Within this essay, the author will reflect on a critical incident using a reflective model. In order to guide the author undertake this reflection, Johns (2002) reflective model will be utilised. As the first stage of Johns reflective model asks for the description of the event, the descriptive part will be attached (see appendix A). In accordance with the NMC Code of Professional Conduct (2008) the names of the individual involved have been changed using pseudonym in the form of James, Jennifer and Christina for the purpose of maintaining confidentiality.
This reflection has been chosen as it has shown the author the inadequacies on her part as a student nurse. Also to highlight the need for the author and professionals to have an accurate documentation as it plays an important role in providing effective nursing care. Therefore, this provides me with the opportunity to have a better understanding and ways to improve my documentation skills. Nursing documentation is written information about patient care and is a tool of communication with other health care professionals.
Documentation is also a legal duty of nurses as it is an evidence of the care provided by the nursing team. Dimond 2005) Williams and Lowes (2001) suggests that reflection can be understood as a process of analysing, reconsidering and questioning personal experiences. This may be a way of opening something up into smaller pieces and thinking about it on a deeper level. In nursing, context-reflection helps nurses to learn about the actual practice of the profession and help them to evaluate their own practice and performance. This enables the individual to be self aware and enables them to analyze feelings and gain deeper understanding of the incidence.
Moreover, critical incident is defined as a significant event that raises important questions in relation to the experience (Gould and Baldwin 2004). In order to reflect, one has to be able to think critically. Critical thinking allows the person to critically look at the incidence into its smallest components thus considering the incident from every angle. It also gives us the opportunity to change our way of thinking. Hence when we reflect on an incident we can learn valuable lessons from what did and did not work.
In this way self-awareness can be developed along with skills in critical thinking and problem solving (Prize 2004). There are many reflective models the author could adapt to help with this reflection. These include Gibbs’ (1988), Johns’ (1995), Atkins’ and Murphy’s (1993), and Kolb’s (1984). I have chosen John’s model of reflection, because it is simple and straightforward to follow and uses cue questions. The cue questions ensure that the important questions are answered and that deep thought takes place. Moreover, Duffy (2008) state that Johns model is suitable for students, because it allows them to reflect on action.
This takes place after the event and encourages the student to revisit an experience, with the intention of critically exploring and learning from the incident. For this incident, reflection on action will be discussed. Furthermore, Nash (2000) suggests that Gibbs reflective cycle is not sufficiently constructed to offer detailed reflection. Whereas, Jasper (2003) advises that when a nurse reflects he or she must be aware of the dangers of reducing their experiences to a series of questions, posed by a model of reflection; as this might prevent real reflection. Aesthetic
The second stage of Johns model requires the person to examine what they were trying to achieve and the consequences of their actions (John’s 1995). At the time of the incident under examination my co-mentor instructed me to assist James with admitting Christina the patient. I was there to only return an Electrocardiograph (ECG) machine and had no intention of staying in the resuscitation room as I was not allocated there. However, upon reflecting I accepted the instruction because I felt powerless as a student as we are told what to do and was trying to satisfy my co-mentor. I also wanted demonstrate my willingness to help.
Furthermore, upon assessing Christina I noticed that she was experiencing breathlessness and showing signs of distress. According to Kisiel and Perkins (2006) recording vital observation is an important aspect of nursing care as this provides the physiological state of the patient. At this point my main priority was to assess the patient’s baseline. I also felt it was unnecessary to disturb Christina with questions regarding her history and identity. As this could have leaded the patient become more breathlessness. However, I was distracted by the patient’s breathlessness and distress.
Therefore the consequence of my actions was that I wrote the vital signs on the wrong chart. The lack of proper documentation could have lead a negative impact on the patient health and can ultimately cause fatal consequences. The NMC (2008) requires practitioners to make correct documentation as this could cause dangerous consequences for patients and result in further disciplinary action. Looking back, Nurse James would have been held accountable for my action. The NMC (2008) clearly states that a registered nurse is obligated to ensure the safety of patients at all times.
