Reflective Practice in Nursing

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Reflective Practice in Nursing
01.07.2019
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Introduction

The Gibbs framework for reflective essay writing is a model created in 1988 by Prof Graham Gibbs. The model provides a way of reflection which learners and anybody can use to have a clear overview of the activities they have undertaken in the recent past. The model, which is sometimes known as an iterative model, implies that the student learns through repetition of the same activity and is required to reflect on the steps through which the activity is done (Department of Health 2007, p. 2). Gibbs framework has six stages that can help the student to evaluate and reflect on the actions or activities within a given setting. Because of its repeating cycle, the model is effective for understanding routine activities such as nursing in a medical ward.

Description of framework

Introduction

The Gibbs model is a popular six-stage model used in reflection. The model is mostly applied in nursing reflection because of its continuity and its applicability to repetitive activities. This section of the paper will provide a description of the stages of the Gibbs framework.

Gibbs Framework

The model has six main stages. The first stage is the description of where the student is supposed to know precisely what happened. The second stage is the feeling that the student experienced while performing the said activity (Ely & Scott 2007, p. 15). The third stage is the evaluation of the activity including what went right and wrong. In this stage, the student will be able to identify improvements that might be essential for the future process. The fourth stage is the analysis. It includes critical analysis, where the student tries to make sense of why the certain activity was undertaken and what was done (Bulman & Schutz 2013, p. 76). The fifth stage is the conclusion where the student is expected to outline exactly what has been learned throughout the experience and identify areas that might require improvement or changes in the future (Moon 2013, p. 17). The last stage is the action plan where the student identifies the requirements for better preparation in the future experience, he/she identifies possible areas of improvement, priority areas, and the specific steps that must be taken in the future to meet the suggested improvements.

Conclusion

This model is particularly important when the student or the person involved in doing some activity wants to challenge the underlying assumptions. It is also essential where there is a need to explore new ideas and approaches as well as promote self-improvement. Most importantly, the student can also identify areas of strengths and weaknesses and thus, take essential actions to address them.

Reflection

Introduction

The use of the Gibbs framework in reflection means that the process is broken down into stages. In this section of the paper, I use the six stages to reflect on the successes of my work as a nurse in a medical ward. The model will be helpful in identifying the successes and failures and also how to improve later.

Description

Working as a nurse in a medical ward is one of the most fulfilling but also challenging tasks one may hold in a health institution. For a start, it is sometimes a repetitive activity as you find patients lying on the same bed and sometimes suffering from the same illnesses as the others. As a result, there is a strong tendency to base the work on assumptions about the patients and the work that is done in a medical ward (Price & Harrington 2010, p. 9). However, it is important to understand that each patient is unique and presents new challenges or new opportunities for the nurse to offer their care services. As a nurse working full time in a medical ward, I have had to deal with many patients on a daily basis, which has given me a sense of appreciation for good health and also spurred in me the need to serve people regardless of their medical condition. I consider my presence in a medical ward as a work of passion whenever I think about the patients I have served and who left the medical ward with smiles on their faces (Butts & Rich 2015, p. 21).

Feelings

As a part-time masters student, I am always pressed for time. In most cases, I leave the medical ward at 5 pm irrespective of what is going on there. On a particular day, we were going in for our continuous assessment and I did not want to miss it. When the time came, I immediately rushed out. However, at the door, I met an old woman who seemed to be in much pain from the way she was screaming (Bulman & Schutz 2013, p. 19). I knew my partner was running late and, therefore, would not be in time to help the poor woman. Thus, I decided to stay longer and attend to her regardless of what I was going to do next. The woman had broken her leg when she fell in her house. Based on the fact that she lived alone, it had taken long for her to be discovered and taken to the hospital (Quinn 2000, p. 32). The accident happened in the morning and she came in for treatment in the evening. Thus, she was in great pain and needed immediate attention.

