Reflective Assignment Three: Analysis of Nursing Handover Experience
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This report presents a reflective analysis of a nursing student's clinical experience, specifically focusing on a challenging handover situation. The student utilizes Gibb's Reflection Cycle to dissect the experience, including a description of the events, the feelings involved, an evaluation of the situation, and a thorough analysis. The assignment highlights the importance of effective communication, self-confidence, and adherence to NMBA standards in ensuring patient safety. The student identifies weaknesses in communication and self-esteem during the handover process and proposes an action plan to improve these areas, including enhancing verbal and non-verbal communication skills and increasing social interactions to build confidence. The report concludes with a reflection on the learning experience and its implications for future nursing practice, emphasizing the student's preparedness for similar challenges.
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Running head: REFLECTIVE ASSIGNMENT THREE
Reflective Assignment Three
Name
Institutional Affiliation
Reflective Assignment Three
Name
Institutional Affiliation
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REFLECTIVE ASSIGNMENT THREE 2
Reflective Assignment Three
In this essay, I will reflect on my clinical experience during my degree program. The
reflection will use Gibb’s Reflection Cycle, which is considered a popular reflection tool in
nursing practice. This model encourages learning from experience for people that are interested
in long-term learning. I will maintain the confidentiality of patients, the institution where I was
attached, and the head registered nurse under whom I was working. This is a professional
requirement as outlined in the Australian Health Practitioner Regulation Agency (AHPRA)
(2018). The clinical experience I intend to focus on is the one that occurred during the handoff
shift. Gibb’s Reflection Cycle will be used to critically analyze the situation to enhance my
learning and future changes in case I encounter a similar situation in my clinical practice.
Description
I was taking care of three patients that my RN head nurse had assigned to me. My RN
supervisor had allocated me the task of maintaining full care for three patients and the
responsibility of maintaining vital sign records for each of the three patients that were under my
care. I observed the patients groan in pain and an increase in her respiration. I watched as she
struggled to remain calm even when it was evident that she was suffering, and the signs of her
health were observable on her skin and her face. I waited anxiously for my shift to end so that I
could hand her off to another nurse.
In my previous shifts, my RN supervisor had helped me in handing off the patients to the
next nurse. She was not, however, available during this day, and I was left with the responsibility
of handling the complete handover process. It is at this point that I found out my weaknesses. I
was expected to explain everything to the nurse that was coming in for the next shift, but after
explaining the basics of the process, I got confused, panicked, and started sweating profusely.
Reflective Assignment Three
In this essay, I will reflect on my clinical experience during my degree program. The
reflection will use Gibb’s Reflection Cycle, which is considered a popular reflection tool in
nursing practice. This model encourages learning from experience for people that are interested
in long-term learning. I will maintain the confidentiality of patients, the institution where I was
attached, and the head registered nurse under whom I was working. This is a professional
requirement as outlined in the Australian Health Practitioner Regulation Agency (AHPRA)
(2018). The clinical experience I intend to focus on is the one that occurred during the handoff
shift. Gibb’s Reflection Cycle will be used to critically analyze the situation to enhance my
learning and future changes in case I encounter a similar situation in my clinical practice.
Description
I was taking care of three patients that my RN head nurse had assigned to me. My RN
supervisor had allocated me the task of maintaining full care for three patients and the
responsibility of maintaining vital sign records for each of the three patients that were under my
care. I observed the patients groan in pain and an increase in her respiration. I watched as she
struggled to remain calm even when it was evident that she was suffering, and the signs of her
health were observable on her skin and her face. I waited anxiously for my shift to end so that I
could hand her off to another nurse.
In my previous shifts, my RN supervisor had helped me in handing off the patients to the
next nurse. She was not, however, available during this day, and I was left with the responsibility
of handling the complete handover process. It is at this point that I found out my weaknesses. I
was expected to explain everything to the nurse that was coming in for the next shift, but after
explaining the basics of the process, I got confused, panicked, and started sweating profusely.
