When I retired three years ago from the United States Air Force as a Production Superintendent with 25 years of service, I was an expert in my field. During technical school I put in the classroom and study time on book materials and lectures to learn as much as I could. During the hands on experience I watched and duplicated what the instructors were teaching and asked questions when I did not understand. When I actually started working on aircraft and moving through the ranks, that’s when the true learning started. I was learning by experience. As I gained more and more experience I became an expert. Learning by experience is a lifelong learning process of success and failures. One of the greatest learning tools that can be used with life experiences is reflective thinking. As I start to learn and as I progress through my second career, reflection will be an important tool that I will use in what I hope to become; an expert nurse.
Reflection is not something new; it has been used for years. According to the article “Exploring reflective thinking in nursing practice” publish...
In this essay, the author
Explains that they retired from the united states air force as a production superintendent with 25 years of service and learned by experience. reflection is an important learning tool as they progress through their second career.
Explains that reflective thinking has been used since the early 1900s by john dewey, an american philosopher, psychologist, and educational reformer. the university of hawaii defines it as a part of critical thinking.
Explains gibb's reflective cycle for post-fall huddles, where nurses discuss their feelings, evaluate the good and bad from the experience, analyze the situation, and make an action plan to help prevent or decrease the likelihood of another fall.
Explains that numerous studies have been conducted to evaluate the effectiveness of reflection in regards to enhancing the nursing skills of critical thinking and clinical decision making.
Explains that reflective models like gibb's reflective cycle and reflective journaling can be used by nurses to improve ways of doing things, such as preventing or decreasing falls.
The term reflection means the examination of personal thoughts and actions. For nurses this means focusing on how they interact with their colleagues and with the environment to obtain a clearer picture of their own behaviour. This means it is a process in which a nurse can better understand themselves in order to be able to build on existing strengths and take appropriate future action (Somerville, 2004). Reflection is a way to bring your own intuition along with empirical knowledge together. Reflective practice in nursing is guided by models of reflection. Reflective practice model serves as a framework within which nursing or other management professions can work. Reflective practice model is also a structural framework or learning model that serves the purposes of a profession and is particularly applicable to health related professions. Reflective practice enables practitioners to learn to value themselves as significant people with values and feelings that are important factors in giving care. Whilst reflective practice allows the nurse to recognise the value of their experiences, they may also need support to work through a difficult situation. This is where reflection aids nurses in dealing with these challenging experiences (Johns, 1995). Reflection on experience offers nurses the opportunity to reflect on caring in practice in ways that its nature can be understood, where the skills necessary for effective caring can be developed and most significantly, where the values of caring for people can be highlighted, both to the individual nurse and the world in general (Johns 1996)
In this essay, the author
Explains that reflection is the examination of personal thoughts and actions to obtain a clearer picture of their own behaviour. reflective practice in nursing is guided by models of reflection.
Explains that the event they will discuss and later reflect on gave them more confidence in themselves while they were out on clinical practice.
Explains how they were assigned to two 6 bedded wards with a staff nurse. they bleeped the sho on call to explain what was wrong with the patient.
Explains that johns' model of reflection is based on five cue questions which enable you to break down your experience and reflect on the process and outcomes.
Opines that reflection offers practitioners a window for themselves to look inside and know who they are as they strive towards understanding and realising the meaning of desirable work.
Opines that john's reflective cues stood out to them the most during their journey of reflection. their primary concern was for their patient.
Explains that self-confidence underpins nurses' competence to carry out care effectively. recognition from staff for contributions to patient care can be seen as positive reinforcement for students.
Explains that clinical placement is an invaluable experience in nursing as it ensures you are exposed to a variety of events that require quick thinking and excellent interpersonal skills.
Opines that johns cue ‘how might i reframe the situation to respond more effectively given this situation again’ is not relevant to this particular situation.
Opines that john's model of reflection asks 'what other choices did i have and what were those consequences?'
Opines that undertaking the treatment of patrick unaccompanied gave them the sense of developing as a professional and that their previous experiences enriched their belief in themselves and their nursing skills.
Explains that they felt nervous when they first began their internship after hearing stories of interns being thrown in at the deep end and left to manage areas by themselves. anderson and kiger (2008) found that students who made their own decisions and follow through aspects of nursing gave them satisfaction.
Concludes that the final cue in johns' model of reflection is ‘am i more able to realise desirable practice?’
Opines that reflective practice can improve patient care, improve performance, identify educational needs, highlight barriers to development, and provide evidence of continuous professional development.