Evaluation

Working in a medical ward can be challenging sometimes. For me particularly, the incident with an elderly woman screaming at the top of her voice was challenging and emotional. I am glad that I was able to be the first to react against my routine of having to leave the medical ward no matter what the situation was when my time arrived. Particularly, I am impressed because, apart from acting ethically to save the elderly woman from pain, I also did not miss any exams since there had been communication of postponement due to this situation. During the treatment of the patient, I am glad that I was around to assist the doctor in examining the patient and quickly providing the necessary treatment. Indeed, within a half an hour of examination, the elderly woman was feeling relaxed and comfortable and was not screaming any more (Daly 2005, p. 11). Other patients in the hospital felt confident in our services and I could see that some of them actually waved at me when I was finally leaving for home. One lesson I learned from the incident is never to act selfishly when it comes to providing the services to patients in a health care institution. I had the right to leave since my official time of leaving had come but the situation demanded that I had to stay a little longer, which was worthwhile.

Analysis 

The ethical practice for nurses requires that nurses work with passion and unselfishness. There is also the Hippocratic Oath, where medical officers vow to serve their clients without looking down upon them (Callara 2008, p. 2). Many health care professionals tend to overlook small but very important policies and requirements for one to become a nurse. The Nursing and Midwifery Council Code of Professional Conduct (2004, section 8) requires nurses to act in a manner that will minimize the risks to the patient. This is largely applicable to my situation as a nurse working in the medical ward.

Conclusion

Analyzing the incident, I am glad that I acted quickly and within the policies set for nurses. I can now see that my action saved the client from much pain and also brought comfort to the medical ward, where there were many clients. Discussing this with my mentor, later on, revealed that my performance in the medical ward had been above average even though I needed to work closely with my colleagues to pass the same skills and perceptions about working in a medical ward (Brotherton & Parker 2013, p. 35). I discovered that I needed to support my colleagues more to understand the challenges in their work environment so that they would be able to provide better services.

Action Plan

In future, I will want to develop the skills of my colleagues concerning working in a medical ward and ensuring that they put everything about the patient before their selfish interests (Doel & Shardlow 2009, p. 12). My goal of learning will be about how to work with colleagues effectively, and about the strategies that I need to use to achieve this.

To conclude this section of the paper, the six stages of the Gibbs framework are essential when it comes to reflecting on nursing work. They allow the reflection to be systematic and to identify areas that were done appropriately and those that require improvement.

Evaluation

Introduction

In this section of the paper, I will provide the critique of the Gibbs framework and how it has contributed to my understanding of the situation I have experienced in the medical ward at my place of work.

One criticism of the Gibbs framework is the assumption that the events are repetitive in their very nature and, therefore, the student meets the same sequence of events. It is a faulty assumption because even though the activities might seem similar, they are always different (Davies & Bullman 2011, p. 13). Thus, the model cannot be used to understand unique events that are not repeated. Despite this, Gibbs framework offers the student an opportunity to have an action plan in case the same incident is to happen. This is especially important for areas like nursing, where learning from experience is an important aspect of acquiring professional skills. Moreover, the framework provides identifiable steps through which a user can identify the lessons learned and the challenges experienced during the execution of a certain task (Speedy & Jackson 2009, p. 32). This is particularly important as it provides an opportunity to learn each step independently and identify what could have been done differently in the respect of the outcomes. It provides the opportunity for somebody looking at an incident to evaluate it against the strengths and weaknesses demonstrated and to have areas where improvement should focus.

In conclusion, the critics of the Gibbs framework do not acknowledge the fact that the model is suited to some repetitive functions such as nursing. In my evaluation, the framework can help nurses to understand the dynamics in their place of work.

Conclusion

Gibbs framework is a good model for understanding the experiences that nurses are likely to have inside the medical wards. To begin with, they may not be able to describe the situation that they are experiencing in clear terms. They may also not be able to provide an analysis or even an action plan on how to handle future incidents (Jasper 2010, p. 22). However, using the Gibbs framework, they will have a guideline upon which they can build their understanding of their experiences and be able to reflect on such experiences in a manner that could improve their future experiences.

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