What writing a reflective essay does then, is to help the writer to make sense of their experience, reflective account essay some in-depth analysis of it, so that some valuable lessons can be learned, moving forwards. The experience raises a number of issues frequently encountered in daily nursing practice. Spending time with Mrs M has helped me to understand her and her capabilities better, which in turn will enable us to work towards a therapeutic relationship. Benner and Wrubel state that nurses who develop and use appropriate skills such as empathy and understanding with a caring attitude help people to open up and address the needs of individual patients. We learn through our experiences and by coping with a variety of situations, reflective account essay. Popular Topics employment gender celebrity starbucks of mice and men cricket leadership arranged marriage mobile phone hiphop, reflective account essay.
Personal Reflective Sample
Reflective practice has been a familiar topic in nursing journals and the term is regularly used in professional nursing practice. This article describes a reflective experience related to caring for a patient with chronic obstructive pulmonary disease in the community. The professional implications of this experience are explored through reflection. This exploration raised two main issues: the development of a therapeutic nurse-patient relationship and the feelings of guilt experienced when reflecting on whether I had let the patient down when most needed, in the final stages of her life. obstructive pulmonary disease COPD in the community. This has enabled me to explore the meaning and significance of my clinical reflective account essay and to recognise the complexities within it, reflective account essay.
The experience raises a number of issues frequently encountered in daily nursing practice. However, for the purpose of this article, two issues will be discussed in depth. These relate to the development of a therapeutic nurse-patient relationship and dealing with feelings of guilt. The reflective process allows practitioners to question and analyse their experiences and actions as a means of developing their knowledge, skills and behaviour, to enhance clinical practice. Author Margaret Barnett is COPD nurse specialist, reflective account essay, Derriford Hospital, Plymouth.
Reflective account essay margaret. uk Description of the experience My work as a specialist nurse involves caring for and managing patients in the community with COPD, reflective account essay. I had been caring for Mary not her real name for two years, reflective account essay. She reflective account essay in her early 50s but had severe COPD. Initially, Mary was fairly stable and during exacerbations of COPD she could be managed at home effectively. She had a caring and supportive family and husband. Last year we had discussed her being referred to Harefield Hospital in London for consideration for a lung transplant, but after her first visit for assessment she withdrew and said she could not go through with the investigations.
Over the last six months her condition showed signs of deterioration with frequent chest infections that required management in hospital. Because of her deterioration she had been receiving weekly visits from the COPD home care service, reflective account essay. I visited Mary at home a week after she had been discharged from hospital, as she had an exacerbation of her COPD. On my visit she was in good form and cheerful. She looked well, in fact the best I had seen her in some time. may 18 :: vol 19 no 36 :: 41 Keywords Reflective practice; Respiratory system and disorders These keywords are based on the subject headings from the British Nursing Index.
This article has been subject to double-blind review. For related articles and author guidelines visit the online archive at www. uk and search using the keywords. THE ESSENTIAL purpose of reflective practice is to enable the practitioner to interpret an experience in order to learn from it Johns It is a process that involves examining individual personal thoughts and actions in daily practice Somerville and Keeling This reflective account relates to knowing-in-action everyday practicewhich Schon identifies as reflection-on-action. We discussed how to manage reflective account essay by keeping her oxygen in place and using her salbutamol inhaler Bellamy and Bookerto try pacing herself and to develop a coping strategy that would help her to manage her panic attacks.
She said she would try this. When I completed my clinical assessment and documented her spirometry, which was reflective account essay, I felt satisfied that her condition was stable. I explained to her that I was going on leave the next day but that I would visit her on my first day back at work the following week. If she had any problems, she had the office telephone number to contact other members of the respiratory team. This I did and arranged to visit him that afternoon at home. He informed me that she had been unwell for a couple of days. Hospital admission was offered but Mary declined and stated that she would wait for the GP to visit the next day. In the early hours of Friday morning Mary informed her husband that she felt unwell and requested an ambulance.
