical reflection as a way to continually develop and improve the nursing practise. The Gibbs' model, one of the reflection models, assists nurses in complying to the codes and guidelines of nursing practice. For example, developing action plans, evaluating patient outcomes, and thinking critically. This essay will describe an event involving nurses and explain the feelings it evoked. It will also provide an evaluation of the positives and negatives, analysis and enhancement of learning, and an action plan.

Critical reflection is vital to develop evidence based practice for safe and quality approaches to professional nursing practice. Nursing professionals should critically reflect on events to identify what health professionals might do to improve their practice and reduce the risk of a similar error. Reflective practice can help to learn from their mistakes, be empowered and most importantly to deliver best possible care to patient as nurses must work closely with their patients to develop a therapeutic relationship. Critical reflection is a valuable skill to ensure patient centred care. This practice promotes personal development by enhancing students’ self-awareness, their sense of community, and their sense of their own capacities for

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.

Skin integrity is an important concept that’s nurses assess on their patients. A key skill in nursing practice is to frequently assess the skin for possible breakdown or decreased skin integrity. Skin assessments should be conducted thoroughly once a shift and frequently reassessed for any signs of change. Skin discrepancies may be the first sign of an underlying issue. Early detection of any breakdown can help to implement interventions sooner. Unfortunately, unless there is a major skin discrepancy, skin issues can easily get overlooked, specifically in documentation and report. The focus of this paper is to research new skin integrity assessments to improve documentation effect and accuracy, resulting in decreased prevalence of skin breakdown in hospitalized patients. Topics discussed include reviewing current practices and new skin assessment techniques that decrease the prevalence of skin breakdown and pressure ulcers.

This objective will affect my future nursing practice because conducting physical head to toe assessments and obtaining vital signs is a different process when working with paediatric patients rather than adults. It is crucial to note any changes that I can catch throughout my assessments, and vital signs since paediatric patients might not be able to communicate with me if they feel any changes in their health. By understanding the anatomy and physiology, the developmental stages of children, and obtaining accurate vital signs and assessments, it will increase my knowledge, skill, ad judgment to successfully complete and distinguish any abnormities and changes during my assessments. Also, knowing the developmental stages and distraction therapy method techniques can help me provide thorough examinations and find ways to help my patients cope if they are feeling anxious and scared.

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).

The following essay is a reflective account on an event that I, a student nurse encountered whilst on my second clinical placement in my first year of study. The event took place in a Fountain Nursing Home in Granite City. I have chosen to give thought to the event described in this essay as I feel that it highlights the need for nurses to have effective communication skills especially when treating patients that are suffering with a mental illness. Upon arriving to the Nursing home for the second time on Thursday November 14,2013; assigned the same patient as before. On meeting my patient the first thing I noticed myself doing without even thinking about it was giving her a visual inspection. Before nursing school I never really looked at

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 this case study I will use Gibbs (1988) model of reflection to write a personal account of an abdominal examination carried out in general practice under the supervision of my mentor, utilising the skills taught during the module thus far.

The objective of this reflection is to explore and reflect upon a situation from a clinical placement on an orthopedic unit. The incident showed that I did not provide safe, timely and competent care for my patient when the oxygen saturation was low. Furthermore, this reflection will include a description of the incident, and I will conclude with explaining what I have learned from the experience and how it will change my future actions.

Starting the Registered Nurse (RN) to Bachelorette of Science in Nursing (BSN) program at Jacksonville University in June 2015 was a simple transition for me. I had graduated an Associates Degree in Nursing (ADN) program in December 2014 and became a licensed RN in January 2015. I had just gotten hired for my first nursing position the month prior to the start of class and had not yet started working. I was very much still in student mode. While this makes it a bit easier to learn and process information in a classroom setting, I had no real world experience to help guide me. Through the knowledge I have gained as a student at Jacksonville University I have become a competent and well-rounded nurse. I am able to quickly problem solve and utilize critical thinking to identify and rectify issues. I have even put together, and will be presenting, and presentation about nursing practice for staff members at the facility where I work.

As higher standards expected are from the public and higher patient safety demands are expected from health boards, therefore, there is a need for a way of measuring standards of practice which can be achieved through active thinking in a clinical environment brought about by critical reflection (Rolfe, Jasper & Freshwater 2011). Reflection has become such a key component in the role of a nurse that the Nursing and Midwifery Council (NMC) have seen it fit to include it in their professional code of conduct the Code: Professional Standards of Practice and Behaviour for Nurses and Midwives, hereafter referred to as the Code (Nursing & Midwifery Council [NMC], 2015). With reflection being a vital skill for nurses to continue their professional development (Parrish & Crookes, 2013), an analysis of what it means to reflect within nursing is needed by all who intend to enter the profession to ensure its effective use is applied.

The Royal College of Nursing defines reflection as the process of thinking deeply with the purpose of understanding (RCN 2013). Reflection is a way people recollect, think and evaluate their knowledge which is a vital part of learning. (Boud et al cited in Royal College of Nursing). Reflection allows us to be conscious of any form of discrimination. It enables learning from mistakes and prevents future occurrence (RCN 2013). In addition, Jasper et al (2013) looks at reflection as a way professionals learn through various experiences in their role. They also went further to say, for development to happen in our roles as professionals, there is the need for continuous process of building our knowledge.

09/08 When I have arrived at the unit every shift, the first thing I do before receiving report and starting my assessments is washing my hands. However, I consistently wash my hands before and after I enter in a patient’s room throughout my shift using the guidelines from the CDC to prevent the transmission of infection in my patients. I also administered medicaments safely for all my patients using the six rights and the three checks of med administration. I verified the patient’s name, the doctor’s order in the MAR before and after I remove the meds out of the med room and at the bedside, I verified my patient’s name and date of birth against the arm band in accordance with the initiatives for National Patient Safety Goals (NPG.01.01.01; NPG.01.01.07). This week, I managed the care of four patients. I delegated the BP’s and BS’s to the NA. I did all my assessments and documented them. I passed all the medications for all four patients on time before 2200p. On this time, another change of shift occurs and assignments are divided to accommodate based on the census and personnel availability by the charge nurse. I prioritized my patients based on their acuity and ordered meds. I administered first a beta blocker and an ACE inhibitor with parameters (held if SBP of 110 or less) for my patient with a BP of 152/77, then I administered Pro-stat 30 mg protein drink and docusate sodium a stool softener to another of my patients. I recognized that was not easy to manage and