example of reflective writing using gibbs

example of reflective writing using gibbs

Reflective Writing Using Gibbs

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1. Introduction

This incident was brought to my attention by a colleague who was talking to me about the difficulties of power abuse and the corrupted actions of many healthcare professionals. My first feeling was one of shock and repulsion that such an incident could happen in a supposedly caring environment. At this point, I was working on an infection control program focusing on raising awareness of MRSA. Much of my project was referred to highlighting poor practices of healthcare workers and the effect this has on the spread of infection. Thus, an incident regarding the safety of aseptic techniques had strong relevance to my work.

The incident involves the conspiracy of silence and demonstrates similarities to the work of Francis (1999), focusing on the abuse of power and its impact on the healthcare environment. This secretive incident involves a junior doctor who had found that a nurse was using an incorrect needle to administer a drug to a patient in a busy emergency department. The doctor had informed the nurse that this was dangerous and should not be used. The nurse then spoke to the charge nurse in private. Neither the doctor nor the patient was informed of the conversation, and a decision was made to cover up the mistake by the nurse, albeit to protect her from mistakes. Both the doctor and patient were unaware of the conspiracy of silence and were thus not informed of the mistake.

The purpose of this text is to produce a reflective account of a critical incident using a suitable model. In this reflective account, I will focus on an incident that I have related to in my recent role as an Occupational Health Nurse Advisor in an acute care NHS trust. I will be using the Gibbs model of reflection. This model is particularly good as it is a simple, clear framework and effective in promoting a reflective process.

2. Description of the Event

– Now what? Again, for each aspect of the description ask ‘now what?’. This is where you begin to think about how you might do things differently in a similar scenario in the future. E.g. a newly qualified staff nurse is writing a reflection on an event where a urinary catheter needed to be inserted for a patient, but a more senior colleague was not available to carry out the procedure. Asking ‘now what?’ might highlight some of the anxieties and uncertainties this colleague faced, and identify his or her learning needs in this area.

– So What? For each aspect of the description ask ‘so what?’. This will deepen the level of critical analysis taking place. E.g. a student describes how they felt very nervous before giving a presentation. ‘So what?’ reveals a belief that feeling nervous is a bad thing, which might not necessarily be the case.

– What? Begin by describing the event (you may be writing about a specific experience, but you will also be reflecting on an area of your practice in a generic sense – so be clear about which one you are writing about). What happened? This should be a purely factual account of the event, which might be useful in the future for trying to reconstruct the thoughts and feelings of the time in greater depth. Try to use this description as an opportunity to begin ‘sense making’ into what happened. As well as asking what happened, asking why it happened can be useful in terms of beginning to shape perceptions and beliefs about an event.

As well as helping you to write a full account of an event, this stage in the cycle also invites you to begin the process of making sense of the event. Before moving on to the next stage of the cycle, have a good think about the event and ask yourself if you have written enough. The following framework can be used as an option for describing the event, although you should always modify it in a way that makes it feel most comfortable for you.

3. Analysis and Evaluation

Looking back at this event and how I felt, I interpreted it as a useful experience due to the fact that I can learn from this mistake. In a similar situation, I would now take more time to prepare the consultation, gathering information about my patient’s condition with the intent of making sure he fully understands his condition and the available treatment. This would require me changing the way I communicate with a patient, and the level of information I can provide may be in a week. This is something I need to assess in the future.

During the consultation, I was so involved in my role that I became upset and angry. This was something I did not foresee or intend to happen; therefore, it was an unpleasant experience. I felt that I let my patient down as I did not find the appropriate information that he was seeking, and I caused him to become more agitated, which was evident when my role play patient said, “now look what you’ve done.”

In the hospital’s accident and emergency department, I experienced a role play simulating a patient consultation. I took on the role of a confused patient with cancer. I became very distressed and agitated due to the fact that I was not receiving clear information about my condition. I recall saying, “I feel like I’m stuck in the middle and I do not understand anything.”

The analysis and evaluation of the event is based on three main components: description, how I felt, and how I could have handled the situation better. If the event were to occur again, I would react in a much different way, learning from the previous experience.

4. Conclusion and Learning

Firstly, I would like to say that I am quite happy with the finished result of both the ethical approval application and the service user information leaflet. Throughout the course of this assignment and reflective report, I have learnt many things about the ethical conduct of qualitative research and how NRES guidelines help shape research tools in order to protect the rights of the research sample. I feel that this knowledge will be quite beneficial in my progression into the clinical doctorate and through to becoming a qualified clinical psychologist as it has allowed me to see and fully appreciate what goes on before actual research data collection and how important this phase of research is. It has also highlighted the complexity and multi-faceted nature of qualitative research which I will be better prepared for when critically appraising new research articles in the future. All of these lessons have had a huge influence on how I have shaped the research tools for this assignment and I will definitely be taking this knowledge forward into future research projects.

5. Action Plan for Improvement

I do not feel that the experiences discussed in this essay have had a negative effect on my self-esteem or ability in practice, but rather an opportunity to enrich my learning. An alternative action plan to the one above may be to avoid certain situations or placements and to only seek knowledge in areas I feel safe. This would be a safer option, preserving my self-esteem and avoiding these stressful emotions. However, this conflicts with Student Nurse training and the NMC code of conduct. A lot of the knowledge here would not have been gained, and I would have less ability in decision-making in the future. This would have been a short-term ideal solution but with long-term consequences.

Some action plan for the future was decided upon as a result of this reflection. The things I have reflected on and plan to change for my future practice are: When on placement there is often a lack of guidance, whether using scenario-based learning or real patients. I need to be better prepared, utilizing evidence through increased reading and notes from previous sessions on that topic to ensure I get the most from the experience. This will allow me to identify the tasks I must undertake and see the most effective ways of doing so, again increasing learning further. At times of difficulty, I need to remember to step back and think about what I have learned in the past and seek advice from classmates or lecturers. Any event can be seen as a learning incident. As mentioned in the introduction to this essay, I must continue to search for knowledge and develop the abilities. This may be a long-term goal but can be achieved. Finally, organization is crucial to time management, and so I intend to use a diary for work and placement activities and a task priority list to avoid stress of an unfinished.

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