Reflecting upon a career in nursing allows an individual to draw upon past experiences. A nurse can think about what motivated them when they first started their career and compare it to their motivations today. It offers insight as to which of the nursing code of ethics correlate to their individual nursing practice. Reflection also allows a nurse to see their progression towards their goals, or if any have changed throughout their career. When used everyday, reflection can improve our practice and allow us to transcend as care providers.
In this essay, the author
Explains that reflecting upon a career in nursing allows an individual to draw upon past experiences. it offers insight as to which of the nursing code of ethics correlates to their individual nursing practice.
Explains that a career in nursing can have many meanings. caring for oneself, patients and individuals close to the patient, coworkers in healthcare, and about everyone in the general public improves relationships.
Explains that they were assigned to a patient who was non-compliance with their medications because he had not been taking them for about one year. they focused on assessing the patient's needs by asking positive questions.
Explains that the nursing code of ethics is a reminder of the responsibilities that establishes the profession.
Opines that respecting a patient's right to decide what treatments or therapies they want to have or not have gives the patient autonomy.
Opines that establishing a caring relationship with patients begins with protecting the patient's privacy and confidentiality. without trust, patients will not disclose personal information about themselves, making aiding them to better health and lifestyle impossible.
Opines that the caring relationship continues as we preserve the patient's integrity. when our own integrity is compromised, an eroding of the ethical environment occurs.
Explains the importance of creating an environment that supports nurses and pursues excellence. their hospital system recently initiated a rn residency program for new nurses.
Describes how their nursing career has offered many rewards, such as the feeling they receive when they invest their energy, time, and compassion into the patient and they return that effort with appreciation and recognition for their services.
Explains that they want to continue caring and helping patients by obtaining a bsn degree. their compassion, integrity, and desire for patient advocacy can be best utilized in the critical care setting.
Opines that they would like to continue their education and obtain an advanced degree in nursing. they also want to become part of the american association of nurse practioners and have a peer-reviewed journal.
Explains that their bsn is a stepping stone and first step to achieve all their goals. professional advancement integrates education, certification, increased responsibility and authority over practice, and increased salary.
Explains that reflecting on their nursing practice can help them become a better professional. all goals are dynamic and never static.
In reflection in action, expert professionals examine their experiences and responses as they occur and adapt t...
In this essay, the author
Aims to critically analyse a clinical incident involving an adult with congenital heart disease (chd). they will define reflection, select reflective models and critically reflect on the incident.
Explains that reflection is a key element of the human learning process. it can be used to justify aspects of practice and legitimise the knowledge gained from it.
Explains schon's distinction between reflection on action and reflection in action, whereby professionals scrutinise their past practice to gain insight and improve future practice.
Explains that experts examine their experiences and responses as they occur and adapt their practice simultaneously, even intuitively, whereas novice practitioners follow procedures without question.
Analyzes how greenwood (1993) criticises schon's ideas for not acknowledging the importance of reflection before action, while moon (2004) believes reflection in action is unachievable because it is not possible to distance oneself from the situation.
Explains gibb's (1988), john' (1995) and driscoll’s (2007) reflective models exist to guide reflection. argyris and schon (1996) develop these models by adding single loop learning, which involves the modification of personal objectives, strategies or policies.
Explains driscoll's (2007) model of structured reflection and argyris and schon’s (1996) single and double loop reflection.
Narrates how they felt the system failed a 26-year-old nursing student with complex chd.
Explains that pac's aim is to reduce the cancellation of cases, improve throughput and efficiency by identifying problems that can affect a patients admission.
Opines that it is important to experience anger, sorrow, failure and apprehension as these feelings are our teachers. failures can drive one to search for answers resulting in new learning and practice change.
Explains that they have little experience of caring for patients with achd. advances in surgical procedures have resulted in patients living longer.
Explains that the current trend is to transition patients into adult care. smooth transitions are essential to prevent complications and lapses in care
Opines that the lack of formal education for nurses and the current low level of nurses’ knowledge about achd are among the top five challenges for the next decade.
Explains that lawler's research found that most nurses in her study were not comfortable caring for patients with achd. this discomfort may be related to a lack of understanding and knowledge.
Explains that they knew that pacemaker generators could be inserted in the abdomen but had expected it to be lower down than this one was sited. the scar stopped them challenging the treatment plan.
Explains that benner used dreyfus's model of skill acquisition to develop a pathway from novice to expert in nursing.
