September 12th, 2012
Yuri Arcurs/ Fotolia
An interesting question was raised online in Nursing Times: Do nurses have time for reflective practice?
Reflective practice can be defined as reflecting on experiences in order to critically evaluate what you do well and how you might improve your personal nursing practice (i.e. skills, communication, interpersonal relationships, professionalism, beliefs, values and behavior). It involves the process of critical thinking. Nursing students are encouraged to perform reflective practice throughout their nursing education; in fact, reflective practice is often a formal component of nursing education in the form of journaling or other forms of writing that are evaluated by nursing instructors.
What happens when we graduate from nursing school and enter the “real world”? How many of us take the time to reflect critically on our nursing practice? How many of us have the time to practice critical reflection?
Some might argue that nurses are not allowed the time to practice critical reflection in the workplace. Many nurses are overworked, with too many patients and too few staff members available. Many nurses are focused on whether they will have time to break for lunch or visit the washroom, let alone take the time to engage in reflective practice.
However, reflective practice does not need to be as formal as it was in nursing school. Most of us engage in reflective behavior regarding our experiences as nurses on a daily basis, but don’t recognize that that is what we are actually doing. For example, when conflict arises with a patient’s family member, we may spend time thinking about how we responded to the family member’s criticism. We may take it a step further when we discuss the issue with our colleagues and ask their opinion about how we handled the situation, perhaps soliciting advice on how to better handle a similar situation in the future. We may grieve the loss of a patient to whom we had grown close, or dread the imminent loss, and spend time reflecting on how the relationship we formed with the patient was special or different from relationships with other patients, and why this particular patient moved us. We may engage in an informal debriefing session following a particularly difficult trauma in the ER, identifying ways to improve performance and what might have been done differently. These are all common scenarios and are examples of reflective practice, whether we think of them in that fashion or not.
The bottom line is that reflection does not need to be a formal process (although it can be if you prefer). As nurses, we constantly strive to become better practitioners. Just as formal continuing education is a requirement of the profession, so too is reflective practice. Reflection is a skill that we learn in nursing school that becomes engrained in our psyche.
We first learn the practice of critical reflection in the form of reflective activities and assignments that nursing instructors comment on, pointing out things we perhaps did not or would not have realized without someone’s greater experience. As we evolve in our ability to reflect critically in regards to our practice, our reflection becomes a reflex, a skill we have learned that we no longer think about consciously while performing, much like the physical skill of inserting an IV or taking a blood pressure reading.