Reflective practice in nursing Reflection is an integral component of personal and professional self-nursing. But in today’s world, reflection is considered something ethereal and special. Few people can reflect on how it should be done, and the rest of us can learn the art of reflection under exceptional guidance.
Reflection is defined as an assessment, evaluation, and intervention. When a nurse makes an assessment, he/she takes information and then creates an intervention based on the information. When we evaluate a situation, we form an opinion based on the result of that evaluation, causing the continuation of the cycle of assessment, evaluation, andintervention. This is a simple iteration.
As nurses, we’re naturals in reflection. It is a vital aspect of nursing practice. Reflection is necessary for the success of nursing care.
Reflection should be focused, purposeful, and questioning. Many nurses think that they reflect regularly. They may, but for this reflection to be purposeful, the nurse must ask what they did or are doing, what might happen, and its relationship to their objectives. Nurses should be more careful when situations go in the desired direction or investigate why something went well or wrong.
By adopting a strategic and structured approach, nursing practitioners can link experience to the intentions of what is or is being attempted.
Why is reflection special?
Take your mind back to your first in-person clinical. There was a lot of information about humans, their physiology, and perhaps their spirits. In this clinical period, you had to interact with a live human, incorporate everything you had learned, and apply it. But this wasn’t a person’s idea or an object. It was a natural person. The person had their agenda, which you had to incorporate into your care. Recall the hours you spent working to actualize your nursing care plan. It was somewhat agonizing to try remembering, looking up, or even asking questions of others so that your care met this person’s needs. You were reflecting without even knowing it.
Reflective practice in nursing Reflection is a skill and is typically slow at first. There is a stop moment, one where you do an intentional consideration. Your first in-person clinical was designed to accommodate multiple stop moments, creating a chance to consider your assessment, pool the resources and information to meet your patient’s needs, and then discuss your plan with your patient to evaluate the outcomes together. Every time you provide nursing care, you unwittingly build your reflection skill. As you grow from a novice to an expert, you reflect even without considering it.
In self-nursing, we have many opportunities to reflect throughout the year. We use the calendar to mark the beginning of a new season or year. Faith traditions help us to identify significant holy times or days. As nurses, our professional practice prompts throughout a shift. Work is the same concerning our self-nursing care plan. We assess the condition, intervene, and evaluate with reflection.
What is the outcome of using our nursing skills on ourselves?
We become immersed in our reflection. We do not remember that we also are humans, just like those we care for. Our bodies and lives need to be healthy. We may not focus on a particular situation, whether joyful or stressful. We keep moving from one thing to the next. Sometimes, we may be unkind to ourselves and wind up in a state of negativity. And that’s hard to leave. The good news is that life is cyclical, and we can always make a choice, and it is best to make the same choice – the choice of reflection (self-nursing) over and over.
- Reflection is a critical component of nursing practice, allowing nurses to evaluate their actions and improve their care.
- Reflective practice can improve clinical outcomes, enhance patient safety, and increase nurse job satisfaction.
- Effective reflection requires self-awareness, critical thinking, and a willingness to learn from mistakes.
- Reflection can be challenging and uncomfortable, but it is essential for personal and professional growth.
- By making reflection a habit, nurses can enhance their performance, reduce burnout, and improve their overall well-being.
Here are a few case studies that demonstrate the importance of reflective practice in nursing:
Case Study 1: Medication Error
Mary is a registered nurse who works in a busy hospital. One day, she administered the wrong medication to a patient, which resulted in adverse effects. The patient tried to tell Mary it was the wrong medication and refused at first, but she insisted it was correct. Mary was devastated and felt like she had failed as a nurse. However, she used this experience as an opportunity for reflection. She analyzed what went wrong, identified the root cause of the error, and developed an action plan to prevent similar incidents in the future. Mary also discussed the incident with her colleagues and sought their feedback. Through this process of reflection and learning, Mary was able to turn a negative experience into a positive one and improve her practice as a nurse.
Had a similar experience? Here are some reflective questions to ask yourself:
- How did you feel when the patient refused to take the medication, and how did you manage your emotions?
- Did you use any specific communication techniques or strategies to try and persuade the patient to take the medication?
- In retrospect, was there anything you could have done differently?
- How did the patient’s refusal to take the medication impact the care plan, and did you have to make any changes to accommodate this?
- Did you discuss the situation with other healthcare professionals or seek colleague advice? If so, what did they suggest, and did you find their advice helpful?
- Did you take any steps to prevent a similar situation from happening again? If so, what were they?