Explains that even expert practitioners can become less reflective in action due to repetitive work practices. a habit based system can have detrimental effects in routine practice.
Explains that there is a high demand to increase efficiency and throughput without reducing the volume of work. efficiency can sometimes affect patient care as in the case of x.
Explains that workload pressures, lack of specific knowledge and repetitive nature of the pac process have driven them to follow a standard approach to the consultation.
Explains how fay identified curiosity, commitment, and intelligence as prerequisites to reflection. curiosity is fundamental to creative thinking.
Opines that openness is the best policy and by being honest, it was more likely to restore x's trust in the health care service.
Explains how x's chd and surgery were complex. the surgeon documented in the notes that the future was uncertain following this type of surgery.
Explains that when they re-read their documentation, they may have become distracted by his concern over his pacemaker twitching and that he looked and behaved normally. his chd was complex.
Opines that taking the achd course has given them a better understanding of the condition, its investigations and treatments, and will improve their assessment, planning, implementation and evaluation of their care.
Opines that they will devote more time to reading achd patient’s notes and visualise the functioning of their heart, to improve their practice and advice.
Explains that some achd patient's notes are difficult to understand and often have contradictory entries. they state that written communication should be in a language that is easily understood.
Advises that achd patients should carry a health care passport to inform healthcare professionals. it should contain important historic information including comprehensive diagnostic data, procedures, operations, medications, treatment plans and contact numbers of the relevant clinicians and specialist nurses.
Suggests that achd patients are given longer appointments, or the last appointment of the day, to ensure enough time to investigate and understand their case. the format of pac appointments should vary to suit the needs of these patients.
Concludes that their newly acquired knowledge of achd will enable them to ask the right questions. future reflection will help them develop this further.
Reflection has its importance in clinical practice; we always seek to be successful and that can be achieved by learning every day of our life through experiences we encounter. In that way we can reconsider and rethink our previous knowledge and add new learning to our knowledge base so as to inform our practice. Learning new skills does not stop upon qualifying; this should become second nature to thinking professionals as they continue their professional development throughout their careers (Jasper, 2006). According to Rolfe et al. (2001), reflection does not merely add to our knowledge, it also challenges the concepts and theories by which we try to make sense of that knowledge. Acquiring knowledge through reflection is modern way of learning from practice that can be traced back at least to the 1930s and the work of John Dewey, an American philosopher and educator who was the instigator of what might be called ''discovery learning'' or learning from experience. He claimed that we learn by doing and that appreciating what results from what we do leads to a process of developing knowledge, the nature and importance of which then we must seek to interpret (Rolfe et al., 2001).
In this essay, the author
Explains that it was an unethical and irresponsible action by the acp not to check or double check the drugs with the anaesthetist before their administration and to delegate an unqualified staff member to give any drugs without supervision.
Explains that drug-administration errors during anaesthesia are common in many countries, which gives the impression of this being an international problem.
Explains that s admitted that reporting was voluntary and vulnerable to bias or variation in the degree of compliance. they did not mention if the anaesthetists who worked emergency were involved in this research.
Explains that they started teaching students about drugs and colour-coding, and the importance of drugs checks, including strength, doses and expiry dates.
Recommends that a memo be distributed to all anaesthesia departments with the incident details, including the pharmacy.
Explains the feasibility of confirming drugs administered during anaesthesia. a qualitative study in pilot nhs sites, england and wales.
Explains that webster cs, merry af, larsson l, mcgrath ka, weller j. the frequency and nature of drug administration error during anaesthesia.
Explains that reflection has its importance in clinical practice, and that it challenges concepts and theories by which we try to make sense of that knowledge.
Recommends that anaesthetists and other professional groups implement methods of confirming drugs to avoid errors in this process.
Cites clamp, gough, land, and evley, russell, mathew, hall, gemmell and mahajan.
Explains that jasper, m., munhall, p. and beck, c. (2007) nursing research: generating and assessing evidence for nursing practice.
The position statement in paper 2 has an introduction and conclusion, as well as have used a large amount of evidence in the context to demonstrate the contribution of reflective practice in the health care setting. This essay has used credible and relevant references on most occasions. Nevertheless, it is not well structured. The author does not provide a clear plan for this position statement in the introduction, the context is lack of argument, and there are new information presented in the conclusion. The author does utilise several evidences from journal articles and NMBA, and yet have insufficient consideration of alternative views. Furthermore, some sentences in the context are not coherent and logical.
