Critical Reflection on Adult Nursing

This document provides a critical reflection on adult nursing, focusing on the importance of reflective analysis in learning and development. It explores a specific nursing care experience and discusses the use of the Gibbes model for reflection. The document also highlights the challenges faced and the lessons learned from the experience.

Critical Reflection on
Adult Nursing

Table of Contents
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................1
CONCLUSION................................................................................................................................7
REFERENCES................................................................................................................................9

INTRODUCTION
Critical reflection and reflective analysis is the most important tool or approach of
learning and development, because it helps in the brief analysis and evaluation of the specific
education and professional event, through which person can learn from their experience. They
can evaluate their weakness, strength and learning which can be further use in the development
plan and work accomplishment (Naicker, K. and Van Rensburg, G.H., 2018) . Thercritical
reflection can also help the nursing practitioners to identify the particular are of literature review
and research. Adult nursing care is involving the multiple roles of the nurses in context to the
care of patients who are suffering from the different health issues and condition. Therinvolves
the different types of care process such as the holistic care to improve the patient condition by
providing the effective care and support. In therreport reflective analysis of adult nursing care
practice is going to be done in order to develop the evaluation of experience for identifying the
particular are of literature review. Therreport is going to step conduct systematic reflection, such
selection of the reflective model and its justification. Analysis and selection of adult nursing
experience for systematic reflection. Then critical reflection in relation to the chosen experience.
MAIN BODY
Reflective model
Reflective models are the key source of the specific action reflection which helps to
engage in the continuous process of the learning and development. There are the various
reflective models such as the Kolb reflective model, Schon model, Johns model, Gibbs reflective
model and so on. In context to therreport for reflective analysis of the adult nursing care
experience and for the identification of literature review topic Gibbes model selected. Theris the
simple cyclical model which makes it easy to implement for reflective purpose. Theris popular
among the nurses. Therselected due to its easy steps and effective benefits in context to the
effective reflection and action plan development ( Rasmor, M. and Dekker, L., 2018) . There are
the various advantages of Gibbes model over all other reflective models, due their higher
limitation. Below is the brief illustration and comparison of some selective reflective models
along with the Gibbes model in order to justify the selection of Gibbes model.
Gibbes reflective cycle
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Therreflective model is one of the most applied and effective, therwas developed by the
Graham Gibbs in 1988, in context to the facilitating the structure of learning from experiences. It
cyclic structure of experience reflection also helps in the regular action plan for learning and
development. Theris involving the 6 stages or steps of the reflection which is illustrated below.
Description- Therinvolves the process of experience explanation.
Feeling- Therinvolves the person thoughts and feelings about the experience.
Evaluation – Therinvolves the brief illustration of the good and bad facts of experience.
Analysis- In therstep person has analyse the specific sense of that situation.
Conclusion- Therstep is involving the summarised conclusion of the experience that
what was the effective facts and unique action done by the person (Melquíades Menezes, P.C
2017).
Action plan- Therinvolves the use of identified weakness for further improvement and
development.
Kolb reflective model
Theris most efficiently the learning cycle which helps the person to make effective
learning steps, but thernot focusing on the reflection in brief, such as it is involving four steps of
learning from which one is focusing on the reflective analysis and other is about action and
feeling of the learning.
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There the four steps of thermodel is concrete experience (therinvolves participation in
experience) , reflective observation (making the sense of experience) , abstract conceptualization
( make generalization and related to the theories) and active experimentation (Therinvolves the
development and implementation of new action plan with different approaches).
Limitation
Thermodel is not involving the sufficient steps of reflective analysis
Thercan results in false conclusions
Theris not appropriate to understand and explain change and new experiences
Therrequire huge time in context to reach reflective stage.
Schon reflective model
Therreflective model is divided two major stapes of the reflection and learning that is the
Reflection in action and reflection on action.
Reflection in action- Therinvolves the reflective analysis of contemporary situation,
under which person have consider the situation, make decision that how to act and in final step
person have act imminently.
Reflection on action- Therreflective step of the model is involving the consideration of
situation, think that what happen and what need to change for future (Li, Y., 2020).
Limitation
Theris difficult to understand the reflective process of thermodel
It could be time consuming
Thercreates confusion in which situation and experiences to reflect upon.
Theris not adequate for resolving the clinical problems
Analysis and selection of the adult nursing care experience
Adult nursing care is the most important and respective field of health care under which
nurses work with the young and old adults with the diverse health conditions, related to both
chronic and acute situation. Nurses have to use all educational, practical and interpersonal skills
to improve the quality of patient life and to control health condition of patient by the health care
practices like caring, counselling, managing, teaching and support. I am at the position of adult
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nurse and I had experienced various adult care cases from which one of the case is explain
below.