Case Study 2: End-of-Life Care
John is a nurse who works in a hospice care setting. He recently cared for a dying patient who had no family or loved ones to support them. John struggled to cope with the emotional burden of the situation and questioned his ability to provide compassionate care. However, he recognized that his feelings were a normal part of the grieving process and used reflective practice to process his emotions and learn from the experience. John sought guidance from his supervisor and attended a bereavement support group. Through this process of reflection and self-care, John regained his confidence and provided better care to his patients.
- How did your values and beliefs about end-of-life care impact how you cared for this patient? Did you need to adjust your approach at any point?
- Were there any ethical or moral dilemmas you faced while caring for this patient? How did you navigate those challenges?
- Did you find it challenging to provide compassionate care to patients with no family or loved ones to support them? If so, how did you work through those feelings?
- Did you identify any areas of your practice that could be improved through this experience? If so, how will you work to address those areas?
- How did you communicate with the patient about their end-of-life care? Were there any challenges or barriers to effective communication?
- What did you learn from this experience that you can apply to future end-of-life care situations?
Case Study 3: Cultural Competence
Maria is a nurse who works in a diverse community. She recently cared for a patient who spoke a different language and had cultural beliefs that were unfamiliar to her. Maria struggled to communicate effectively with the patient and provide culturally sensitive care. However, she recognized the importance of cultural competence in nursing and used reflective practice to improve her skills. Maria sought resources to learn more about the patient’s culture, engaged with an interpreter to facilitate communication, and reflected on how to apply this knowledge to future patients. Through this process of reflection and learning, Maria was able to provide more effective and compassionate care to her patients from diverse backgrounds.
- Besides language, what other cultural beliefs or practices did the patient have that were unfamiliar to me?
- How did my lack of knowledge about the patient’s culture impact my ability to provide effective care?
- What resources or strategies did I use to improve my cultural competence?
- How did the interpreter facilitate communication with the patient, and what did I learn from this experience?
- How can I apply what I learned about cultural competence to future patients from diverse backgrounds?
- What can I do to continue developing my cultural competence as a nurse?
- How did my personal beliefs or biases impact my interactions with the patient, and how can I work to address them in the future?
- What did I learn about the importance of cultural competence in nursing through this experience?
To learn the easiest ways to get started on Cultural Competence, start here:
Setting aside time for reflection is essential in nursing practice, as it allows nurses to process their emotions and experiences, learn from their mistakes, and identify areas for growth. An example of this would be a nurse who takes a few minutes at the end of each shift to reflect on their interactions with patients, what went well, and what could have been improved.
Seeking guidance and support from colleagues and supervisors is also crucial, as it allows nurses to receive feedback, advice, and encouragement from those who have more experience or expertise in a particular area. For instance, a nurse who encounters a complex patient case may seek guidance from a more experienced colleague or their supervisor to ensure they are providing the best possible care.
Continuously learning and growing through resources such as journals and training programs is essential in nursing practice, as it allows nurses to stay up-to-date on the latest research and best practices, and develop new skills and knowledge. For example, a nurse who is interested in improving their cultural competence may attend a training program on cultural humility or read articles in nursing journals focused on caring for patients from diverse backgrounds.
In addition, joining a nursing community or peer group can provide an opportunity for nurses to reflect and learn from others, share their experiences, and receive support and encouragement. Nurses can also use self-care practices such as meditation, exercise, or journaling to reduce stress and promote overall well-being. Ultimately, incorporating reflection, seeking guidance and support, and continuous learning and growth can help nurses provide the highest quality of care to their patients while maintaining their own emotional and mental health.
In conclusion, reflective nursing is a crucial practice for nurses to provide the best possible care to their patients while also taking care of their own well-being. By regularly reflecting on their experiences and emotions, nurses can learn and grow from their mistakes, improve their skills and knowledge, and develop greater empathy and compassion towards their patients. This practice can be challenging at times, but it is essential for nurses to prioritize their own self-care and well-being to be able to provide the best care to their patients. Actionable steps to incorporate reflective nursing into practice include setting aside time for reflection, seeking guidance and support from colleagues and supervisors, and continuously learning and growing through resources such as journals and training programs.
By consistently choosing the path of reflection, nurses can continue to improve their practice and positively impact the lives of their patients.
Rolfe G, Jasper M, Freshwater D (2010) Critical Reflection in Practice. Second edition. Palgrave Macmillan, Basingstoke
Nursing and Midwifery Council (2015a) Revalidation. www.nmc.org.uk/standards/ revalidation (Last accessed: March 31, 2016.)
Nursing and Midwifery Council (2015b) The Code. Professional Standards of Practice and Behaviour for Nurses and Midwives. tinyurl. com/k5mlard
Howatson-Jones L (2010) Reflective Practice in Nursing. Second edition. Learning Matters, London
Johns C (2013) Becoming a Reflective Practitioner. Second edition. John Wiley & Sons, Chichester