As he was making the call he described Mary as having some form of fit and she appeared to stop breathing. Her husband had some first aid experience and was able to revive her. The ambulance crew arrived soon afterwards, but she arrested as they were transporting her from the house to the ambulance. The framework allows practitioners new to reflection to examine personal thoughts and actions with a structure that is easy to apply and understand. The reflective account essay outlined in the model helped me to analyse my clinical practice and provided a framework for reflection Box 1. This related to the development of a therapeutic nurse-patient relationship and the feelings of guilt I experienced in that I may have let the patient down when most needed, in the final stages of her life.
Questions in the model asked why I responded in the way I did and the consequences of this for myself and others involved, how I felt about the situation and whether I could have responded to the situation in a different way. Development of a therapeutic nurse-patient relationship Knowing and understanding the patient as an individual is pivotal to establishing a therapeutic nurse-patient relationship and sets a particular patient reflective account essay from other patients with the same medical diagnosis Radwin Mitchell emphasises reflective account essay patients who feel understood and accepted also feel cared for, reflective account essay.
As I visited Mary weekly at home, I witnessed the effects that living with COPD had on her — how minimal exertion caused her severe breathlessness, which affected her daily life and her role in the family. According to Benner and Wrubeltheory relates not only to theoretical and formal knowledge, but also to experiential knowledge of the real-world experience. To develop a professional nurse-patient relationship To empower Mary to manage her panic attacks To enable Mary to die at home Why did I respond as I did? I felt guilty that I may have let Mary down. If I had been on duty would the result have been the same? Following her death they were devastated but felt that she was now at peace, which comforted them How do I know how the patient felt? Mary told me that she looked forward to my visits.
She felt I really understood how she felt and what she was experiencing How did I feel about the situation? Very guilty that I had not been around at the time of death, reflective account essay, when I was most needed When Mary died I experienced sadness and grief at the loss of someone with whom Reflective account essay had shared a great deal regarding her illness I felt disappointed that I had not been able to experience the closure of her care What factors influenced my decisions and actions? A strategy had been discussed on my last visit of how Mary should manage her panic attacks What sources of knowledge influenced my decision-making? Although Mary had reported an increase in her panic attacks, her condition was unchanged clinically Mary and her family were fully aware of how to contact my colleagues in my absence What other choices did I have?
I could have requested my colleagues to either telephone or visit the patient What were the consequences of this choice? I do not feel that these choices would have altered the course of events How do I now feel about this experience? I have mixed emotions, as Mary did not die peacefully at home as she had wished. However, reflective account essay, had I created a vision of a perfect death and the end result had not been as I had visualised? What have I learnt from this experience? As an example of using my clinical skills and knowledge, I had recognised that Mary was developing early signs of cor pulmonale right sided heart failure caused by primary lung diseasewhich is one of reflective account essay complications of severe COPD.
I had recognised this by clinically assessing the patient, recording her oxygen saturations and monitoring her symptoms: low oxygen saturations below 90 per cent ; increasing shortness of breath; and peripheral ankle oedema. Consequently, longterm oxygen therapy was implemented following discussion with her consultant and blood gas analysis, reflective account essay. She was grateful for this and felt it helped her to manage her symptoms and improve her daily activities of living Roper et al Webb reflective account essay that listening and showing empathy is of great importance to patients because, reflective account essay, for some patients, psychosocial needs were seen as more important than the physical aspects of their care, where action could be taken to deal with worries or concerns.
Luker perceives the nurse-patient relationship as the means by which therapeutic nursing care can be delivered. Mary trusted my judgement and abilities as a 44 may 18 :: vol 19 no 36 :: nurse and often told me how much better she felt once I had seen her. My visits gave her confidence and reassurance. At times her needs were extensive and she would call me in times of crisis when unwell, reflective account essay. I had previously been available when needed and was dependable, therefore providing a sense of security to Mary, reflective account essay. I was happy to do whatever I could to promote care and comfort, and to ease her reflective account essay. Ramos describes levels of liking and bonding with patients.