Mrs Johnson is 80 year old with history of chronic venous ulceration affecting her both
legs, and earlier in she was also diagnosed with type 2 diabetes in 2019 it has been analysed that
Ulcerations which associated with diabetes are the most common cause of foot ulcers. And
according to medical history she had symptoms like hyperglycaemia, and her blood glucose
record is indicating the higher glucose value of 118-125 mg/dl. Which was described that she is
indicating the borderline diabetes. At the time of first diagnosis, she was advised to take low
calorie diet and lose weight and then no further action was taken. One year ego her case was
reported in the health care organisation, due to complexity in living condition and huge pain in
the libs. As an adult student nurse, I had placed in community care practices, under which I was
responsible to provide effective holistic care, by taking the care of her medication, emotional
support, education and in that time, I had a responsibility of coordinating with the health care
professional on regular basis for motoring the improvements and effectiveness of the
intervention in context to the selective outcomes. In that situation there was the higher need of
team work and effective interdisciplinary skills implementation, the main objective in that was to
control of JOHNSON libs ulcer and help him out live healthy life by improving the day life
activities and habits of the patient with healthy habits and activities. Patient was having the bad
habit like alcohol and junk food. Her body weight was 120 kg which had to be reduce, so in that
case I used my professional skills and personal skills to effectively manage and improve the
medical condition of Mrs. JOHNSON . Such as in one day she was not getting ready to take her
medications and prescribed diet, due to which I faced the issue of patient abnormal behaviour
like she falls down by trying to pushing me out. But in that situation is used my communication
skills to manage the patient along with that I used my team-working skills to solve the problems
and influence the patient to take her medication and diet (Oguntibeju, O.O., 2019). Every day
had to help him out in exercise and I got success in that due to my motivation, communication
and people engagement skills. Within the specific control in the weight and libs ulcer the case
task was ended.
Critical and systematic reflection in context to the chosen experience by the aid of Gibbes
model.
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Description- Chronic venous ulceration, is the type of ulcer which is most usually occur
in the patient legs. This is the type of chronic sore which takes more than two weeks to recover
or take more than that. Patinate medical history is the medical condition at which patient body
cannot produce the enough insulin or either resists the insulin reaction in the cells, which causes
the higher blood glucose level due to the inappropriate processing of the glucose in cells. Patient
in that situation faces the higher problems in their professional life, due to the physical
symptoms. Such as the, weight gain and loss, frequent urination, blurred vision and poor wound
healing. So in my adult nursing care practice experience, there was the chronic venous ulceration
patient, who was having the history of chronic venous ulceration and type 2 debate’s which are
associated influencer of legs ulcer. came with problem of libs ulcer and body movement issues.
On that case I was responsible for holistic care practices, under which I had to perform various
task and care practice’s, such as emotional supporutcomes.t, social and medical support, personal
support in eating, walking and gaming. On that adult care practices, I faced various issues and
achieved various outcome, with in the influence of changing environment and skills
implementation. On that care process I was doing the Daly responsibility of patient care, such as
on, that time I were managing the exercise timing and activity of patient along with her diet plan
and medication. One day I was helping her out in exercising plan and compressive dressings due
to which I was doing compressive dressings of MRs JOHNSON three time per week. But I
faced the huge issues in that care process because she refused with very abnormal behaviour and
tried to harm me, that situation was the bad, but I was not aware that how to react in holistic care
approach during the abnormal behaviour of patient. So that bad factor of situation was solved by
teamwork king, because I called my health care colleagues to help me out in that situation.
Feeling- In context to that adult care case my feelings and thoughts is very influencing, at that
time when patient refused to follow her exercise routine, I thought that there should be evidenced
based guidelines related to the patient management practices, with more detailed information of
risk management. In context to the compressive dressing of the patient that is difficult to be
patient and provide effective care but I managed this with empathy. That time I feel that I should
possess the complete knowledge of the holistic care practices in context to the specific type of
medical condition. On that case it was my professional skills how managed me to handle the
stress of patient care responsibility, I feel that empathy and communication skills are helping me
out in various issues and stress of that patient care plan and practice’s. Now my feeling for Mrs.
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JOHNSON . is that he should be facilities with all facilities when he tried for the primary care of
diabetes at the starting stage when he diagnosed with the symptoms of diabetes. Because that is
important in each and every case to make best efforts for disease control as soon as possible, as it
can be effectively control in primary stage. Due to my different care responsibility in context to
the Mrs. JOHNSON . I feel that engagement is the most important factor of the patient care as it
helps to engaged the patient in positive talks and motivate them to take every care precaution and
prescription. Because on that case most of the time I used to implement the communication skill
in order to engage the patient in hercare practice’s, positive communication and patient
engagement is important in order to get best results and outcome. Most of the time I applied the
team support and participation in patient care practise’s, which resulted the positive outcome,
due to which I feel that team work is the most important aspect of adult nursing care practice’s. I
thought that the successful achievements of the outcomes’ is done due to the implementation of
all essential evidence based practice’s and it can be further more improve for more effective
management and care of the patient.
