example reflective writing nursing

example reflective writing nursing

The Importance of Reflective Writing in Nursing

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1. Introduction

The purpose of this essay is to reflect on the importance of reflective practice in clinical and theoretical outcomes. It is mainly to expound on an experience with a patient during the clinical placement and the related changes in the feelings and thoughts of the author. Step one of reflective practice is a self-awareness phase. In this, using structured self-reflection, the author is able to provide an explanation and understanding to take the best possible action, thus providing the best possible care to the patient concerned. The Gibbs cycle (see figure 1) encourages a clear description of the situation, analysis of feelings, evaluation of the experience, and analysis to make sense of the experience and examine whether other options could be drawn from the situation. The final stages are an increased knowing of the actions required when the situation arises again and empowerment of the aforementioned action.

Reflective practice has gained increasing momentum in nursing, and there is growing consensus on the importance of this activity in the education and development of healthcare professionals. Reflective writing is a vital skill in nursing in that it enables nurses to make sense of and learn from practicing clinical situations. This is a competency requirement for most healthcare professionals. Learning through reflection is a process of internally examining and exploring an issue of concern, triggered by an experience, which creates and clarifies meaning in terms of self and results in a changed conceptual perspective. It is a valuable skill for nurses as it helps them to theorize practice and better understand the complexities of the care they provide. Reflective writing explains that the more nurses are able to express their understanding of the relationship between their actions and the consequences, the more they will be able to assess, plan, and implement new actions. This is an essential stage in the cognitive learning process. Cognitive learning processes involve attaining knowledge through thought, experience, and the senses.

2. Benefits of Reflective Writing in Nursing

Johns (1994 451) narative crib sheet uses a cue or “trigger” to help the practitioner reflect on a particular incident. He describes the event in detail, listing what happened during the incident, “whilst on shift in the disability home my mentor asked me to follow her into the stockroom where she asked me to watch her give a service user an injection.” I felt as if I did not want to follow her into the stockroom, or watch her give the service user the injection, but I done a HCA does no child left behind essay test, there’s more than enough evidence that what I am doing is correct nm2 and it would be deceitful if I told my mentor that I was not comfortable watching her, so I thought I would say to her at a later date. And my final thought is what spurted my decision during the incident. The cue then reveals the practitioner’s feelings and thoughts during the event. Lastly, the practitioner will consider what can be learnt from this incident, and what changes can be made in order to improve the same event if it occurred again. This particular model of reflection will be used because it helps to look at personal thoughts, and using the step-by-step format, will make things a lot clearer.

Reflection is an imperative component of nursing. Riberson (1997) shines on a simple reflection through “to reflect on action requires looking back on what has happened so that its experience can be understood and learning enhanced” (p. 6). Reflective practice is increasingly the professional text complex magazine writing staff because of the flexibility and positive outcomes. It is a process where an individual thinks about experiences, and it is generally triggered by an experience, and it has a positive or negative outcome. The essay will describe and discuss a situation from a practice placement, in this case an in disability home, and reflect on the motivation behind the decision and the positive learning that has emerged.

3. Techniques for Effective Reflective Writing

The first two techniques that are commonly suggested are self-reflection and effective communication. Boud et al (1985) defined reflection as “a process of reviewing an experience of practice in order to describe, analyse, evaluate and so inform learning about practice”. This can be achieved by thinking and making notes about a certain experience. Johns (1994) explains that the value of reflection is in gaining a better understanding of the self, as self-awareness is a prerequisite for effective communication. Johns goes on to suggest that effective communication can be achieved through an intensive writing process, enabling a clear description of a situation or experience. By communicating effectively on paper, a nurse can better explain an experience or a concept, which in turn will help them to understand better. Johns (2004) also explains that the writing process will help the writer make more sense of a situation, it will show what has been learned from the experience, as well as indicating what more needs to be learned. This is a useful strategy for identifying what knowledge an individual has gained as well as aiding the planning of future learning. This is a benefit which would transfer over to a health professional’s practice. Reflective writing can also enhance the practitioner’s confidence, as they will have evidence of skills development and learning to refer back to whilst at the same time continuing to improve their practice. This in turn may increase the ability to provide effective care for patients.

4. Incorporating Reflective Writing into Nursing Practice

Another aspect to consider is whether the reflective documents are to be personal or made public between healthcare professionals. Joint documentations can have benefits to individuals writing them because they can later bring the document to discussions on the event being reflected upon. By pooling thoughts and ideas between individuals, events and experiences can be viewed from different perspectives, helping to clarify issues and promote understanding. This has been said to be useful in community health nurses reflecting on their caseloads, providing a visual map of their communities and a method which they can work through problems (Glass and Walter, 2000). The downfall to joint documentation is finding time for group meetings and the possibility for individuals to limit going in-depth during reflective work if they are conscious of sharing with others. Personal documents generally allow for more free writing and thought, with privacy being a non-issue. These documents are the exclusive property of the writer and can be used for a variety of reasons, including an aid to memory, a tool to work through a difficult situation or pattern of events, or documentation to show personal development over a period of time. Step one in reflection can involve a simple “pause and think”. This is very general and may not always lead to phase two, which is reflective writing. However, if thoughts and feelings on a certain matter are strong, an individual may naturally progress and record their reflections.

To incorporate reflective writing into nursing practice, a valid toolkit will be required. It is essential for the individual nurse to find the right style and context that will work in their field. Handwritten notes can be lost quite easily and scribbles on pieces of paper can be hard to read later on, potentially impossible to decipher. However, some nurses find that jotting down a few notes on paper is sufficient. A preferable method of reflective practice can be the use of a tape recorder. By speaking into a recorder, you are able to document personal thoughts and ideas on certain events which can later be transcribed into a diary or journal. Longhurst and Phillips (1999) used tape recordings and semi-structured interviews in their study and found the use of a tape recorder to be very useful. Electronically saving work is an effective method which can be easily formatted, spelling and grammar checked, and then printed to keep a hard copy. Each individual nurse needs to find what they are most comfortable with. When beginning reflection, it is often quite difficult for nurses to recall events that have taken place previously due to the fast-paced environment and sheer quantity of daily events and tasks. For reflection to be most effective, documentation should occur as close to the event as possible.

5. Conclusion

Through the process of reflective writing, the student nurse may continually self-evaluate their personal experiences. The nurse can then take isolation brings about a feeling of loneliness and depression. This can affect the patient’s ability to fight off infection and increase the length of recovery time. By analyzing the patient’s nutrition history, the nurse formulated two NANDA diagnoses. They are imbalanced nutrition more than body requirements and less than body requirements related to inadequate food intake as evidenced by patient having poor appetite and stating that he is not sure what he should be eating. The patient had been skipping meals and stated he has “no pep” and “feels run down all the time.” Achieved through intervention of a quality, utilizing evidence-based practice and resulting in research and analysis conducted to improve nursing care. Through continued analysis and modification of the care plan, the nurse can continue to use reflective writing as an unfolding case study to critically think about strategies used and the end result. In conclusion, reflective writing has been found to support and enhance critical thinking, continuing professional development, self-improvement, and the enhancement of nursing care.

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