Mary and I had established a bond and professional friendship, which was easy and comfortable, reflective account essay. Ramos found that, at Level 3, nurses would give care above and beyond the call of duty, reflective account essay. Her care involved more than delivering treatments and performing tasks; it involved demonstrating an understanding of her experiences, her personal beliefs and what was important to her. Even though I felt my relationship with Mary was purely professional, my feeling of reflective account essay may account for why I felt so guilty when I heard that Mary had died. This led me to question whether I had become overinvolved with Mary without being aware of this.
However, I do not feel that I jeopardised the team network or allowed my relationship with Mary to affect my judgement. This might have been because, without realising it, reflective account essay, I had been overprotective and felt that I was the only professional reflective account essay could reflective account essay her wish to have a peaceful and dignified death at home. Karlsen and Addington-Hall acknowledge that many patients would prefer to die at home rather than in a hospital setting. This had been discussed several months previously, following her decision not to go ahead with the assessments for a heart and lung transplant. Mary was aware of the severity of her condition and had said that, if she only had six months to reflective account essay then, so be it.
I often refer to the stages of dying — denial and isolation, anger, bargaining, reflective account essay, depression and acceptance — that Kubler-Ross reflective account essay, when patients are entering the terminal phase of illness. Although patients may not experience these feelings in this reflective account essay, they enable practitioners to help patients to cope with dying and death. In contrast, Benner and Wrubel suggest that the way these psychological stages have been used has led to the concept of a perfect death. Benner and Wrubel state that nurses who develop and use appropriate skills such as empathy and understanding with a caring attitude help people to open up and address the needs of individual patients, reflective account essay.
However, as I discovered, developing a close and open relationship with patients increases the risk of experiencing personal and emotional pain. Although this study relates to the experiences of novice nursing students, it reflective account essay also be related to nurses with more experience. I can relate to the feelings of guilt, shock and letting the patient down that many of the students experienced, but perhaps on a different level. As qualified practitioners, we develop skill, knowledge and expertise over time to enable us to relate theory to practice and deliver expert care. We learn through our experiences and by coping with a variety of situations. The most common explanations reflective account essay that student nurses really liked the patients Loftus They had developed good relationships with the reflective account essay, finding them easy to talk to, especially as there was openness concerning their condition and prognosis.
Maybe this is reflective account essay why we sometimes feel different levels of sadness when patients die. Inter-subjectivity relates reflective account essay the notion of embodiment; in other words, where the nurse is wholly immersed in the experience of the patient Maeve
what should i write my essay about
As such, these kinds of reflective practices can lead to profound changes in the way that you conduct your work, and in how you think about certain situations. In addition, by becoming more proficient at reflective writing, you will also become more adept at analysing what you have read, observed, or listened to, and this a skill that will come in useful in other areas of your work, as critical analysis is an important part of most academic writing. Moreover, you will also become more skilled at making connections between academic texts and theories, and your own experiences, which is useful in joining the dots between theory and practice. Thus, if you can make such connections, then you are more likely to be enthusiastic about studying such theories, as you will be more convinced about their application in the real world.
Furthermore, you will also become more skilled at subjective writing too, which can come in useful from time to time, even in your academic writing. As an example, on a very simple level, a reflective piece could look something like this:. Description: I worked at a psychiatric hospital for a period of six weeks, on a voluntary basis. As such, based upon this particular reflection, it might be concluded that the writer reflecting on this experience might no longer wish to pursue a career in mental health.
Or, they might decide that they would be better suited towards low-level counselling work such as in a school , rather than working with people with chronic and severe mental health conditions. Of course, reflective essays are likely to be much more in-depth than this, with your assignment perhaps specifying a particular number of words for the piece, such as 1, words, or words, for example. If this is the case, then you are going to need to go into some considerable depth, and this will likely lead to further revelations as your analysis of your experience becomes more extensive, and as you add theories and different perspectives into the equation. In the end though, the overall purpose of a reflective essay is for the writer of it to reflect upon their experience, and to ultimately learn something from it.
