What is reflection

There
is a wide variety of definitions for the word reflection. Bolton (2010)
describes reflection as the contemplation of past events that have occurred
outside oneself or the ability to meditate on one’s merits and mistakes. Therefore,
this makes a person to stop and consider their actions thoroughly. It is simply
a mode of thinking. The emphasis is not only placed on one’s actions and
emotional state but also the effect that they have on their significant others and
those they are accountable for. This consists of recalling or revisiting the
experience to bring it back into focus and retelling it from various points of
view. Reflection might direct one to perception, regarding something not observed
in that period, identifying perhaps when the detail was overlooked. Everyone
has his/her own understanding of what reflection is. According to Smith 1992 as
cited in Cotton (2001) “Reflection can
mean different things to different people.”

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There
are two main types of reflection according to Schon (1983) as outlined in
Bolton (2010). Reflection in action which is the reflection that takes place
whilst you are engaged with the situation, often a patient interaction. Reflection
upon action includes a stepping back from the circumstance indicating that it occurs
at some time after the situation has arisen. Hence, it requires a time commitment.
Both types of reflection have a significant role in professional development.

John
1995 states “that reflective practice is
the practitioner’s ability to assess, make sense and learn through experiences
to achieve more desirable, effective and satisfying work. ”

 

 

Why reflection is important to
professional practice

 

Reflection is important to professional
practice as the role of the health care professionals is to promote and support
reflection as an important movement in our care. Engaging with the process of
reflection, and its outcome we will achieve a better result for our patients care.
Therefore, learning from our mistakes or achievement help us to create a sense
of our views to plan our nursing actions.

Reflective practice leads to
a change in insight. It is taking full consideration into the rational values
and techniques which enlighten everyday activities, by analysing practice thoughtfully
and instinctively.

The incentive for you as an expert
is that this tactic will make your practice more satisfying and maintainable;
it may also benefit you through a tough and perplexing time at work. Your
reflective practice will increase the understanding of people for whom you have
responsibility and those you work with.

Using reflection in practice we enhance our learning
via our achievements and faults. Therefore, reflective practice supports us in
making the best of our experiences and helps us to advance in our knowledge as
an outcome.

“Often
during reflective practice, you will see where your best skills lie and
recognize that you have capabilities you hadn’t expected. “according to Hargreves & page (2013).

Therefore, when an incident occurs, reflective
practice can aid you to recognise where a change or interference could have
improved the solution for all those implicated. 
So reflective practice takes the intensity out of the circumstances and offers
you a secure process in which you can discover your role and contribution to
the incident. Also, reflection can expand practice for instance, it may make
you more knowledgeable and open to others. Using reflection can equally help
you to recognise when you have failed in your duty of care.  Hagreaves & Page (2013) also states that “There is no health or social care
professional who has not made a mistake. But recognising small mistakes for what they are can prevent us making
bigger ones at a later stage. ”

Reflective practice can be interpreted
as being the practitioner’s capability to evaluate, understand and learn
through experience to achieve more agreeable, useful and rewarding work. Reflective
practice emerges as one of those remarkable concepts that have turned out to be
such a huge part of the acknowledged perception of professional practice. Therefore,
it seldom obtains the type of judgemental attentiveness to which other, possibly
less important, notions are subjected.

‘Without reflection, we stumble heedlessly on our journey,
generating more unintentional outcomes, and failing to accomplish whatever is beneficial’.
– Margaret J Whitley

 

Why the chosen model is
suitable for analysis of the critical incident

As
health care professionals we are always reflecting in our work, while carrying
our daily duty. We are constantly thinking and reflecting in our work.
Reflection is a part of our daily routine, as we are moving about, doing our
work. This is unstructured reflection. 
Reflection can be structured as well when we sit down and write and
reflect about an incident that had happened during our shift and reflect on the
incident, using a model of practice. This can be something positive or
negative.

There
is different type of models for reflection when it comes to reflect on an incident
that has happened.

Below is an incident that the writer has encountered
in practice.

One Saturday morning I went to work after
being off for a week. After getting my hand-over, I went to check on my
patients as usual. As I was doing my rounds I came across Ann in bed one, a
92-year-old lady. I was shocked to see the way she looked and how much she
deteriorated in one week.  I was very
upset to see that she had worsened so much. When I saw her, I knew that she did
not have long to live, as her early warning scores were high, and all the
interventions used to mend her condition were failing, having not improved her
condition at all.  Her family was
informed of her deterioration and they agreed to leave Ann alone, so we could
make her comfortable while she was living her last moments. My struggle that
day was to get the doctors to see that Ann had lost her desire to live and to
let her be in peace and comfortable on her last hours of her life. After a lot
of phone calls and getting the doctors to see her, they decided that I was
right and decided that Ann was only for comfort measures. After that I went and
asked the nurse in charge for Ann to be moved to a single room so that the
family could stay with her. As the day went on I tried to make Ann as
comfortable as she could be. When I went home that night, I was thankful that
Ann was surrounded by her family and was undisturbed. The next day when I went
to work, my colleagues told me that Ann had passed away during the night, but
she had been in the company of her family and was comfortable. I felt that I had
done something right for Ann and her family, and all my work from the previous
day was rewarded. (see appendix II for full incident description)

For
this paper the writer will use Driscoll Model of Reflection (2000), to reflect
on the above incident. This model is used
due to the easy way to understand the stages of reflection, and it helps the
writer to reflect on the incident with ease. Therefore, it will help the writer
to reflect on the incident and be able to critically analyse and reflect on its
own progress in practice. Furthermore, according to Solum et al (2016)”
Critical reflection will lead to a better
understanding of how existing nursing practice can be improved…and to create a
learning climate that enhances critical reflection… to ensure moral competence,
thus protecting patient’s rights and safety.”

Driscoll Model of reflection
poses three questions when we reflect on an incident. These are:  ‘What?’, ‘So What?’ and ‘Now What?’ (see
appendix I for diagram.)   

The what stage
is making us to return to the situation, and think of what has happened? What
did I see / what did I do at that moment? What was my reaction?  And what did other people do?

So What Stage this
stage, make us think of how did we feel about the incident? How did these feelings
relate with other people’s feelings? Did I feel still the same? What were the results
of my behaviour? What are the positive characteristics of what has happened?
Did I notice anything different about my behaviour? What have the other individuals
noticed about my behaviour?

Now What stage
this is the final stage of Driscoll’s model of reflection.  This stage makes us think back and see what
were the implications of my behaviour – for me and for others? Then moves on to
make us think that, if we would have not acted the way we did what would have
happened? Were my skills enough to act the way I did? Or would I need more
information / skills if the same incident would arise in future? If I would
need more skills / help to deal with the same situation in future, where will I
need to go to obtain these skills? This stage of the model ends up with a
question which makes the reflector think what was the main learning from the
incident, and the experience that we went through by reflecting in the
situation?   What is the main learning from this experience
and reflection? How will I act in future if I need to deal with the same
situation again?

The
writer will describe the incident using all stages of the model in paper two of
this assignment by reflecting on each one individual. The anticipated learning
from this process of reflection will help to critical analyse the above
incident, using a few core concepts relevant to nursing practice. The concepts
covered in the next paper will be looking at patient-centred care, compassion
and caring, and advocacy. This will be connected by using the model of
reflecting and connect theory to practice. As according to (Hatlevik 2012) “Structured reflection is important as it bridges the Gap between theory
and practice”