University Nursing Reflective Essay: Clinical Skill Assessment Report

This reflective essay analyzes a student nurse's experience with a clinical skill assessment involving a subcutaneous insulin injection, using the Gibbs reflection cycle. The student describes the clinical scenario, including patient details and vital signs, and reflects on their performance, highlighting both strengths and weaknesses. The essay covers feelings during the assessment, evaluates what worked and didn't, and analyzes the impact of stress and anxiety on performance, referencing relevant literature and nursing practice standards. It further discusses peer feedback and identifies areas for improvement, including drawing up medication, patient positioning, and documentation. The conclusion emphasizes the importance of continuous professional development and outlines an action plan to address stress management and enhance clinical competence through professional courses, supervisor guidance, workshops, and reflective journaling. This essay demonstrates the student's commitment to safe and effective patient care, in line with nursing practice standards.

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

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REFLECTIVE ESSAY
Introduction:
In nursing practice, there are various factors and conditions where the nursing
professional will have to take a clinical decision which will guide the care delivery and
maintaining the safety and welfare of the care provided though continued professional growth
(Boud, Keogh & Walker, 2013). The Gibbs reflection cycle serves as one of the greatest tools
which is abundantly used by the nursing professionals to assess their personal strengths and
weaknesses and improve their practice credentials continually (Moon, 2013). This essay will
reflect on the clinical experience that I have gained while in placement taking the assistance of
the Gibbs reflection cycle.
Description:
For the clinical experience, we were given the opportunity to administer a subcutaneous
insulin injection to a patient. In this case, I was assigned to a patient named Barbara Smart, who
had been an 84 year old patient with type 1 diabetes. the case history of the patient revealed the
fact that she had underwent a surgical procedure for umbilical hernia two years ago and her vital
signs indicated 88 bpm heart rate, 125/78 blood pressure, tympanic body temperature, 97%
oxygen saturation, 18 breaths per min respiratory rate, and 10.2 ml/mol blood glucose. I had
been given the opportunity to administer subcutaneous insulin injection to the patient as per the
medication chart. The primary aim of this particular exercise had been to assess our ability to
perform a few key skills that are necessary for nursing practice, where I scored 31 out of 40The
second test that I had to perform is peer feedback, where I scored 18 out of 20.
Feelings:

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REFLECTIVE ESSAY
I would like to mention that first and foremost, I would like to address in this context that
this had been an extremely beneficial experience for me before which helped me discover my
key strengths and my weaknesses with respect to my professional attributes and my scope of
practice before formally starting my practice in the real world clinical scenario. Exploring
further, I would like to mention that the overall score of my skill performance assessment had
been 31/40 and I had performed with excellent competence in most of the skills in this
assessment. As a student nurse I had felt extremely proud of myself to be able to perform all
these crucial nursing practice skills with required adequate competence. However, in the stress
and pressure of handling a patient for the first time, I had completely forgotten to document the
relevant information and I received 0 for this skill in the assessment which had been mortifying
and demotivating for me. The second test that I had to perform had been the peer feedback where
my performance had been much better and I regained my confidence with this assessment task.
Overall, this had been an excellent opportunity and although, I had been tensed and scared in the
beginning, as I went on performing the skills my confidence and knowledge was heightened at
each step (Paterson & Chapman, 2013).
Evaluation:
This is the third step of the reflection tool where the nurses evaluate what worked and did
not work in the scenario (Bulman & Schutz, 2013). In my case, I believe I had been very scared
and intimidated by having to administer a subcutaneous injection to a patient for the first time
and in the stress I fumbled with a few skills and ended up not being able to perform a few of the
skills without adequate competence approach from my end such as drawing up medication using
aseptic technique to prepare the medication, positioning the patient properly, and safely
administering the medication safely to maximize effect and minimize discomfort along with

