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Reflection in nursing
Conclusion on reflection in nursing
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INTRODUCTION This paper aims to highlight an incident in theatre where environmental pressure has the tendency to lead to human error thereby compromising the patient’s safety. To reflect and critically analyse the situation, human factors, theories, guidelines and national policies that govern a theatre environment so as to improve the practice, raise awareness and prevent adverse event thereby improving patient safety in theatres. Nurses are constantly being encouraged to be reflective practitioners (Sommerville and Keeling, 2004). Reflective practice can be defined as the process of making sense of events, situations and actions that occur in the workplace (Oelofsen, 2012; Boros, 2009) It helps the practitioner in thinking and examining his actions and behaviour thereby, aids in his learning and improvement. Reflective practice is important for nurses. The NMC Code (2002) states that nurses are responsible for providing care to the best of their ability to patients and their families. As nurses, according to Sommerville and Keeling (2004), they need to focus on their knowledge, skills and behaviour to ensure that they are able to meet the demands made on them by this commitment. Identifying strengths enable nurses to learn, develop and grow professionally. A suggestion made by Schon (1991) states that there are two fundamental forms of reflection: reflection-on-action and reflection-in-action. He further defined Reflection-in-action as a means of examining one’s own behaviour and that of others while in a situation (Schon, 1995, 1987). However, Grant and Greene (2001) and Revans (1998), defined reflection-on-action as focusing on identifying negative aspects of personal behaviour with a view to improving professional comp... ... middle of paper ... ...ry. Furthermore, the circulating person should have kept the bowl liner inside the theatre until the operation’s completed, and the final count was undertaken and everything that was accounted for at the beginning of the case were out. The local trust policy (c) (2012) states that at no time should laundry, orange-bagged clinical waste, and non- clinical waste containers including suction liners leave the theatre. In line with the infection control standard precautions, the fluid that was taken in the sluice should have been sucked via suction tubing to the suction liner. The NICE (2012) guideline states that health- care-associated infections are caused by wide range of microorganisms. These are often carried by the patients themselves, and have taken advantage of a route into the body provided by an invasive device or procedure.
Step by step, this recognised framework aids us in asking ourselves the right and critical questions with self-development in mind. Questions such as: What has happened and how do I feel about what happened? How did I experience this? Good or bad? What can I do to turn this around? Or what did I do to make this a positive experience? Implementing reflective practice in the workplace benefits nurses by allowing them to continuously fine-tune and improve on their skills, thus reducing the risk of errors for all parties involved, and consequently ensures patients receive a better standard of care. To illustrate with a quote: “The outcomes of reflection are so profound, and so personally enlightening, that you are unable to let them go, or to return to former unquestioning ways.” (Emden,
Nurses are able to reflect upon their past experiences of work and build and improve this ensuring their level of competence and skills is in line with NMC guidelines. Improving the quality of care provided to patients is an ongoing process and requires practitioners to contently reflect and improve their practice. (Howatson-Jones, 2013) One way in which reflection can improve the quality of care is through the use of professional supervision, as stated by (Daly, Speedy and Jackson, 2014) a focus for supervision should be enhancing a nurse’s skills and ability to reflect on practice. It should reflect on the standard of care provided and highlight areas for improvement such as further training. This, in turn, leads to a greater self-awareness of practitioners’ own abilities. The process is not about finding faults, but to improve and learn to ensure the quality of care is high and professional for all patients. Being self-aware is a skill important to reflection and the provision of quality of
Burns, S. Bulman, C. Palmer, A. (1997) Reflective Practice in Nursing - The growth of the professional practitioner. London: Blackwell Science.
There are certain barriers in using reflective practice such as lack of proper resources to improve their learning experience. Some nurses are not aware of how to undertake reflective practice due to their lack of knowledge and also may be worried about documenting experiences and emotions. Furthermore, time is one of the main barrier for reflective practice, learning through reflective practice can be time consuming, and if a nurse is reluctant or shows lack of motivation to spend time in improving their skills or knowledge through reflection or reflective practices, it will not benefit in making any changes in their profession and also in their patient care. According to Forneris et al, (2009) lack of time can cause beginner nurses to become
Rolfe (2001) claims that reflection- in-action is more advanced form of thinking and leads to more advanced practice. He further describes that is it is a process of what the nurse is always testing theories and hypothesis in a cyclical process while simultaneously engaged in practice (Rolfe, 1993). It means examining behaviour and that of others while in a situation (Schon, 1995; Schon, 1987). “To be able to reflect one must step outside the experience in order to make the observance comprehendible” Gray (1998). “Aziza highlighted (Forum 2; Challenges and debates about reflective practice, Reflection-in-action/practice and Reflection-on-action/practice) that competent nurses encounter an unusual event or “wicked problem”. Rolfe (2014), calls it, the nurse automatically analyse, problem solve and reflects in that instant without even realising it.” Hence, it brings about confidence, skills and knowledge and anticipation in professionals in nursing. Professionals are accountable for their actions and in this case students, and new nurses would have an opportunity to think what could have been better to improve the
Freshwater, D., & Johns, C., (2005). Transforming nursing through reflective practice. ( 2nd ed.). (pp.101).Oxford: Blackwell.
