Reflective Essay on Nursing Practice Standards

This reflective essay discusses the author's experience in a clinical placement and reflects on the second and sixth standard of care as set by the registered nursing practice standards set by the AHPRA. The author identifies strengths and weaknesses in their practice and develops an action plan for improvement.

Running head: REFLECTIVE ESSAY
Reflective essay
Name of the student:
Name of the university:
Author note:

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REFLECTIVE ESSAY
Introduction:
The nurses have job responsibilities and job roles that can overlap among each other
which can often lead to various complications associated professional competence. Often the
nurses do not understand the most plausible course of action for the nurses in ethically
pressing situations (Levett-Jones, Reid-Searl & Bourgeois, 2018). The registered nurse
practice standards provides a set of clear guidelines for the nursing professionals so that they
can engage in practice while adhering to all of the critical practice legislations and
requirements. The registered nursing practice standards set by AHPRA provides a set of clear
guidelines and practice care requirements (Ahpra.gov.au, 2018). In this essay I will reflect on
the second and sixth standard of care as set by the registered nursing practice standards set by
the AHPRA on the basis of the clinical placement that I have attained as an imminent
registered nurse to be.
Description:
I have been given the opportunity to complete my clinical placement in the primary
health care facility where I had been placed under the supervision of a senior registered nurse
caring for a chronically ill culturally diverse patient. Her name and personal details will not
be disclosed in the assignment in order to protect the privacy and confidentiality. However, in
order to provide certain demographic detail, I would like to mention that she had been dealing
with COPD for a considerable period of time and had been extremely exhausted and agitated
due to the recent exacerbation event she underwent. Communicating with her had been a
considerable challenge due to her extreme irritation and agitation along with the struggle of
coping with the COPD exacerbations. I had been given the opportunity to communicate with
her and administer a medication to her taking her consent and explaining about the need for
medication administration (Barksby, Butcher & Whysall, 2015). When I approached to take

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REFLECTIVE ESSAY
her consent and perform the safe practice of five rights of medication administration, she
appeared nonchalant and disturbed throughout me trying to communicate with her. However,
as she started to get agitated with I continuously trying to administer the medication, my
supervisor stepped in with a few calming and conventional gestures apt for culturally diverse
patient, she calmed down and the medication was administered ultimately. Hence, I believe
this particular experience easily aligns to the standard two (Engages in therapeutic and
professional relationships) and standard 6 (Provides safe, appropriate and responsive quality
nursing practice) (Ahpra.gov.au, 2018).
Feelings:
First and foremost, I would like to mention in this context that this had been an
excellent opportunity for me to apply my theoretical knowledge in the practical practice
scenario. This clinical placement scenario had been my first encounter with the real world
patient care and I had been both euphoric and extremely tense regarding the experience. I
would like to mention in this context that I am extremely grateful for the support and
assistance I have received from the supervisor that I had been assigned to, and I strongly
believe that her support and assistance has helped me tremendously in completing the
placement experience successfully and also helped me acquire an array of different skills and
expertise that will help me in the future practice. furthermore, considering the challenging
issue that I faced in the placement, I would like to mention that I was very nervous, confused
and scared while communicating with the patient and administering medication. Although,
the help and support from the supervisor helped me overcome the challenges effectively.
Evaluation:
The evaluation section of the Gibbs’s reflection cycle instructs the nursing
professional to reflect on the experience, and discovering all the positive aspects in the

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REFLECTIVE ESSAY
experience that worked in the experience and the negative aspects that did not work in the
experience (Levett-Jones et al., 2015). There are various positive aspects, firstly, I adhered to
all the safe practice guidelines for care delivery while attending to the patient. I had been very
respectful in communicating with her and attempted to appear compassionate and empathetic
while engaging with her. According to the sixth standard of the registered nursing practice
standards, the nurses are to engage in safe effective and responsive quality of practice while
attending to the patients. In my case, I had been given the task of administering the
medication to the patient, and as per the guidelines of the safe and effective practice, a
nursing professional is expected to perform the 5 rights of medication administration,
respectfully extract informed consent for medication administration while explaining the need
for the medication administration before actually administering it (Chang, 2015). I had
successfully adhered to all of the mentioned requirements which indicates that my
performance had been concurrent with the sixth standard or registered nurse practice
standards. On the other hand, discussing the negative aspects which did not work, although I
employed effective patient engagement tactics, I completely forgot to implement nonverbal
cues of communication while engaging with her which agitated the patient. According to the
second standard, the nurses are required to engage in therapeutic and professional
relationships. As mentioned by the authors, in this case the nurses are required to employ
effective communication techniques, both verbal and nonverbal to establish therapeutic
relation. Especially for the culturally diverse patients, effective nonverbal cues of
communication such as gestures and eye contact has more impact on calming the patient and
helping the patient feel respected and valued in relation to their cultural identity and dignity.
Due to the excitement and nervousness, I completely forgot to implement effective non-
verbal cues of culturally appropriate communication which must have seemed offending and
disrespectful to the culturally diverse elderly patient which further agitated her. Evidently,