REFLECTIVE ASSIGNMENT THREE 3
My RN supervisor arrived in time and explained everything that I had left out and assisted me in
handing off the patients.
Feelings
I was satisfied with the whole process of taking care of patients and recording their vital
signs. I felt like a professional and wanted to do everything to adhere to the standards of care that
could maximize the quality of life in my patients. However, there were some instances when I
became emotional when taking care of the patient, especially when I observed their health
deteriorating under my care. I started thinking of what was going to happen to them next,
especially when I saw the health of the patient deteriorate in my presence. One of the most
embarrassing moments was during the handover process when I started sweating profusely and
lost control of my speech. I was worried that my RN supervisor and other nurses were going to
laugh at me for acting unprofessional. When I lost my communication ability, I started blaming
myself that I would endanger the lives of the patients that I had been handling by giving
misleading information due to my poor communication abilities.
Evaluation
The experience had both good and bad elements as per professional requirements in
nursing, especially the role of effective communication during the clinical handover process. The
first RN standard from NMBA (2016) states that nurses think critically and analyze nursing
practice. The experience affirmed my commitment to nursing practice and exposed me to my
limitations or what I am to expect in my future career practice. Even though the experience was
embarrassing, I took it as a challenge and used the opportunity to identify my weaknesses in
communication. I understood that I had low esteem of myself and this could have contributed to
my weakness in communication. Cashin, Heartfield, Bryce, Devey, and Cox (2017) explain that
My RN supervisor arrived in time and explained everything that I had left out and assisted me in
handing off the patients.
Feelings
I was satisfied with the whole process of taking care of patients and recording their vital
signs. I felt like a professional and wanted to do everything to adhere to the standards of care that
could maximize the quality of life in my patients. However, there were some instances when I
became emotional when taking care of the patient, especially when I observed their health
deteriorating under my care. I started thinking of what was going to happen to them next,
especially when I saw the health of the patient deteriorate in my presence. One of the most
embarrassing moments was during the handover process when I started sweating profusely and
lost control of my speech. I was worried that my RN supervisor and other nurses were going to
laugh at me for acting unprofessional. When I lost my communication ability, I started blaming
myself that I would endanger the lives of the patients that I had been handling by giving
misleading information due to my poor communication abilities.
Evaluation
The experience had both good and bad elements as per professional requirements in
nursing, especially the role of effective communication during the clinical handover process. The
first RN standard from NMBA (2016) states that nurses think critically and analyze nursing
practice. The experience affirmed my commitment to nursing practice and exposed me to my
limitations or what I am to expect in my future career practice. Even though the experience was
embarrassing, I took it as a challenge and used the opportunity to identify my weaknesses in
communication. I understood that I had low esteem of myself and this could have contributed to
my weakness in communication. Cashin, Heartfield, Bryce, Devey, and Cox (2017) explain that
REFLECTIVE ASSIGNMENT THREE 4
during clinical handoffs, some nurses may feel incompetent in handing over responsibilities and
this can affect the safety of patients. I experienced this feeling of incompetency at the end of my
shift and thought that the next nurse could identify my limitations and blame me for giving
misleading information if anything occurred after I had handed the patients over.
The second standard of NMBA (2016) states that nurses should engage in therapeutic and
professional relationships with others when working. These relationships were cultivated on a
daily basis with my RN supervisor who guided me and assigned me the roles and responsibilities
during my placement. Even though I lacked confidence at some level and was worried that I
could make mistakes that could interfere with patient safety, I still did not turn down the
assigned roles. Lee and Dorman (2016) explain that handoffs should be conducted in a manner
that maximizes patient safety. Flanigan (2016) explains that people may lose confidence in
themselves even when they are aware of what they have to say. When I relate this to the
experience where I lost my confidence and started sweating instead of communicating clearly, I
feel that the safety of patients was at stake if my head nurse had failed to guide me in the handing
over process.
