Critical Reflection of and Experience with a Patient with Congenital Heart Disease

The aim of this essay is to critically analyse a clinical incident involving an adult with Congenital Heart Disease (CHD). I will define reflection, then select a reflective model and critically reflect on the incident demonstrating my new found knowledge. Lastly, I will suggest how nursing practice should change to improve the care of this group of patients.

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, as opposed to traditional forms of learning.

Definitions of reflection vary depending on the discipline of the author. Having reviewed the literature, Bulman (2008, p.2), a nurse, defines it as “reviewing an experience from practice so that it may be described, analysed, evaluated and used to inform and change future practice”. It is a personal process requiring honesty, openness, self-awareness, courage and a willingness to act on criticism. It acknowledges that feelings and emotions influence actions. Critical reflection involves in depth examination and questioning of personal, social, historical, cultural and political assumptions and perspectives that are embedded in actions. It is an active process enabling one to make sense of events, situations and actions that occur in the workplace (Oelofsen, 2012). It transforms a situation in which there is confusion and doubt to one that is clear and coherent (Dewey, 2010).

Schon (1983) identified “reflection on action” and “reflection in action”. In reflection on action, professionals consciously scrutinise their past practice to gain insight and improve future practice.

In reflection in action, expert professionals examine their experiences and responses as they occur and adapt t...

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...or in depth history taking and sharing of information. As my knowledge of ACHD develops, this will need to be reviewed. Now that I have developed a greater knowledge of ACHD and am more familiar with the ACHD nurses and doctors, I will not hesitate to seek advice from them as required.

To conclude, my newly acquired knowledge of ACHD will enable me to ask the right questions. Future reflection will help me develop this further. This is supported by Dewey (2010) who says it is impossible to reflect against an idea if one has not had experience of a similar situation. It will help me advance along Benner’s (1984) pathway. I will share my knowledge with colleagues and patients and encourage others to enrol on the course. Lastly I will support the introduction of patient passports for ACHD patients to improve communication between patients and health care professionals.