Theory And Practice Of Critical Reflection In Nursing Practice

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.

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

Burns, S. Bulman, C. Palmer, A. (1997) Reflective Practice in Nursing - The growth of the professional practitioner. London: Blackwell Science.

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.

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”.

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.

For the purpose of this essay, I have selected Gibbs (1988) Reflective Learning Cycle to reflect on an aspect of individual professional practice, which requires development in preparation for my role as a Registered Nurse. Gibbs (1988) Model of Reflection provides a clear description of a situation, analysis of feelings, evaluation of the experience, conclusion, and action plan to make sense of the experience to examine what you would do if the situation happens again.

The national league for nurses defines critical thinking in the nursing process as “a discipline specific, reflective reasoning process that guides a nurse in generating, implementing, and evaluating approaches for dealing with client care and professional concerns” (Kozier, 2008). This definition is imperative to help a nursing student learn how to think in terms of nursing care. Nursing students must achieve a comprehensive understanding of critical thinking in order to understand the nursing process. The purpose for this paper is for nursing students to learn how to use the nursing process, how to properly document their findings and assessments, and correctly implement APA formatting in a formal paper.

Reflective practice in nursing is considered an important aspect to nursing. Durgahee ( 1997) defines reflective practice as a process of learning and teaching professional maturity through the critical analysis of experience, whilst John ( 2009) up to date explanation of reflection is learning through our everyday experience towards realising one vision of desirable practice as a lived reality.

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

Reflection is used by nurses and health care professionals to incorporate theoretical and practical knowledge (Cowen et al 2009). On the other hand, Rolfe et al (2011) noted that reflecting on the event and thinking about any action that could have been taken differently. For effective changes to occur when reflecting, the reflector should pay attention to what they are thinking, how they are feeling and what they recall (Taylor 2010 cited in Howatson-jones 2013)