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REFLECTIVE ESSAY
completely forgetting to remember documenting the relevant information. However, throughout
the skills assessment I had attempted to keep my composure and focus on the task at hand and in
most cases I think it worked exceptionally well for me. In the next assessment, however, the
stress of medication administration was lacing and hence I performed much better with adequate
confidence and competence.
Analysis:
According to Sarafis et al., (2016), the professional or occupational stress has a
significant severe impact on the patient outcomes and the performance statistics of the nurse
under consideration as well. Hence the anxiety and stress can be extremely strenuous on the
graduating nurses making transition into practice, especially in the placement scenarios
(Alzayyat & Al‐Gamal, 2014). Exploring my experience of the assessment task that I had
performed, for assessment task 1, I scored exceptionally well in skills including assessment
including identifying indication, verifying the validity of the written order, performing five
moments of hand hygiene, gathering equipment, complying with the rights of medication
administration, locating and assessing the appropriate site, disposing off the sharps appropriately,
tending or assessing the puncture site, cleaning, replacing and disposing the sharps. It has to be
mentioned that my focus and dedication helped me overcome my stress and perform these
activities. Although, for skills such as evidence of therapeutic interaction, drawing up medication
using aseptic technique to prepare the medication, positioning the patient properly, and safely
administering the medication safely to maximize effect and minimize discomfort, which requires
attention and confidence, I lacked optimal competence. As per my best understanding of the
experience, the stress and anxiety had been the primary cause of the most of the errors I have
committed in the assessment. Furthermore, when the stress of administering intravenous

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REFLECTIVE ESSAY
medication was removed I performed much better in the second task with skills including
describing what had been done well and why, describing the areas that are in need for
improvement, completing the feedback timely without rushing it, and finally providing the
feedback in a professional and respectful manner, barring only advising to improve future
performance. However, it has to be mentioned that the occupational stress is an inevitable
element of the professional practice of the nurses and I would need to overcome the detrimental
impact of the stress and anxiety to ensure that my future practice scenario will not be similarly
affected by the stress and anxiety under any circumstances. According to the registered nurse
practice standards, the nurses are required to provide safe and effective care prioritizing the
safety and efficacy of the patient over anything else (van der Riet et al., 2015). Hence, I would
also require to overcome my weaknesses to be able to provide safe and effective care to the
patients without any errors regardless of the stressful situation.
Conclusion:
It is imperative for the nurses to go through continuous improvement of their services in
order to be able to prove safe and effective acre at all times along with adhering to each of the
professional and legal standards of the nursing practice. This exercise did not just provide me an
opportunity to discover my strengths and weaknesses but also have given me guidance of how to
incorporate Gibbs reflection tool in my practice in future to ensure optimal and continual
professional growth, so that I can learn from my errors and be able to improve practice scope
successfully.
Action plan:

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REFLECTIVE ESSAY
In order to be able to overcome my inability to handle professional stress and anxiety, I
would attempt to enroll in professional competence courses. Along with that, I would also reach
out to my supervisor regarding my issues and take her advice in overcoming this stress. I would
also join a few professional stress endurance and competence enhancing workshops to help
overcome the anxiety without letting it affect my performance. Lastly, I would maintain a
documented reflective journal to be able to track my progress effectively (Johns, 2017).

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REFLECTIVE ESSAY
References:
Alzayyat, A., & Al‐Gamal, E. (2014). A review of the literature regarding stress among nursing
students during their clinical education. International Nursing Review, 61(3), 406-415.
Boud, D., Keogh, R., & Walker, D. (2013). Reflection: Turning experience into learning.
Routledge.
Bulman, C., & Schutz, S. (Eds.). (2013). Reflective practice in nursing. John Wiley & Sons.
Johns, C. (Ed.). (2017). Becoming a reflective practitioner. John Wiley & Sons.
Moon, J. A. (2013). Reflection in learning and professional development: Theory and practice.
Routledge.
Paterson, C., & Chapman, J. (2013). Enhancing skills of critical reflection to evidence learning in
professional practice. Physical Therapy in Sport, 14(3), 133-138.
Sarafis, P., Rousaki, E., Tsounis, A., Malliarou, M., Lahana, L., Bamidis, P., ... & Papastavrou,
E. (2016). The impact of occupational stress on nurses’ caring behaviors and their health
related quality of life. BMC nursing, 15(1), 56.
van der Riet, P., Rossiter, R., Kirby, D., Dluzewska, T., & Harmon, C. (2015). Piloting a stress
management and mindfulness program for undergraduate nursing students: Student
feedback and lessons learned. Nurse Education Today, 35(1), 44-49.