Analysis
This experience brought me to the reality of my future nursing career in nursing. The RN
supervisor made sure that I was exposed to every aspect of nursing to nurture my career growth.
In the second standard of NMBA (2016), it is stated that nurses engage in therapeutic and
professional relationships. I relate this to my experience because I was able to comply with the
set standards and adhered to my assigned roles. Even though the handing over experience was
embarrassing, it was a learning moment and exposed the challenges that I have to address in my
future practice. The research study Pascoe, Gill, Hughes, and McCall-White (2014) and
during clinical handoffs, some nurses may feel incompetent in handing over responsibilities and
this can affect the safety of patients. I experienced this feeling of incompetency at the end of my
shift and thought that the next nurse could identify my limitations and blame me for giving
misleading information if anything occurred after I had handed the patients over.
The second standard of NMBA (2016) states that nurses should engage in therapeutic and
professional relationships with others when working. These relationships were cultivated on a
daily basis with my RN supervisor who guided me and assigned me the roles and responsibilities
during my placement. Even though I lacked confidence at some level and was worried that I
could make mistakes that could interfere with patient safety, I still did not turn down the
assigned roles. Lee and Dorman (2016) explain that handoffs should be conducted in a manner
that maximizes patient safety. Flanigan (2016) explains that people may lose confidence in
themselves even when they are aware of what they have to say. When I relate this to the
experience where I lost my confidence and started sweating instead of communicating clearly, I
feel that the safety of patients was at stake if my head nurse had failed to guide me in the handing
over process.
Analysis
This experience brought me to the reality of my future nursing career in nursing. The RN
supervisor made sure that I was exposed to every aspect of nursing to nurture my career growth.
In the second standard of NMBA (2016), it is stated that nurses engage in therapeutic and
professional relationships. I relate this to my experience because I was able to comply with the
set standards and adhered to my assigned roles. Even though the handing over experience was
embarrassing, it was a learning moment and exposed the challenges that I have to address in my
future practice. The research study Pascoe, Gill, Hughes, and McCall-White (2014) and
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REFLECTIVE ASSIGNMENT THREE 5
Greenfield, Hinchcliff, Banks, Mumford, Hogden (2015) explain that embarrassment and lack of
confidence are linked to barriers to effective communication and can affect the safety of patients
during handover shifts. Birmingham, Buffum, Blegen, and Lyndon (2015) further explain that
verbal and non-verbal communication is a crucial aspect in the handover process because it
determines the safety of the patient when the handover process is completed. I believe that my
RN supervisor understood the importance of this, and that is why she came in to help me when I
lost my communication abilities due to embarrassment and lack of self-confidence.
The Australian Commission on Quality and Safety in Healthcare (2018) states that nurses
should focus on patient-centered care in the delivery of services to improve the quality of life.
Patient-centered care involves understanding the needs of patients and their cultures so that one
can meet the professional needs that the patient needs (Eggins & Slade, 2015). My weakness in
communication impaired my ability to show professional skills even when I had managed to take
care of three patients. If I did not manage to communicate with my fellow nurses, I wonder how I
could have managed to express myself to patients that needed my attention. In a separate review
research by Muller, Jurgens, Redaelli, Klingberg, Hautz, and Stock (2018), the authors explain
that nurses that uphold professionalism in their level of practice enhance patient safety. The
Australian Health Practitioner Regulation Agency (AHPRA) (2018) maintains that patients are
partners in their own care regardless of the methods they choose. Nurses can participate in
partnering with patients by understanding their needs thorough proper communication Farmer,
Bigby, Davis, Carlisle, Kenny, & Huysmans, 2018). I believe that even though the experience
was challenging, I learned my professional role, and I am equipped for such challenges in my
professional career.