Middleton, J. (2004). A Practical To Promote Reflective Practice Within Nursing .Retrieved March 31, 2004 from www.nursingtimes.net.
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.
Schön (1987) in his work identifies two types of reflection, these are reflection-in-action (thinking on your feet) and reflection-on-action (retrospective thinking). He suggests that reflection is used by practitioners when they encounter situations that are unique, and when individuals may not be able to apply known theories or techniques previously learnt through formal education.
It may have been something you did differently that had a positive result and you may conclude you would do it again upon reflection. The most important part of reflection is making sense of situations and events that occur so that our decision making and any actions we take lead to good, effective practice. Nurses have to keep a record of their continued professional development. At annual reviews, nurses are able to present evidence of their development through a portfolio which should contain reflective accounts of their practice. These reflective accounts will help them identify strengths and weaknesses, highlight their performance, improve their skills and highlight any areas that could be developed.
Reflective practice is crucial for nurses in continuous development and re- assessment of skills (Bulman & Schutz, 2013). As new innovations are made in healthcare systems more frequently and new tools, technologies and procedures are introduced, ongoing education and training for health care professionals is seen as a crucial strategy. One of the best methods for nurses to improve their knowledge and skills is through Continuous Professional Development (CPD). Reflective practice is an integral component in continuous professional development (Moon, 2013). Reflection when combined into a CPD is seen as an effective way to enhance and maintain reflective practice in clinical settings. CPD is a method of ongoing learning and upgrading of health care professional from preliminary qualifying education. Continuous Professional Development is a significant mechanism, because it ensures that all members of the nursing professions are able to deliver high quality nursing and services and keep pace with health care developments that affect their practice. CPD is very important in nursing because safety of the patients lays on the up to date knowledge and skills of each
In her article, Becoming a Self Mentor, Bloom states, “The capacity to reflect and engage in candid introspection is at the core of achieving self-awareness. Reflective practitioners think creatively, imaginatively, and at times self-critically about what they are doing. Individuals who use a variety of reflective practices have a better understanding of themselves” (pg. 55). If we value continuous programmatic improvements then practitioners must know themselves to effectively change and improve themselves. Teachers and directors cannot adjust or improve their attitudes or behaviors if they are unable to honestly acknowledge and own their actions. Reflection can help to close the gap between “espoused theories and theories in action” (Bloom, 2007). The best written handbooks and program manuals are meaningless if teachers and directors do not implement the philosophy and vision of the program as written.
Reflection is very much his basis for learning, although the concept of reflection was originally work from Schon (1983) Jarvis extended his idea, Schon’s work was very much credited and in the mid-eighties his work on reflection was put on the agenda of professional practice in the nursing profession. Likewise reflection is an important process when attempting to integrate theory and practice. Severinsson’s (1998) directed a study in which it showed how the reflective approach focuses on ways which knowledge can be used in practice and how it enables nurses to develop their own personal knowledge, his study indicated that personal growth enhanced a person’s skill and ability to reflect. Using reflection offers people an opportunity to review their decisions and to help learn from past experiences, which will positively influence future learning and practice. Some individuals may find reflection tough due to the self-awareness that is needed to be able to critically reflect in an analytical way (Steverinsson’s, 1998). The reason for this is that people have to be socialized to see themselves as passive recipients of knowledge instead of recipients of critical constructors. Being self-aware enables individuals to identify their own strengths and identify any areas for development,
Reflection and reflective practice are terms widely used by many professional groups this assignment will focus on the education sector, specifically primary education. Reflective practice was originally defined by Dewey (1933:9) as: “An active persistent and careful consideration of any belief or supposed form of knowledge in the light of the grounds that supports it and the further conclusion to which it tends”. Although dated, Dewey is considered a seminal author and referenced broadly when examining reflective practice (Ghaye and Lillyman, 2006., Tripp, 2012., Schön, 2014., and Carroll and McCulloch, 2014). Many others have subsequently provided their own definitions including Kolb (1984), Boud (1985), Schon (1987), and Gibbs (1988). In
An example in which reflective practice should have been applied in Michelle’s journey of treatment, was the way in which staff in the radiation therapy department at Peter Mac had treated her on her first day. All staff were focused on how to hoist her breast for the scans, however they did not consider asking the patient about her comfort, or informing her adequately on what they were discussing. Through my own personal reflective practice of listening to Michelle’s journey, by applying reflection on action the staff could have communicated more with Michelle and ensure she was comfortable and adequately informed about all procedures taking place. It is important to note that in this circumstance without reflecting upon individuals actions patients could feel discomfort and uneasy in practice and therefore reflective practice is an essential part in medical