On the other hand, as a student I may be held responsible by the university and possible could face being penalised (Pellat 2006). Upon reflection I feel that as a student nurse at advanced stage of my training I was not able to work under pressure and multitask. I should have been able to deal with the patients breathlessness while at the same time ensure the documentation was correct. Personal The third stage of Johns model encourages the individual to evaluate their personal feelings towards the experience (Johns 2002).
My personal response was that I felt powerless and frustrated with my actions. Within the university we are taught the importance of correct documentation and how to ensure the safety of the patient. Despite my knowledge and experienced gained from previous placement regarding the documentation I was unable to utilise the skill appropriately. Johns (2006) states that when an individual wants to express their emotions they tend to feel as a failure. Johns (2006) further argues that both negative and positive feelings should be accepted as this will initiate reflection.
However at the time I felt deeply embarrassed and started to question my ability to document patient care competently. In addition, this bought a sense of anger towards my co-mentor as I felt that she was being unreasonable. Despite my anger, I was keen to impress and to demonstrate my willingness to learn. Burns and Bulman (2000) state the role of a mentor is to guide assist and support the student learning new skills and new behaviours and attitudes. After reflecting it may have been possible that my supervisor initiated the task in order to benefit from the learning opportunity.
Conversely, I believe that the lack of focus and speeding the documentation may have contributed to my error. Speed is essential when working in healthcare, but accuracy and completeness are also equally significant when documenting. Ethics In this section the individual is asked to analyze their person values with regards to the actual incident that took place. Personal value is expressed through moral codes and ethical decision making. According to Burnard (cited in Andrews et al 1998) reflection challenges the way we think, feel and believe.
Therefore I felt that my beliefs, values and professional boundaries were challenged. This is because, i strongly that every patient has the right to valued and given due time when caring for them. In addition, I could have been more empathetic towards the welfare of the patient as I would not want someone treat a member of my family in an emergency department. looking back I felt I have let he patient, myself and my colleagues down, due to the error I made. Now I am aware of the need to have full concentration at all times when providing care. Empirical
According to Atikins and Schutz (2008) empirical is the knowledge used in practice through research and observation. It is now upon reflecting I realise that, being in a ward can be so demanding and emotionally stressful. As a student I have shown flexibility by accepting the instruction. On the other hand I was unable to articulate my concerns to my co-mentor. This may be due to the lack of communicating skills. I feel could have shown more empathy in the form of my own body language to promote active listening and not worry about time or the action of my mentor (Hoppe 2007).
Thus, to act in a way I felt comfortable with and that will provide the best for my patient. This experience has been a good learning curve as it has taught me a valuable lesson to take a step back and assess the whole situation. Looking back I should have ask for a handover of the patient. I believe this would have resulted in comprehensive assessment of the patient. Furthermore using a systematic approach in documentation is needed to be thorough and establish a safe practice. Reflexivity The final stage of Johns model enables practitioners to summarise their experience and identify any improvement needed in future.
I personally found the whole experience to be stimulating, as it has opened the doors to self-awareness and self improvement. Johns reflective model allowed me to utilise critical thinking when assessing personal feelings and not allowing my emotions to cloud my judgements. The experience of reflection has taught me how to convert negative incidence to positive incidence. The incident has not only shown my self -awareness in terms of my beliefs and values, when it in comes to speaking up and being more assertive in difficult situations.
Although I did not handle the situation professionally, I was able to reflect and distinguish the rectification that is needed in the future. The event has made me more aware of my responsibility and safety for myself and also for the patient. Therefore I have taken it upon myself to further educate myself on how to safely document using lectures notes and clinical guidelines. Through using Johns model I was able to see the event from a different context as I am reflecting on action. Hence this has directed me towards becoming a critical thinker and I will utilise the skill I have learn in this essay through my professional practice.
Cite this Critical Incident
Critical Incident. (2017, Feb 18). Retrieved from https://graduateway.com/critical-incident/