Reflective Practice by Nurses

Introduction

Nurses are relentlessly encouraged to become reflective practitioners. Reflection makes nurses exceptional and competent practitioners. It also assists nurses to attain the core competency standards since they are able to work efficiently. Reflective practice has overtime been identified as a helpful tool that aids nurses in identifying their individual strengths and weaknesses. It is, thus, a process through which practitioners are able to understand themselves in a better way and to build on present strengths along with taking suitable future actions. The vital word is action: since reflective practice aims at developing professional actions, which are aligned with individual beliefs and values. This endeavors to bring the significance of reflective nursing for practitioners.

Reflection

Reflection refers to the evaluation of individual thoughts along with actions. For nurses this requires them to focus on the interaction with their colleagues along with the environment to acquire a clearer picture regarding their individual behavior (Somerville, 2012).  There exist two kinds of reflections namely, reflection-on-action along reflection-in-action. To start with, reflection-on-action refers to cautiously re-running in an individual’s mind’s events, which have happened in the past.  The objective is valuing the nurse’s strength and developing variant, more effectual methods of acting in future. The emphasis here is locating negative individual behavior aspects with the intention of improving professional practice. For instance NMBA (2014) registered nurse competency standards requires a registered nurse to demonstrate competence during nursing care provision, this is can be achieved by engaging reflective practice. Secondly, reflection-in-action is the characteristic of an experienced professional nurse. It requires a nurse to evaluate own behavior along with that of others whilst in a situation (Chong, 2009). It involves being a participative observer in situations offering learning practices, focusing on individual feelings while making connections with past experiences.

Importance of reflective practice

Reflective practiceis very important to nurses’ professional practice. Professional practice associates to professional, ethical, and legal accountabilities that require exhibition of an adequate knowledge base, practice responsibility, operating in accordance with legislation influencing nursing and healthcare in general, along with protection of personal and group rights (NMBA, 2014). Reflective practice is thus important due to a number of reasons (Freshwater et al., 2008). Firstly, nurses are accountable for offering care utilizing the best of their capability to patients along with their families. This requires them to focus on their individual knowledge, expertise and behavior in ensuring they are able to satisfy the requirements made on them through this commitment.

Secondly, reflective practice forms part of the necessity for nurses to constantly update their professional skills. Maintaining a portfolio provides significant opportunities for reflection on continuing development (Hannigan, 2008). For instance, yearly reviews allow nurses to attain self-awareness and opportunity areas for future development. Thirdly, nurses require taking into consideration ways that they interrelate and correspond with colleagues. The nursing professional calls for mutual support (Howatson-Jones, 2010). Thus nurses should aim at being self-conscious, self-directing and in contact with their environment. This can be achieved through critical thinking, which relates to individual-appraisal, professional growth and valuing evidence along with research for practice (NMBA, 2014). In addition, reflecting on practice, beliefs and feelings along with their consequences for persons/groups is regarded an essential professional benchmark.

How to be Reflective

Nurses might think they have insufficient time to live their lives and work let alone reflect regarding oneself. But there exist numerous ways in which one can reflect. The following are tools that  nurses can use in the crucial reflection skill and can only take a few moments.

1.   Feedback

This originates from other people in numerous dissimilar ways, verbal and non-verbal. Nurses receive feedback from other people regarding their behavior, skills, values and ways they relate with others and also about their identity. One can argue that an individual is who they are grounded on feedback received from others. This makes feedback fundamental to the reflection process (Kilpatrick & Purden, 2007). A nurse can acquire greater understanding of their performance by directly asking other individuals how they view a particular incident. This means that a nurse should develop a tendency of asking other relevant individuals how that individual perceives the nurse’s work (Howatson-Jones, 2010). For instance, would you give me feedback on how I performed? Of course, a nurse should ask a trusted person who will extend an honest response.

Particularly, responses can be acquired from persons who are more experienced than the nurse for example a clinical facilitator (Taylor, 2010). This feedback will help he nurse enhance their professional development by reflecting on individual practice to locate professional development needs. The nurse however should take the feedback as gospel truths since some might be negative but they should give the feedbacks some consideration. Thus, a nurse recognizes that clinical opinion entail consideration of varying information along with evidence. 

1. What have I learnt?

This is an additional invaluable approach towards reflection for a nurse: using a question such as, what have I studied today? This forms a positive approach towards processing information and is a productive way of dealing with events, which might have been upsetting. Additionally, a nurse can ask their colleague what he or she has learnt that day (Gustafsson et al., 2007). This is especially significant when the other individual is new in the practice or is developing new expertise and knowledge. Nurses should rely on one another to communicate and share what they have learnt and this forms part of the culture (Chamney, 2008). This helps in establishing, maintaining and concluding professional relationships with individuals/groups in the future (NMBA, 2014).  Additionally a nurse is able to assist and support patients in making well-versed healthcare decisions.