What writing a reflective essay does then, is to help the writer to make sense of their experience, through some in-depth analysis of it, so that some valuable lessons can be learned, moving forwards. In order to achieve this, a number of frameworks have been created over the years, to help guide the writing process of a reflective essay, and so some of these should be considered before you start. There are a number of theoretical frameworks that can be drawn from to construct your reflective essay, and two of the most well known are those of Kolb and Gibb For more detailed guides on the various models of reflection take a look at our reflective models guide on NursingAnswers. Thus, the key difference here is that you should not only learn from a reflective experience, but you should also put what you have learned into action.
You should note that this framework closely resembles Essay Structure 1 , which we discussed above, with the addition of a more practical element for the final step. Thus, you could try out what you have learned in a practical setting, and then add the result of this into your conclusion section. This is perhaps currently the most well known and popular model used in reflective essays. Thus, this time, the six stages are: 1 description, 2 feelings, 3 evaluation, 4 analysis, 5 conclusions, and 6 action plan.
Therefore, the description is fairly self-explanatory, and involves, again, a description of the events. Next, you are to document your feelings about the events, both during the event, and after it; and this should be followed by an evaluation of the experience, and what the pros and cons were, including the reactions by those present, and whether the situation changed in any way. The analysis section can then include pertinent literature, which has relevance with the event, and this will be followed by a conclusion, showing what was learned, and what could have been done differently. The action plan then details what you would do if the situation unfolded again, and what preparations you might go through prior to it. As such, these frameworks provide a useful structure to work from, and this could also be incorporated into the structure of your essay if you prefer, if you work better with a more formulaic approach.
This then, more closely resembles Essay Structure 2 , detailed previously, with the analysis section being split into sections on feelings, evaluating these feelings, and then analysing the events, in addition to the action plan suggested by Kolb Figure 1. The reflective essay has become a staple of assessment in educational institutions around the world, and is particularly commonplace on university undergraduate or postgraduate courses—and so it is important to understand the ins and outs of such assessments, so that you are better prepared when you get handed such an assignment. If you can become familiar with the reflective cycles of Kolb and Gibb , then you will have a good idea of what is expected of you when you receive one of these assignments, and you should be adept at writing in the first person, and in an formal tone, so that you can hit the mark with the kind of style you should be aiming for.
However, the main thing to remember, when doing such an assignment in addition to striving to get a good grade! In the end, what your teacher wants to see is that you are reflecting upon your personal experiences, rather than just letting them pass you by, and that you are linking theory with practice, and gaining a deeper understanding of your experiences. If you can do this, and your writing is solid, written in the correct tense, and with the right tone, then you are almost certain to get the grade that you want. Fair Use Policy Customer Login. Nurse conducting a patient interview How Do I Write a Reflective Essay? Thinking About the Structure of Your Paper Next, you need to think about the structure of your paper.
Essay Structure 1: Introduction, Main Body, Conclusion Essay Structure 2: Introduction, Description of Event, Analysis, Conclusion Thus, if you choose to go with Essay Structure 1, then you will need to merge your description and reflective analysis, and you can do this by having a topic sentence detailing this particular part of your experience , followed by some analysis and supporting details, and then by adding a paragraph-ending mini conclusion—and then you can follow this micro-structure within each proceeding paragraph in your Main Body. As such, in Essay Structure 1, each paragraph of your Main Body might look something like this: Topic Sentence: Describe this part of your experience and what happened Analysis and Supporting Details: Reflect upon this particular part of the experience and try to explain it with the use of various theories, perspectives, or supporting evidence Paragraph-Ending Mini Conclusion: Round off the paragraph by making some conclusions based upon the reflections However, for many people, Essay Structure 2 might be easier to handle, as by taking this approach, you can simply write a description of your experience in full, and then analyse everything, in more general terms, and pick out particular parts that you find especially interesting.
