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Critical Thinking in Nursing Practice
Critical Thinking in Nursing Practice
Critical Thinking in Nursing Practice
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Introduction
This essay is going to focus on the nursing skills that I developed during a period of placement simulations and in the community, placing emphasis on oral care, communication with a non-engaging patient and bed bath. It will outline the fundamental aspects of clinical nursing skills that I have begun to acquire. This will also highlight the learning processes which took place and how it helped me to enhance my knowledge, and ethical values in order to deliver quality and safety of care. Using other sources of current literature, I will use a reflective model to discuss how I have achieved the necessary level of learning outcome. By utilising this model I hope to demonstrate my knowledge and understanding in relation to these skills as well as identifying areas with scope for learning.
Reflection is the process of reviewing an experience in order to describe analyse, evaluate and so inform learning about practice (Reid 1993). There are many reflective models that I could have used, including Johns (2004), Driscoll (2000), Atkins and Murphy (1994), Kolb’s (1984), and Gibbs (1988).
However, Gibbs (1988) model of reflection model was selected, as a framework, because it focuses on different aspects of an experience and allows the learner to revisit the event fully. By contemplating it thus, I am able to appreciate it and guided to where future development work is required.
For confidentiality (NMC, 2008) purposes, patient’s real names will not be used and will be referred to as R where appropriate.
Skill 1: Oral Care
Description
I was part of a placement simulation group which went to the multi-skills laboratory to practice delivering and receiving oral hygiene. I was assigned a colleague to brush his teeth ...
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...Today. 13:305-309.
Rigby P and Alexander J (2008). Understanding Schizophrenia: Nursing Standard 22:28, 49-56
Sheldon, LK (2009) Communication for nurses: talking with patients, Jones and Bartlett Publishers, Sudbury
Sturdy, D. (2007) Indignity in care: are you responsible? Nurs Older People. 2007; 19(9): 9.
Thomas, B. Hardy, S. and Cutting, P. (1997) Mental health Nursing: Principles and Practice London: Mosby
Voegeli D; British Journal of Nursing (BJN), 2010 Jul 8; 19 (13): 810, 812, 814 Care or harm: exploring essential components in skin care regimens.
World Health Organisation (2010) ‘Oral Health’, at http://www.who.int/topics/oral_health/en/ (Accessed 19/11/2010
Wilkinson, S.(1992) Good communication in cancer nursing. Nursing Standard 1992; 7(9):35–9.
Williams, Diana (1997) Communication Skills in Practice Jessica Kingsley Publishers London
Walsh, A. & Clarke, V. (2009) Fundamentals of Mental health Nursing New York: Oxford University Press.
Stuart, G. W. (2009). Principles and Practice of Psychiatric Nursing (9th ed. pp 561). St. Louis, MO: Elsevier Mosby.
This article was written by several well educated professionals in the nursing field. The article appears in a peer reviewed nursing journal that covers topics in psychiatric and mental health nursing that has a 37-year history. The sources history, along with the use of various references from other professional sources establish the journal entries
The purpose of this essay is to reflect and critically study an incident from a clinical setting whilst using a model of reflection. This will allow me to analyse and make sense of the incident and draw conclusions relating to personal learning outcomes. The significance of critical analysis and critical incidents will briefly be discussed followed by the process of reflection using the chosen model. The incident will then be described and analysed and the people involved introduced. (The names of the people involved have been changed to protect their privacy) and then I will examine issues raised in light of the recent literature relating to the incident. My essay will include a discussion of communication, interpersonal skills used in the incident, and finally evidence based practice. I will conclude with explaining what I have learned from the experience and how it will change my future actions.
On the 1st of November 2013, I performed my first simulation on the module, Foundation Skills for Nursing. This simulation was on checking for vital signs in patients particularly, measuring the blood pressure (BP) which is the force of blood vessels against the walls of the vessels (Marieb and Hoehn, 2010). We also measured the temperature, pulse and respiratory (TPR) rates of a patient. This simulation’s objective was to engage us in practising some basic observation techniques taken on patients in and out of hospitals and to familiarise us on some of the tasks we will be performing when in practise. I will be applying the “What”, “So what”, and “Now what” model of reflection in nursing by Driscoll (2000).
Wrycraft, N, 2009. An Introduction to Mental Health. 1st ed. Glasgow: Bell and Bain Ltd.
Wilkin P & Baker P (2004) “The Craft of Caring” Psychiatric and Mental Health Nursing, Arnold Press, London page 26-33
Reflection is a significant component of pre-registration education (Davis et al.2000). Hillard (2006) claims that for practitioners to learn from an experience they need to go beyond description and should reflect on their experiences in practice as this could potentially uncover any underlying influences, motivations and knowledge. Reflecting on an experience could then be identified as a process to bridging the gap between theory and practice (Bulman & Schutz, 2004).
Darby, S. Marr, J. Crump, A Scurfield, M (1999) Older People, Nursing & Mental Health. Oxford: Buterworth-Heinemann.
The ability to become reflective in practice has become a necessary skill for health professionals. This is to ensure that health professionals are continuing with their daily learning and improving their practice. Reflective practice plays a big part in healthcare today and is becoming increasingly noticed.
It is important that students have the ability of being competent in a clinical setting. To be deemed competent in skills according to nursing regulations and requirements. This is a challenging factor for many students, as they enter transition period. This is due to students feel they do not have the desired clinical competency that promotes the skills and authorities of a registered nurse (Harsin, Soroor & Soodabeh, 2012). Clinical research studies have found that students do have the required expected levels of knowledge, attitude and behaviour’s. However, the range of practical skills aren’t sufficient for the range of practice settings (Evans, 2008). This research has also found that other evidenced based studies found that competency in nursing skills is still lacking (Evans, 2008). These skills are lacked by students and newly graduated nursing how are in the first or second year of
This reflective essay will discuss three skills that I have leant and developed during my placement. The three skills that I will be discussing in this essay are bed-bath, observing a corpse being prepared for mortuary and putting canulla and taking it out. These skills will be discussed in this essay using (Gibb’s, 1988) model. I have chosen to use Gibb’s model because I find this model easier to use and understand to guide me through my reflection process. Moreover, this model will be useful in breaking the new skills that I have developed into a way that I can understand. This model will also enable me to turn my experiences into knowledge that I can refer to in the future when facing same or similar situations. Gibbs model seems to be straightforward compared to the other model which is why I have also chosen it. To abide by the code of conduct of Nursing and Midwifery Council (NMC) names of the real patients in this essay have been changed to respect the confidentiality.
Reflection is a key part of our personal development plan that is significant from both academic and employment perspectives. It investigates and someway measures our present level of skills and knowledge by looking back to reflect our latest performance and monitoring future improvements (Gallagher K., 2013, p. 23-24).
Reflection within early year’s settings and schools allows for the practitioner to think about the work that is being completed either whilst doing it or after it has occurred, the reflection allows for seeing how the work has gone or whether it needs to be changed for future practice. Schön is a key writer about reflection and illustrates the differences between reflection in action, reflection on action and reflection whilst completing the task. The above critical skills help all practitioners to develop understanding as they hugely impact on others lives, if this skill is not engaged in then practice could be effected (Leeson, 2004).
The reflective dimension is the journey of self-development through a critical analysis of one’s thoughts, behaviours and values. Reflection allows you to relate your inner self to the environment around you. It encourages social responsibility and constant improvement as you learn from experience and acknowledge success. (Olckers, Gibbs & Duncan 2007: 3-4) Reflection can boost learning by stimulating awareness of our feelings and practices. This allows health professionals to cope with unfamiliar circumstances and conflicts.