Reflective Practice

Reflection on your current evidence – collecting practices.

Most recently I have recorded and documented achievement on graphs and tables using excel programs or word documents. These are mostly from unit audits or other data collect via external sources. Overall however, I have left my personal achievements largely unrecorded and have kept little or no evidence. This is probably due to never being informed of, or heard of, the need or benefits of reflective practice as was explained by (Jones, 2010). So if reflection was conducted at all it would often be done quite some time retrospectively. Trying to reflect by relying on memories has been noted by (Shepherd & Hannafin, 2013) as potentially unreliable and that events may be misrepresented. Jones also goes on to explain that without subsequent teaching and practiced reflective writing the process can be quite difficult and would most likely be unsustained (2010).

Once data was/is collected it is presented at meetings, emailed to relevant stakeholders and occasionally put up on boards for staff to view. Often activities or other forms of follow-up that is required is not actioned unless constant surveillance and reminding is done. This makes the cyclic task of action and reflection a very arduous and time consuming task. Evidence, action and reflection is only completed depending on the level of supervision and importance. Mann et al., describes the reflective practioners process as a “revitalising experience” (2007), however as this is not conducted as per current recommended process this is/has not been the case.

Therefore, the current methods, it would appear, are not only limited in provision of growth and development but also in encouraging accountability and autonomy (Green et al., 2014). The current method I use is almost a claytons method as it appears to address requirements but has no real means of producing evidence of reflection and promotion of decision making processes or learning outcomes. This module has highlighted, in fact, that there is a better way for myself, the organisation and most importantly the standard of care for the patients. As Jones suggests that reflection devoid of evidence of performance is a failure to capture the quintessence of performance in regard to teaching and learning (2010).

This unit has made me think more about how I perform both as a personal health practioners and as a health leader. If I can successfully utilise the ePortfolio tool to showcase, as suggested by (Debra Anderson et al., 2009), both theoretically and practically, to improved outcomes for patients and significant others then this would assist all concerned to create a bridge between theory and practice with the evidence as confirmation (Debra Anderson et al., 2009).

For current standards to which I have little or no literal evidence to date I may be able to support evidence by asking for feedback from peers and nursing executive about past performances and collaboration with organisational goals and patient outcomes. This may also be my opportunity to utilise the PDP process for reflection and feedback on how I am perceived to meet existing standards and mentorship[ practices. (Shepherd & Hannafin, 2013).

 

Descriptions of your practice and reflections on your learning.

I think I could improve my reflective practice in all the standards both ANMCA and the NSQHS. However for the current situation I will discuss the following three standards in relation to my evidence, professional and learning activities:

  1. Governance for Safety and Quality in Health Service Organisations
  2. Preventing and Controlling Healthcare Associated Infections
  3. Clinical Handover.

Governance for Safety and Quality in Health Service Organisations

I have discussed within the portfolio(see NSQHS in appendix), what I have achieved but I have not discussed reflection on activity or lessons learned. What I will need to do is reflect upon activity and belief systems and record these at the time of investigation and/or instigation. To get into the habit of doing this I will have to carry a diary of some description and dialog events thoughts, theories and beliefs as close to the incident as possible. As stated by (Jones, 2010) “the most significant threat is lack of engagement”. Therefore until this becomes second nature I will have to use prompts such as the aforementioned note pad. After all, within many of the references it is mentioned as “reflective writing”, (Cambridge, 2008; Debra Anderson et al., 2009; Gordon & Campbell, 2013; Green et al., 2014; Jones, 2010; Mann et al., 2007; Shepherd & Hannafin, 2013)

 

Preventing and Controlling Healthcare Associated Infections

I have mentioned hand hygiene nevertheless data presented should be made more personal to how I have affected outcomes and demonstrate/evidence my association with this standard. I may have to highlight my perceived knowledge and review how I can influence/mentor said behaviour in subordinates. I would endeavour to have them examine their own practice (Shepherd & Hannafin, 2013). How exactly I will bridge theory with practice is currently a work in progress. As stated by Benjamin Franklin “Either write something worth reading or do something worth writing,” I think I will have to work toward both.

 

Clinical Handover

While this may appear to be a simple standard I have found trying to get staff compliance is quite a task. However if I can show staff that professional engagement and reflective thinking is practiced (Mann et al., 2007), outcomes do improve. The difficult part is that reflection needs to be a deliberate conscious effort with the aim of understanding (Green et al., 2014). Unfortunately opportunity is often disguised as hard work and getting past that barrier requires one to persistently keep the opportunity/goal in view. Discussing my aims and goals with a significant other within the work environment will also help me to remain focused and work toward goals. Feedback not only informs but strengthens resolve. I may also be able to engage other team members such as Quality Coordinators, Patient Safety Officers and other Clinical Governance associates. I am about to embark on a steep learning curve and teaminvolvement, research and encouragement will be of prodigious assistance in my journey.

 

References:

Cambridge, D. (2008). Layering networked and symphonic selves: A critical role for e-portfolios in employability through integrative learning. Campus-Wide Information Systems, 25(4), 244-262. doi:10.1108/10650740810900685

Debra Anderson, Glenn Gardner, Jo Ramsbotham, & Ramsbotham, J. (2009). E-portfolios: developing nurse practitioner competence and capability. AUSTRALIAN JOURNAL OF ADVANCED NURSING, 26(4), 70-76.

Gordon, J. A., & Campbell, C. M. (2013). The role of ePortfolios in supporting continuing professional development in practice. Med Teach, 35(4), 287-294. doi:10.3109/0142159X.2013.773395

Green, J., Wyllie, A., & Jackson, D. (2014). Electronic portfolios in nursing education: A review of the literature. Nurse Education in Practice, 14(1), 4-8. doi:10.1016/j.nepr.2013.08.011

Health, G. C. H. a. (2015). Nurse Unit Manager Job Description. Retrieved from: www.health.qld.gov.au/workforus or www.smartjobs.qld.gov.au http://www.health.qld.gov.au/goldcoasthealth/

Jones, E. (2010). A professional practice portfolio for quality learning. Higher Education Quarterly, 64(3), 292-312. doi:10.1111/j.1468-2273.2010.00458.x

Mann, K., Gordon, J., & MacLeod, A. (2007). Reflection and reflective practice in health professions education: a systematic review. Advances in Health Sciences Education, 14(4), 595-621. doi:10.1007/s10459-007-9090-2

National Safety and Quality Health Service Standards, (September 2012).

Registered nurse standards for practice, (June 2016).

Shepherd, C. E., & Hannafin, M. J. (2013). Reframing portfolio evidence. Journal of Thought, 48, 33-51.

Registered nurse standards for practice – Effective date1 June 2016 http://www.nursingmidwiferyboard.gov.au/News/2016-02-01-revised-standards.aspx. March 2016