In this essay, the author
Analyzes how the position statement in paper 2 has an introduction and conclusion, as well as a large amount of evidence to demonstrate reflective practice in the health care setting.
Argues that reflective practice plays an essential role in nursing practice. the nmba competency standard regulates and educates registered nurses to improve nursing knowledge and skills while providing patients with the best quality of care.
Agrees with 's opinion that reflective practice can assist registered nurses recognise unprofessional practices, avoid the recurrence of dangerous practices and improve nursing practice through seeking help from others.
Bulman, C and Schutz, S. (2004). Reflective Practice in Nursing. Australia: Blackwell (3 ed). pp.29.
In this essay, the author
Explains that trust is an important strategy in therapeutic relationship. nurses should develop trust in their clients mind so that the client can discuss the problem with the nurse.
Explains the three stages of reflective practice: self-awareness, intuition, critical thinking, and emotional intelligence. nurses should be able to plan and monitor their actions to improve the client's care.
Explains that nurses have reflective tools to improve their own practice by journaling, sharing information, sleep and rest, personal hygiene, vital signs, food and nutrition, and developing skills.
Explains that vital signs play a crucial role in saving someone's life and shows how our body functions. nurses should be engaged more in carrying out information and practicing those concepts critically with the rationales.
Explains that emotional intelligence is an ability to reason out with the emotions and with emotions promoting thinking and understanding the importance of those emotions. reflective practice means thinking positively and analyzing critically of one’s action.
Explains that emotional intelligence and reflective practice are integral components of building a therapeutic relationship in nursing.
Explains that nurses should be sincere and honest with patients and communicate with them with interest. communication is a major concern in therapeutic relationships.
Cites bocchino, medialdea, and schutz as examples of classroom strategies improving interpersonal communication skills in nursing students.
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.
In this essay, the author
Explains burnard, p., learning human skills: an experimental and reflective guide for nurses and health care professionals.
Opines that the nurse patient relationship will prove key to effective medication adherence. nursing times 105(3).
Explains that reflective practice has become a necessary skill for health professionals to ensure that they are continuing with their daily learning and improving their practice.
Explains that the first stage of gibbs' model of reflection requires a description of events.
Explains that the nurse patient relationship is considered the core of nursing, and emphasizes the importance of the relationship between the source and the receiver.
Opines that reflective practice is becoming an essential skill that is incorporated into clinical practice and cpd and it is important that the nurse understand the role and the potential of reflection.
Describes the nursing and midwifery council's code guidelines for records and record keeping. o'shea, e., factors contributing to medication errors.
Burns, S. Bulman, C. Palmer, A. (1997) Reflective Practice in Nursing - The growth of the professional practitioner. London: Blackwell Science.
In this essay, the author
Describes how they felt comfortable and accepted within the mdt meeting. everyone seemed to have something to contribute. they felt they could have contributed if they had known the patient better.
Explains that clear leadership and good communication between members of the team is vital to ensure they come together with a clear understanding of outcomes to be achieved and equally equipped with all the information available to overcome patients' individual problems.
Explains that good teamwork and communication between each other is vital to the outcome of the package of care decided. they will address this learning need by working closely with their mentor and other multidisciplinary team members.
Explains that perkins, r., repper, j. (1998), dilemmas in community mental health.
Explains the purpose of the essay, which is to discuss the importance of multidisciplinary teams within the mental health environment and discuss factors that can influence their success or failure.
Explains the advantages of a multidisciplinary team approach, such as collecting facts and bringing information together to obtain complete views of the problems of each individual patient. gibbs (1988) is the model to help with their reflective process.
Describes how kate, a 66-year-old nurse, was referred to the hospital after presenting with an 18-month history of memory problems. she was observed to be repetitive, disorientated, with poor concentration and short-term memory.
Opines that the mdt worked well together as a team with the same goal in mind. kate will hopefully be able to remain in her own home, safely for as long as possible.
Analyzes how kate's illness affects her and her family. the mdt arranged a case meeting with the son so that all the different options could be discussed.
Introduces burns, bulman, palmer, a., darby, marr, crump, scurfield, and gibbs.
A key technique current and nurses in learning can use is reflection based on past experiences. This method of critical thinking enables the user to have an approach of systematic analysis for present and future scenarios with the intent of improvement. In terms of knowing, reflection has appeared to be a crucial part of learning and understanding. (Bonis, 2009).
In this essay, the author
Explains that nursing can distil stagnation while advancing with the constant flow of healthcare, providing ever increasing care. reflection based on past experiences is a key technique for learning and understanding.