Conclusion
Greenfield, Hinchcliff, Banks, Mumford, Hogden (2015) explain that embarrassment and lack of
confidence are linked to barriers to effective communication and can affect the safety of patients
during handover shifts. Birmingham, Buffum, Blegen, and Lyndon (2015) further explain that
verbal and non-verbal communication is a crucial aspect in the handover process because it
determines the safety of the patient when the handover process is completed. I believe that my
RN supervisor understood the importance of this, and that is why she came in to help me when I
lost my communication abilities due to embarrassment and lack of self-confidence.
The Australian Commission on Quality and Safety in Healthcare (2018) states that nurses
should focus on patient-centered care in the delivery of services to improve the quality of life.
Patient-centered care involves understanding the needs of patients and their cultures so that one
can meet the professional needs that the patient needs (Eggins & Slade, 2015). My weakness in
communication impaired my ability to show professional skills even when I had managed to take
care of three patients. If I did not manage to communicate with my fellow nurses, I wonder how I
could have managed to express myself to patients that needed my attention. In a separate review
research by Muller, Jurgens, Redaelli, Klingberg, Hautz, and Stock (2018), the authors explain
that nurses that uphold professionalism in their level of practice enhance patient safety. The
Australian Health Practitioner Regulation Agency (AHPRA) (2018) maintains that patients are
partners in their own care regardless of the methods they choose. Nurses can participate in
partnering with patients by understanding their needs thorough proper communication Farmer,
Bigby, Davis, Carlisle, Kenny, & Huysmans, 2018). I believe that even though the experience
was challenging, I learned my professional role, and I am equipped for such challenges in my
professional career.
Conclusion
REFLECTIVE ASSIGNMENT THREE 6
I consider this experience as a preparation for my future work in nursing practice. If I
encounter a similar situation in my future practice, I do not think that I will be embarrassed or
lose my communication abilities. I have learned how to communicate with fellow nurses and
colleagues. The incident also made me to reflect on NMBA standards of registered nurse
practice. I am convinced that the skills I acquired have prepared me for other challenging roles in
my future career.
Action Plan
I have identified some of the areas of improvement to avoid the challenges that I
encountered when the experience occurred. One of the areas is to improve my communication
and enhance my self-confidence. I am prepared to embrace change by tackling the discomfort I
feel when trying to talk to other people. I have listed the areas that make me comfortable. I have
discovered that I have poor verbal and non-verbal communication skills. Each day in the evening
I highlight the areas of improvement. To overcome these limitations, I have decided to be active
in classroom environments by asking questions and responding to my peers wherever there is a
chance for participation. I have also discovered that I am uncomfortable in social settings. I will
start increasing the network of colleagues and friends to challenge my discomfort. Lack of self-
confidence and low self-esteem affected my attitude and behavior during the handover process.
In my future practice, I will be more objective of my abilities and bring out the best in my
communication with my seniors.
I consider this experience as a preparation for my future work in nursing practice. If I
encounter a similar situation in my future practice, I do not think that I will be embarrassed or
lose my communication abilities. I have learned how to communicate with fellow nurses and
colleagues. The incident also made me to reflect on NMBA standards of registered nurse
practice. I am convinced that the skills I acquired have prepared me for other challenging roles in
my future career.
Action Plan
I have identified some of the areas of improvement to avoid the challenges that I
encountered when the experience occurred. One of the areas is to improve my communication
and enhance my self-confidence. I am prepared to embrace change by tackling the discomfort I
feel when trying to talk to other people. I have listed the areas that make me comfortable. I have
discovered that I have poor verbal and non-verbal communication skills. Each day in the evening
I highlight the areas of improvement. To overcome these limitations, I have decided to be active
in classroom environments by asking questions and responding to my peers wherever there is a
chance for participation. I have also discovered that I am uncomfortable in social settings. I will
start increasing the network of colleagues and friends to challenge my discomfort. Lack of self-
confidence and low self-esteem affected my attitude and behavior during the handover process.
In my future practice, I will be more objective of my abilities and bring out the best in my
communication with my seniors.