1. Valuing own strengths 

Often, the literature on reflection focuses on a nurse’s identification of weaknesses along with using reflection in addressing opportunity areas (Chamney, 2008). Whilst this is essential in improving efficiency a nurse should never disregard their positive accomplishments. A nurse should take time review the achievements attained during the recent past. In the process of appreciation a nurse might identify something their wish to improve in order to make more positive contributions in the place of work (Kilpatrick & Purden, 2007). These achievements may be helping individuals/groups enhance their self-esteem, integrity and dignity or collaborating with the healthcare interdisciplinary team to offer comprehensive nursing car and so on.

1. Keeping a journal

Reflection can take the form of recording thoughts by giving a brief description with regards to the best and worst things which took place during the day. This list gives a nurse an opportunity of identifying their highs and lows overtime (Somerville, 2012). Additionally recording daily experiences helps a nurse identify an existing pattern, which leads to their daily actions (Taylor, 2010). Writing is cathartic and assists a nurse put into thoughts and perspectives in priority. Keeping track of experiences assist a nurse to responding efficiently to unexpected and rapidly changing events in future (NMBA, 2014). Through identification of weaknesses recoded a nurse is able to maintain self-control within a clinical setting and utilizing healthcare resources efficiently towards promoting optimal health and nursing care.

Preparation for the future

Planning future actions forms part of the reflective and learning process: having identified patterns and made sense of the reflections a nurse will be able strategize and adopt changes for the days to come (Hannigan, 2008). For a nurse, planning and implementing small changes is extremely effectual in transforming their professional practice along with their relationship with colleagues. Small changes call for little effort to implement (Somerville, 2012). Planning for future activities allows a nurse to evaluate progress towards anticipated personal/group health outcomes through consultation persons/groups, colleagues along with interdisciplinary healthcare personnel.

Creating own future

A critical reflective process part is planning for behavioral changes. Efficient future planning by a nurse requires a synthesis of three dissimilar vital elements (Hannigan, 2008). These are firstly being a dreamer so as to generate fresh ideas and objectives. Secondly, being a realist in order to transform the ideas into tangible expressions. Thirdly, the critic element is essential for refining objectives along with avoiding probable problems (Taylor, 2010). These elements will ensure that a nurse actualizes their reflective goals thus improving the delivery quality nursing care.

Conclusion

Reflection is a critically important embedded within the professional nursing practice. The capability to create clinical judgments and get involved in nursing care activities require reflection effectual nursing practice are based on human relations and therefore necessitates careful thinking to attain triumphant results. Reflection has been linked to successful inculcation of skills to nurses; such skills include efficient self-monitoring and self-reinforcing. Thus nurses require being educated on the benefits of reflective practice in order of ensuring effectual service delivery coupled with motivated and enthusiastic nurses.    

References

 Chamney, M. (2008). Reflective Practice in Nursing. Journal of Renal Care, 34, 220.

Chong, M. (2009). Is Reflective Practice a Useful Task for Student Nurses? Retrieved from http://www.kan.or.kr/new/kor/sub3/filedata_anr/200903/111.pdf

Freshwater, D., Taylor, B. J., Sherwood, G., & Sigma Theta Tau International. (2008). International textbook of reflective practice in nursing. Oxford: Blackwell Pub.

  Gustafsson, C., Asp, M., & Fagerberg, I. (2007). Reflective practice in nursing care: Embedded assumptions in qualitative studies. International Journal of Nursing Practice, 13 , 151–160.

Hannigan, B. (2008). A discussion of the strengths and weaknesses of ‘reflection’ in nursing practice and education: Reflection in nursing practice and education. Journal of Clinical Nursing. doi:10.1111/j.1365-2702.2001.00459.x

Howatson-Jones, L. (2010). Reflective practice in nursing. Exeter: Learning Matters.

Kilpatrick, K., & Purden, M. (2007). Using Reflective Nursing Practice to Improve Care of Women With Congenital Heart Disease Considering Pregnancy. Mcn-the American Journal of Maternal-child Nursing. doi:10.1097/01.NMC.0000269561.97239.d8

NMBA. (2014). National competency standards for the registered nurse. Retrieved from http://www.nursingmidwiferyboard.gov.au/documents/default.aspx?

Somerville, D. (2012). A practical approach to promote reflective practice within nursing. Retrieved from http://www.nursingtimes.net/Journals/2012/11/30/v/l/x/040323A-practical-approach-to-promote-reflective-practice-within-nursing.pdf

Taylor, B. J. (2010). Reflective practice for healthcare professionals: A practical guide. Berkshire, England: Open University Press.