This essay will utilize a reflective model, specifically Johns (2002) model, to reflect on a critical incident. The first stage of Johns reflective model requires providing a descriptive account of the event, which can be found in appendix A. To adhere to the NMC Code of Professional Conduct (2008), pseudonyms have been employed to protect the identities of those involved. James, Jennifer, and Christina have been selected for this purpose.
This selection has been chosen because it demonstrates the author’s recognition of their own shortcomings as a student nurse and emphasizes the importance of accurate documentation for effective nursing care. It presents an opportunity for the author to improve their documentation skills. Nursing documentation serves as written information about patient care and facilitates communication with other healthcare professionals. It is also a legal obligation for nurses and serves as evidence of the care provided by the nursing team (Dimond 2005). Reflection, as suggested by Williams and Lowes (2001), involves analyzing, reconsidering, and questioning personal experiences. It allows individuals to break down experiences and thoughtfully consider them at a deeper level. In the nursing context, reflection helps nurses learn about the actual practice of their profession and encourages self-evaluation and analysis to gain a better understanding of incidents and their own performance.
The term critical incident refers to a significant event that poses important questions regarding the experience (Gould and Baldwin 2004). Reflecting on the incident requires one to think critically, examining it comprehensively from various perspectives. This process also allows for reconsidering one’s mindset, opening the possibility of learning valuable lessons from both successful and unsuccessful approaches.
Self-awareness and critical thinking skills can be developed through reflection. Several reflective models, including Gibbs’ (1988), Johns’ (1995), Atkins’ and Murphy’s (1993), and Kolb’s (1984), can aid in this process. The author has chosen John’s model of reflection due to its user-friendly nature, inclusion of cue questions, and emphasis on addressing important questions and engaging in deep contemplation. Furthermore, according to Duffy (2008), John’s model is particularly suitable for students as it allows them to reflect on their actions.
After an event, it is encouraged for students to revisit their experiences and critically explore and learn from them. In this case, we will focus on reflection on action. Nash (2000) argues that Gibbs reflective cycle is not detailed enough for reflection. On the other hand, Jasper (2003) warns nurses about reducing their experiences to a series of questions posed by a reflection model, as this may hinder real reflection. Aesthetic
According to John’s model (1995), the second stage involves reflecting on the intended goals and consequences of one’s actions. During the incident in question, my co-mentor instructed me to assist James in admitting the patient, Christina. Initially, I had only gone there to return an Electrocardiograph (ECG) machine and had no plans of staying in the resuscitation room since it was not my assigned area. However, upon further reflection, I complied with the instruction because I felt powerless as a student and wanted to please my co-mentor. Additionally, I hoped to demonstrate my willingness to help.
Furthermore, upon assessing Christina, I observed that she was experiencing breathlessness and showing signs of distress. According to Kisiel and Perkins (2006), recording vital observations is an essential aspect of nursing care as it provides information about the patient’s physiological state. My main priority at that point was to assess the patient’s baseline. I also believed that it was unnecessary to bother Christina with questions about her history and identity as it could have exacerbated her breathlessness. However, I found myself being distracted by the patient’s breathlessness and distress.
Thus, I mistakenly recorded the vital signs on the incorrect chart, which could have serious implications for the patient’s health and potentially even fatal consequences. According to the NMC (2008) guidelines, healthcare professionals must accurately document patient information to avoid potentially dangerous outcomes and potential disciplinary measures. In retrospect, Nurse James could have been held responsible for my mistake, as the NMC (2008) expects registered nurses to prioritize patient safety at all times.
On the other hand, as a student, I may face penalties from the university for not meeting responsibilities (Pellat 2006). Upon reflection, I realize that as an advanced nursing student, I struggled with working under pressure and multitasking. I should have been able to manage the patient’s breathlessness while also ensuring accurate documentation. Personal The third stage of Johns’ model promotes self-evaluation of personal feelings related to the experience (Johns 2002).
When reflecting on my actions, I felt helpless and aggravated. The university teaches us the significance of accurate documentation and patient safety. However, despite my prior experience and understanding of proper documentation, I failed to apply this skill effectively. According to Johns (2006), individuals often perceive themselves as failures when expressing their emotions. Johns (2006) also maintains that embracing both negative and positive emotions is crucial for fostering reflection.
Initially, I experienced a strong sense of embarrassment and started questioning my ability to accurately record patient care. Furthermore, I became frustrated with my co-mentor as I perceived her actions as unjust. Despite feeling angry, I remained determined to showcase my eagerness to acquire knowledge and skills. Burns and Bulman (2000) state that mentors have the responsibility to direct, aid, and back students in acquiring fresh competencies, behaviors, and mindsets. In retrospect, it is plausible that my supervisor assigned me this task with the intention of utilizing it as a valuable learning experience.
However, I believe that my mistake could have been influenced by not giving enough attention and quickly going through the documentation. Although speed is vital in healthcare, it is also crucial to be accurate and thorough in documenting. This section involves ethics as individuals are encouraged to examine their personal values regarding the particular incident. Personal values are demonstrated through moral codes and ethical decision-making. As Burnard (cited in Andrews et al 1998) points out, reflection compels us to scrutinize our thoughts, emotions, and beliefs.
I faced a test to my beliefs, values, and professional limits when confronted with a situation that made me strongly believe in the importance of respecting and dedicating sufficient time to each patient during their care. Additionally, I understand the necessity for me to have shown more empathy towards the patient’s well-being as I would not want any of my family members to receive negligent treatment in the emergency department. After reflecting on this incident, I acknowledge that my mistake not only disappointed the patient but also affected myself and my colleagues. This experience has taught me the importance of maintaining unwavering focus while providing care.
According to Atikins and Schutz (2008), practical applications depend on empirical knowledge gained from research and observation. In my time working in a ward, I have learned about the challenging and emotionally demanding nature of the job. As a student, I have demonstrated adaptability by following instructions. However, I struggled to communicate my concerns to my co-mentor, possibly because of insufficient communication skills. To address this issue, Hoppe (2007) suggests that employing non-verbal cues for active listening and disregarding time constraints or my mentor’s actions would have allowed me to show more empathy.
Therefore, to guarantee that I was behaving in a way that made me feel at ease and offering optimal care for my patient, I have grasped the significance of taking a step back and evaluating the situation. Reflecting on it now, it would have been preferable if I had requested a handover of the patient as this would have permitted a more comprehensive assessment. Moreover, employing a systematic approach in documentation is essential to ensure completeness and establish safe practice. The concluding phase of Johns’ model of reflection empowers practitioners to summarize their experience and pinpoint areas for enhancement in forthcoming situations.
Personally, I found the entire experience to be stimulating as it has allowed me to enhance my self-awareness and personal growth. By utilizing John’s reflective model, I successfully applied critical thinking in evaluating my own emotions and making unbiased judgments. This incident served as a valuable lesson in transforming negative circumstances into positive ones, while also demonstrating my self-awareness of my beliefs and values and equipping me with the skills to assert myself and communicate effectively amidst challenging situations.
Although I didn’t handle the situation professionally, I have used this opportunity to reflect on what happened and find ways to improve. This incident has made me more aware of my responsibility for both personal safety and patient well-being. To make progress, I’ve decided to improve my understanding of proper documentation procedures by referring to lecture notes and clinical guidelines. By using Johns model, I’ve looked at this event from a different perspective as I assess my actions. This has helped me develop critical thinking skills that will be useful in my future professional practice, incorporating the lessons learned from this essay.