Explains that using the five r's the nurse can organise their thoughts in an effective manner while being an efficient cycle to use in a range of situations.
Explains that the cycle starts with reporting raw facts and data on the situation, whether the end result was positive or negative and why, relating experiences, applying reasoning to form a rationale for the actions taken and then evaluating upon the rational
Describes how they underwent a simulation based on six exercises, where they were mostly first-year students. the experienced student led the group when necessary and gave us room to learn.
Describes the tasks they took to improve a critical health consumer's life via an iv bag, clean an elderly waste deposit, and replace the diaper. they then practiced small talk while recording vital hydration information.
Opines that the class was brought together for a short discussion on various topics, including cleaning and care of the fecal matter, which made them uncomfortable due to the smell and opposite gender.
Explains that the first scenario was a brief example of what an issue may occur on the upcoming practical. the whole group supplied reasonable solutions and then the key answer, an "i" statement.
Describes how they had to rush back to the lockers to retrieve their student identification and mini clock. each item was used a great deal the proceeding tasks, to introduce themselves and assist in taking vital observations.
Opines that the second scenario was to test the group's scientific knowledge and then apply it to the example presented.
Opines that the group tried their best to answer each question, but certain parts took some time to understand. the teaching staff guided them in a positive manner.
Explains that the next group transition made them nervous as it seemed to be the first practical activity. reflection guided may be used to reduce stress.
Explains that their fears were proved correct with the safety gear present and the apparent foul smell. they volunteered to help and thankfully was not the student nurse giving care, but the assistant leading them near the health consumer.
Describes how their sim was designed with personal judgement and privacy in mind. they started small talk to help keep the health consumer at ease since their group members did not make an effort.
Explains how the group figured out the health consumer's fluid intake was too low and concluded on that.
Explains that the group rushed to the aid and immediately administered first aid, checked vital observations, estimated results of the glasgow coma scale, removed health hazards, and sent forth assistance from the supervising practitioner.
Opines that an addition of guidance and involvement would be beneficial for the students to further develop reflection skills.
Concludes that they have personally learned more about what being a nurse entails and that there is so much more to learn and experience. if they are to succeed, they will need to reflect on future events and put more effort into studying the field.
Middleton, J. (2004). A Practical To Promote Reflective Practice Within Nursing .Retrieved March 31, 2004 from www.nursingtimes.net.
In this essay, the author
Explains that emotional intelligence and reflective practice are integral components of building a therapeutic relationship in nursing.
Explains that perceiving emotions or identifying certain emotions is the first step in becoming emotionally intelligent. reasoning with emotions helps the client prioritize and pay attention to what is important and not.
Explains that nurses are advised to be emotionally intelligent because it improves their work performance, their physical and mental health, and their nurse-client relationship.
Explains that reflective practice is a means of examining ourselves. it involves thinking back on past events and looking forward to improve our professional growth. nurses and nurse educators are constantly reminded to engage themselves in reflection practice.
Explains that reflective practice is important in nursing as it improves a nurse's performance and helps them develop more effective ways of carrying out their work performance.
Explains that reflective practice is important in the nursing profession because it shows both the positive and negative outcomes of an action.
Explains reflective practice has been an effective way of teaching nursing students and professional nurses how to convey their past experiences and assumptions.
Explains that self awareness is the understanding of one's self through their strengths, weaknesses, values and beliefs. it is also about observing our response to certain events whether good or bad.
Explains that it is important for individuals to be self aware so that they can have a better understanding of who they truly and really and improve the way they choose to live their life.
Defines therapeutic relationship as a helping relationship based on mutual trust and respect, the nurturing of faith and hope, sensitive to self and others, and assisting with the gratification of your knowledge and skill.
Explains that therapeutic relationship is important in nursing because it improves the nurse-client relationship, improved the clinical outcome of a patient, allows the client to comply with all treatments given and reduces frustration and anger.
Explains that a good therapeutic relationship can be achieved through verbal communication such as talking, using an interpreter when you do not understand the language, speaking slowly and listening carefully, and taking notes.
Explains that nurses need to establish interpersonal skills to attain therapeutic relationship. interpersonal skills include the ability to communicate verbally and non-verbally, developing good listening skills, and negotiating and solving problems as a team.
Concludes that nurses need to be emotionally intelligent, self-aware, create a therapeutic relationship, and develop reflective practices in order to communicate well with their clients.