net Thinking About the Tone of Your Reflective Essay The tone of your reflective essay is also important, and should be formal in nature, without being overly academic, as you will be including your personal thoughts and feelings, which are subjective in nature. What Are You Supposed to Learn From Writing a Reflective Essay? Reflective Frameworks That Can Be Drawn From There are a number of theoretical frameworks that can be drawn from to construct your reflective essay, and two of the most well known are those of Kolb and Gibb com Final Thoughts… The reflective essay has become a staple of assessment in educational institutions around the world, and is particularly commonplace on university undergraduate or postgraduate courses—and so it is important to understand the ins and outs of such assessments, so that you are better prepared when you get handed such an assignment.
Essays, UK. November Complete Guide to Writing a Reflective Essay. Her husband had some first aid experience and was able to revive her. The ambulance crew arrived soon afterwards, but she arrested as they were transporting her from the house to the ambulance. The framework allows practitioners new to reflection to examine personal thoughts and actions with a structure that is easy to apply and understand. The questions outlined in the model helped me to analyse my clinical practice and provided a framework for reflection Box 1. This related to the development of a therapeutic nurse-patient relationship and the feelings of guilt I experienced in that I may have let the patient down when most needed, in the final stages of her life.
Questions in the model asked why I responded in the way I did and the consequences of this for myself and others involved, how I felt about the situation and whether I could have responded to the situation in a different way. Development of a therapeutic nurse-patient relationship Knowing and understanding the patient as an individual is pivotal to establishing a therapeutic nurse-patient relationship and sets a particular patient apart from other patients with the same medical diagnosis Radwin Mitchell emphasises that patients who feel understood and accepted also feel cared for. As I visited Mary weekly at home, I witnessed the effects that living with COPD had on her — how minimal exertion caused her severe breathlessness, which affected her daily life and her role in the family.
According to Benner and Wrubel , theory relates not only to theoretical and formal knowledge, but also to experiential knowledge of the real-world experience. To develop a professional nurse-patient relationship To empower Mary to manage her panic attacks To enable Mary to die at home Why did I respond as I did? I felt guilty that I may have let Mary down. If I had been on duty would the result have been the same? Following her death they were devastated but felt that she was now at peace, which comforted them How do I know how the patient felt? Mary told me that she looked forward to my visits. She felt I really understood how she felt and what she was experiencing How did I feel about the situation?
Very guilty that I had not been around at the time of death, when I was most needed When Mary died I experienced sadness and grief at the loss of someone with whom I had shared a great deal regarding her illness I felt disappointed that I had not been able to experience the closure of her care What factors influenced my decisions and actions? A strategy had been discussed on my last visit of how Mary should manage her panic attacks What sources of knowledge influenced my decision-making? Although Mary had reported an increase in her panic attacks, her condition was unchanged clinically Mary and her family were fully aware of how to contact my colleagues in my absence What other choices did I have?
I could have requested my colleagues to either telephone or visit the patient What were the consequences of this choice? I do not feel that these choices would have altered the course of events How do I now feel about this experience? I have mixed emotions, as Mary did not die peacefully at home as she had wished. However, had I created a vision of a perfect death and the end result had not been as I had visualised? What have I learnt from this experience? As an example of using my clinical skills and knowledge, I had recognised that Mary was developing early signs of cor pulmonale right sided heart failure caused by primary lung disease , which is one of the complications of severe COPD. I had recognised this by clinically assessing the patient, recording her oxygen saturations and monitoring her symptoms: low oxygen saturations below 90 per cent ; increasing shortness of breath; and peripheral ankle oedema.
