Reflection in Nursing

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 assignment is a reflective account on communicating with a patient who cannot communicate verbally. To remain confidential I will call the patient, Patient A. I’m going to discuss the importance of non-verbal communication within a healthcare setting. Patient A was a 63 year old lady suffering from MND which resulted in her losing her speech.

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

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.

Nurses must assess a patient’s communication needs with respect to their age, gender, culture, developmental status and be able to modify their care related to these needs. This also is a consideration when communicating with those around us daily.

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.

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.

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.

Therapeutic communication is the basis to maintain a proper nurse patient relationship. Furthermore, understanding that therapeutic communication which is so vital, patient’s literacy level is also crucial in the communication process. Boykins D., 2014 states that “individuals that experience health literacy problems receive less preventative care and have poor understanding of health problems and care”. A nurse assesses each patients’ literacy level upon their first interaction, she also uses therapeutic communication to build a strong nurse patient relationship. Therapeutic communication can be verbal and nonverbal, both equally important to help build a bridge for communication. An example of nonverbal therapeutic communication would be silence; in some cultures, silence is a norm and a way of thinking. With a precise assessment and proper

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.

Another non-verbal communication skill that I learned to use effectively was silence as it gave both the patient and the nurse time to reflect upon previous or future events in the patient’s care, although it is important to ensure that the patient’s needs are still met and that the focus is still on them. Therefore it is important that the nurse involves the patient through other means of communication.

Communication involves information being sent, received and decoded between two or more people (Balzer-Riley 2008) and involves the use of a number of communication skills; which in a nursing context generally focuses on listening and giving information to patients (Weller 2002). This process of sending and receiving messages has been described as both simple and complex (Rosengren 2000 in McCabe 2006, p.4). It is a process which is continually utilised by nurses to convey and receive information from the patient, co-workers, others they come into contact with and the patient’s family.

Each nurse also has specific ideas or beliefs about what information should be communicated during a verbal report. Valuable information may not be provided or may be forgotten (Casey & Wallis, 2011). Writing information down may help a nurse recall the data later, but if there is no consistent format for recording the information, it may be lost regardless. Interruptions, distractions, and the frequency of communications also may negatively effect the communication process and contribute to a nurse forgetting to share important information (Cacolice-Hildebrand, 2008). Active listening, which involves reflecting back a meaningful understanding of one’s message, is one of the most important skills in effective communication.

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.

Communication is one of the basic survival skills of human and also a fundamental part of nursing. Effective communication would help to promote a positive nurse-client relationship which is crucial for the delivery of quality nursing care (Sheppard, 1993; McCabe 2003).