Evaluation- One day during the care practice of Mr. JOHNSON , I fund that she is feeling bad
with the higher rate of libs pain, so in context to that symptoms of the patient, she should be
treated with the immediate professional support. But in that time, I faced various challenges due
to the immediate need and unviability of doctor at side, so I used the pain-relieving medication
and give it to her for the pain control and then I followed the Compression therapy which is the
golden way of care in that case. But that incident was very challenging for me and I regret that
did not challenged the doctor practices before he came, because patient couldn’t manage the pain
and faced higher issues in medication impact. I am pleased to that doctor, to respond so
positively to the that mistake, and then I observed that doctor has changed her practices and
managed that situation without reacting on that. I learn for that incident, which has been taught to
me in my education period, the importance of acting assertively with colleagues. In sensitive
manner in order to effectively safeguard the patient, well-being.
Analysis- According to the nursing institute for health and care excellence (NICE), which was
updated in the 2014. The godliness review that there had been changes in the areas for
improvement for diabetes in adults. According to that in most of the case diabetes is preventable
through lifestyle changes, such as the NHS ulcer prevention programme to help the people in
reduce the risk of developing, any chronic venous ulceration risk associated factors like diabetes.
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This involves the quality standard’s such as control of the blood glucose level, quality of life, life
expectancy etc. NICE quality standards support delivery of outcome framework, which was used
by us in development of the Mrs Johnson care plan. Because it consists of prioritised statement
designed to drive measurable improvements in three dimensions of quality, safety, experience
and effectiveness of care for particular area of health care. So, in context to all these quality and
health care standard’s that adult patient care framework was developed and managed to get
effective outcomes. Such I had been used various guidelines of those standards which helped me
out in effective patient care practices and challenge management. In each and every changing
situation is used to implement the NICE, although it was not appropriate for every issue but
effective in selective once.
Conclusion- Looking back to that case and abnormal behaviour of the patient, I can see that I
should have more knowledge of the evidence-based practices along with the problem-solving
skills and time management skills. I should have ensured each and every possible risk and its
management criteria, before the starting of patient care procedure. Now I can see my inaction in
the incident which was the result of inappropriate knowledge of evidence-based practices and
lack of risk assessment. Although I learn various things from that case and I understand my
strength such as the empathy, communication. But after discussion with my mentor, I recognise
that I needs to develop the confidence to challenge the practices of colleagues, putting the well-
binge of patient, I need to do more research in context to the effective evidence based practices
of holistic care.
Action plan- In future I will aim to develop my time management and evidenced based
knowledge of the holistic care, in order to ensure that the well-being of clients is maintained, in
my net assessment learning program I will make their goal for my learning and I will discuss
therewith my mentor that, to make strategy’s that how can I achieve this.
Identification and selection of the topic for modified literature review
Modified literature review is important in context to the nursing educational development
and effective improvement of the nursing care practises with the development and
implementation of more appropriate care practices (Sami, W., 2017). From the reflective analysis
of my adult nursing care experience, I fund that there is the gap in some professional skills and
evidence-based care practises. Such as according to reflective analysis, there is need of
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conducting literature review in context to the development of evidence based practices of patient
holistic care in diabetes medical condition.
CONCLUSION
From the above analysis and evaluation, it has been concluded that reflective analysis is
very essential process of the learning and development which helps in the proper evaluation of
the experiences that what we learn and what was are weakness and strength in particular
situation. In the adult nursing care practices nurses have to perform various care practices
according to the patient and her medical condition that is important to evaluation and reflective
analysis of patient care practices experiences in context to the analysis of skills gap, educational
gap, strength and weakness. Through which person can conduct the effective literature review
and action for the development. So from the assessment effective literature revive topic is
identified and selected, by the aid of Gibbes reflective analysis model and application of that to
the specific adult care experience. I used the model to conduct the reflective analysis of my
nursing care practices, under which is used 6 steps of reflection such as the Description, Feeling,
Evaluation, Analysis ,Conclusion, Action plan. By the aid of all these reflective steps I
identified the specific are of research and development in context to which I have to conduct
modified literature review.
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REFERENCES
Books and journals
Naicker, K. and Van Rensburg, G.H., 2018. Facilitation of reflective learning in nursing:
reflective teaching practices of educators. Africa Journal of Nursing and Midwifery, 20(2), pp.1-
15.\
Rasmor, M. and Dekker, L., 2018. Techniques to promote reflective practice and empowered
learning. Journal of Nursing Education, 57(2), pp.115-120.
Melquíades Menezes, P.C 2017. BURNOUT SYNDROME: A REFLECTIVE
ANALYSIS. Journal of Nursing UFPE/Revista de Enfermagem UFPE, 11(12).
Li, Y., 2020. Nurses’ Psychological Feelings About the Application of Gibbs Reflective Cycle of
Adverse Events. American Journal of Nursing, 9(2), pp.74-78.
Oguntibeju, O.O., 2019. Chronic venous ulceration mellitus, oxidative stress and inflammation:
examining the links. International journal of physiology, pathophysiology and
pharmacology, 11(3), p.45.
Sami, W., 2017. Effect of diet on chronic venous ulceration mellitus: A review. International
journal of health sciences, 11(2), p.65.
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