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REFLECTIVE ESSAY
when my supervisor stepped in with the correct gestures and eye contact while apologizing to
her, she calmed down effectively and the medication administration procedure went
smoothly, which indicates I was unable to adhere to the second standard (Tracey &
McGowan, 2015).
Analysis:
Although the experience left me flustered and embarrassed of my shortcomings and
mistakes, my supervisor helped me realize that it is very common to make such superfluous
mistakes while commencing with first encounter of medication administration (MacLellan,
Levett‐Jones & Higgins, 2015). She helped me identify the root cause of my error which had
been my excitement, nervousness and gap between theoretical and practical knowledge. On a
more elaborative note, confusion and nervousness coupled with momentary lack of
confidence has been reported as very common sources of error and misjudgement in
transitioning nurses. As discussed by the Fry et al. (2015), the transitioning nurses while
engaging in their first clinical practice activity independently suffer from extreme fear,
confusion and nervousness due to the complete lack of ideation and experience of the
practical aspects of care. In support the Forsberg et al. (2016), have mentioned that the impact
of the gap in the knowledge of the nurses that are graduating between the theory and practice
leads to various errors, which leads to the nurses not being able to adhere to nursing
standards. In this case as well, my lack of practice oriented knowledge in engaging with a
patient led to an error which agitated a patient and violated the second nursing practice
standard. However, for aspects that require theoretical knowledge and expertise, my skills
and performance had been up to the mark with the standards of practice (6th).
Action plan:

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REFLECTIVE ESSAY
This experience helped me tremendously in identifying the strengths and weaknesses
in my practice. With the assistance of my supervisor I was able to identify that lack of
confidence, nervousness and lack of knowledge in effective nonverbal communication are my
key weakness which needs improvements. Hence, I would be enrolling in different
professional development workshops to develop my professional as well as personal soft
skills. Along with that, I will also be reaching out to my supervisor to avail suggestions to
bridge the gap in my theory and practice successfully (Kumaran & Carney, 2014).
Conclusion:
On a concluding note, this had been a very helpful opportunity which not only had
been my first encounter in clinical practice but also had helped me drastically in identifying
my strengths and weaknesses in practice. It can be hoped that I will be able to use the
knowledge and expertise gained constructively and with the aid of the action plan developed,
I will easily be able to implement these skills in practice for professional growth in future
practice.

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REFLECTIVE ESSAY
Reference:
Ahpra.gov.au. (2018). Australian Health Practitioner Regulation Agency - Registration
Standards. [online] Available at: https://www.ahpra.gov.au/registration/registration-
standards.aspx [Accessed 30 Sep. 2018].
Barksby, J., Butcher, N., & Whysall, A. (2015). A new model of reflection for clinical
practice. Nursing Time, 111, 34-35.
Chang, E. (2015). Transitions in nursing: Preparing for professional practice. Elsevier
Health Sciences.
Forsberg, E., Ziegert, K., Hult, H., & Fors, U. (2016). Assessing progression of clinical
reasoning through virtual patients: An exploratory study. Nurse education in
practice, 16(1), 97-103.
Fry, M., MacGregor, C., Hyland, S., Payne, B., & Chenoweth, L. (2015). Emergency nurses’
perceptions of the role of confidence, self‐efficacy and reflexivity in managing the
cognitively impaired older person in pain. Journal of clinical nursing, 24(11-12),
1622-1629.
Kumaran, S., & Carney, M. (2014). Role transition from student nurse to staff nurse:
Facilitating the transition period. Nurse education in practice, 14(6), 605-611.
Levett-Jones, T., Pitt, V., Courtney-Pratt, H., Harbrow, G., & Rossiter, R. (2015). What are
the primary concerns of nursing students as they prepare for and contemplate their
first clinical placement experience?. Nurse Education in Practice, 15(4), 304-309.
Levett-Jones, T., Reid-Searl, K., & Bourgeois, S. (2018). The clinical placement: An
essential guide for nursing students. Elsevier Health Sciences.

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REFLECTIVE ESSAY
MacLellan, L., Levett‐Jones, T., & Higgins, I. (2015). Nurse practitioner role transition: A
concept analysis. Journal of the American Association of Nurse Practitioners, 27(7),
389-397.
Tracey, J. M., & McGowan, I. W. (2015). Preceptors' views on their role in supporting newly
qualified nurses. British Journal of Nursing, 24(20), 998-1001.