This reflective account is a personal interpretation and learning from interactions
experienced during placement, maintaining all ethical standards prescribed by the NMC.
Reflection is an essential element in every nurse’s practice and is embedded
in the Nursing and Midwifery Council’s code of conduct – the UK nursing
regulatory body’s code of professional standards of practice and behaviour
Barchard F (2022).The application of reflection to practice has clear
advantages, for example it enables nurses to learn from clinical events and
experiences from the past. Among various models, Driscoll’s model of reflection stand
out as it offers a simple framework, prompting reflection through three basic questions:
"What?", "So what?", and "Now what?". This model is aligned with the experiential learning
theory (Kolb, 1984) and supports critical thinking and learning through experience. Other
reflective models like Gibbs' Reflective Cycle (Gibbs, 1988) and Schön's reflective
practitioner framework (Schön, 1983) also contribute valuable perspectives on
understanding one’s practice.
Reflection in nursing is essential for continual learning and improvement (Rolfe et al., 2001).
It allows nurses to develop a deeper understanding of their clinical practices and behaviors,
which can enhance patient care. It helps identify both strengths and areas for improvement,
fostering personal and professional growth (Johns, 1995; Rolfe et al., 2001). It helps nurses
to understand and learn from their experiences, integrate theory with practice, and enhance
clinical decision-making skills (Atkins and Murphy, 1993). Reflecting on experiences,
especially challenging ones, helps build resilience and adaptability, crucial traits in the
dynamic field of nursing (Atkins and Murphy, 1993). In accordance with the Nursing and
Midwifery Council (NMC) code 2018 which clearly states that the use of actual names for
then purpose of research is not allowed, the patient name in the center of the discussion
have been anonymized to protect his identity .
What
During my clinical placement as a student nurse, my role primarily involved observing and assisting
registered nurses and other healthcare professionals in the care of patients with psychiatric
conditions like Mr. A's psychosis. Mr A used to live a normal life where he spend most of his
managing his restaurant together with his second Wife. After going back and forth with his wife over
a divorce issue, Mr A began loosing his senses as he was sacred to louse his house and custody of his
children. He was brought to the hospital by a friend who reported that Mr A was seen exhibiting a
strange behaviour and talking to himself.
student nurse, I was careful not to overstep my scope of practice, which is limited to supportive and
learning activities under close supervision.
One critical area where I was actively involved was in communication. This involved both listening
carefully to Mr. A and engaging him in simple, clear conversations to foster a trusting relationship,
which is crucial in psychiatric nursing. Effective communication in this setting not only helps in
building rapport but also aids in assessing the patient's mental state and responsiveness to
treatments. My mentors guided me in using therapeutic communication techniques, such as using
open-ended questions to encourage dialogue and showing empathy without reinforcing delusions.
Additionally, I was tasked with observing Mr. A’s behaviors and reporting any changes to the
supervising nurses and doctors. This helped the team in making informed decisions about his care
plan.
Barchard F (2022) Exploring the role of reflection in nurse education and
practice. Nursing Standard. doi: 10.7748/ns.2022.e11605