Consequently, longterm oxygen therapy was implemented following discussion with her consultant and blood gas analysis. She was grateful for this and felt it helped her to manage her symptoms and improve her daily activities of living Roper et al Webb acknowledges that listening and showing empathy is of great importance to patients because, for some patients, psychosocial needs were seen as more important than the physical aspects of their care, where action could be taken to deal with worries or concerns. Luker perceives the nurse-patient relationship as the means by which therapeutic nursing care can be delivered. Mary trusted my judgement and abilities as a 44 may 18 :: vol 19 no 36 :: nurse and often told me how much better she felt once I had seen her.
My visits gave her confidence and reassurance. At times her needs were extensive and she would call me in times of crisis when unwell. I had previously been available when needed and was dependable, therefore providing a sense of security to Mary. I was happy to do whatever I could to promote care and comfort, and to ease her suffering. Ramos describes levels of liking and bonding with patients. Mary and I had established a bond and professional friendship, which was easy and comfortable. Ramos found that, at Level 3, nurses would give care above and beyond the call of duty. Her care involved more than delivering treatments and performing tasks; it involved demonstrating an understanding of her experiences, her personal beliefs and what was important to her.
Even though I felt my relationship with Mary was purely professional, my feeling of sadness may account for why I felt so guilty when I heard that Mary had died. This led me to question whether I had become overinvolved with Mary without being aware of this. However, I do not feel that I jeopardised the team network or allowed my relationship with Mary to affect my judgement. This might have been because, without realising it, I had been overprotective and felt that I was the only professional that could deliver her wish to have a peaceful and dignified death at home. Karlsen and Addington-Hall acknowledge that many patients would prefer to die at home rather than in a hospital setting. This had been discussed several months previously, following her decision not to go ahead with the assessments for a heart and lung transplant.
Mary was aware of the severity of her condition and had said that, if she only had six months to live then, so be it. I often refer to the stages of dying — denial and isolation, anger, bargaining, depression and acceptance — that Kubler-Ross identified, when patients are entering the terminal phase of illness. Although patients may not experience these feelings in this order, they enable practitioners to help patients to cope with dying and death. In contrast, Benner and Wrubel suggest that the way these psychological stages have been used has led to the concept of a perfect death.
Benner and Wrubel state that nurses who develop and use appropriate skills such as empathy and understanding with a caring attitude help people to open up and address the needs of individual patients. However, as I discovered, developing a close and open relationship with patients increases the risk of experiencing personal and emotional pain. Although this study relates to the experiences of novice nursing students, it can also be related to nurses with more experience. I can relate to the feelings of guilt, shock and letting the patient down that many of the students experienced, but perhaps on a different level.
As qualified practitioners, we develop skill, knowledge and expertise over time to enable us to relate theory to practice and deliver expert care. We learn through our experiences and by coping with a variety of situations. The most common explanations were that student nurses really liked the patients Loftus They had developed good relationships with the patients, finding them easy to talk to, especially as there was openness concerning their condition and prognosis. Maybe this is also why we sometimes feel different levels of sadness when patients die. Inter-subjectivity relates to the notion of embodiment; in other words, where the nurse is wholly immersed in the experience of the patient Maeve On reflection, this is possibly the reason I felt guilty — I had let Mary down in terms of embodiment — the experiences of caring for Mary and seeing her struggle with her breathing were not separate to our relationship.
When she died I shared the sadness of her dying and the possibility of being denied the opportunity to close the relationship by being with her at the end of life. Murray Parkes provides a possible explanation that the death of a person, and the nature and quality of the attachment formed, determines the intensity of grief experienced. Integration of reflective experience Nursing ethics relates to moral issues and choices concerning questions about morally right and wrong actions in connection with care and management of patients Carper Fry suggests that nursing ethics concentrates on the nature of the nurse-patient relationship, of which nursing care is central, rather than on decision-making claims of moral justification.
The relationship Mary and I shared was based on the principles of honesty, integrity and trust, identified by McCormack as essential for a caring and committed relationship. I believe the care and support I gave Mary was to the best of my abilities.
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