REFLECTIVE ASSIGNMENT THREE 7
References
Australian Health Practitioner Regulation Agency (AHPRA) (2018). Registration standards for
healthcare practitioners in Australia. Retrieved from
https://www.ahpra.gov.au/Registration/Registration-Standards.aspx
Australian Commission on Quality and Safety in Healthcare (2018). The NHQHS standards.
Retrieved from https://www.safetyandquality.gov.au/standards/nsqhs-standards
Birmingham, P., Buffum, M. D., Blegen, M. A., & Lyndon, A. (2015). Handoffs and patient
safety: grasping the story and painting a full picture. Western Journal of Nursing
Research, 37(11), 1458–1478. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4272331/
Cashin, A., Heartfield, M., Bryce, J., Devey, L., & Cox, D. (2017). Standards for practice for
registered nurses in Australia. The Australian Journal of Nursing Practice, 24(3), 255-
266. Retrieved from
https://www.collegianjournal.com/article/S1322-7696(16)30003-8/fulltext
Eggins, S., & Slade, D. (2015). Communication in clinical handover: improving the safety and
quality of the patient experience. Journal of Public Health Research, 4(3). Retrieved
from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4693345/
Farmer, J., Bigby, C., Davis, H., Carlisle, K., Kenny, A., & Huysmans, R. (2018). The state of
health services partnering with consumers: evidence from an online survey of Australian
health services. BMC health services research, 18(1), 628. doi:10.1186/s12913-018-
3433-y
References
Australian Health Practitioner Regulation Agency (AHPRA) (2018). Registration standards for
healthcare practitioners in Australia. Retrieved from
https://www.ahpra.gov.au/Registration/Registration-Standards.aspx
Australian Commission on Quality and Safety in Healthcare (2018). The NHQHS standards.
Retrieved from https://www.safetyandquality.gov.au/standards/nsqhs-standards
Birmingham, P., Buffum, M. D., Blegen, M. A., & Lyndon, A. (2015). Handoffs and patient
safety: grasping the story and painting a full picture. Western Journal of Nursing
Research, 37(11), 1458–1478. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4272331/
Cashin, A., Heartfield, M., Bryce, J., Devey, L., & Cox, D. (2017). Standards for practice for
registered nurses in Australia. The Australian Journal of Nursing Practice, 24(3), 255-
266. Retrieved from
https://www.collegianjournal.com/article/S1322-7696(16)30003-8/fulltext
Eggins, S., & Slade, D. (2015). Communication in clinical handover: improving the safety and
quality of the patient experience. Journal of Public Health Research, 4(3). Retrieved
from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4693345/
Farmer, J., Bigby, C., Davis, H., Carlisle, K., Kenny, A., & Huysmans, R. (2018). The state of
health services partnering with consumers: evidence from an online survey of Australian
health services. BMC health services research, 18(1), 628. doi:10.1186/s12913-018-
3433-y
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REFLECTIVE ASSIGNMENT THREE 8
Flanigan, K. (2016). NSQHS standard-patient identification. ACORN: The Journal of
Perioperative Nursing in Australia, 29(1), 23. Retrieved from
https://search.informit.com.au/documentSummary;dn=883877754554045;res=IELHEA
Greenfield, D., Hinchcliff, R., Banks, M., Mumford, V., Hogden, A., D(2015). Analyzing 'big
picture' policy reform mechanisms: the Australian health service safety and quality
accreditation scheme. Health Expectations: An International Journal of Public
Participation in Health Care and Health Policy, 18(6), 3110–3122. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5810648/
Lee, S. & Dorman, T. (2016). Handoffs, safety culture, and practices: evidence from the hospital
survey on patient safety culture. BMC Journal of Health Services Research, 6(254).
Retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-
016-1502-7
Muller, M., Jurgens, J., Redaelli, M., Klingberg, K., Hautz, W. E., & Stock, S. (2018). Impact of
the communication and patient hand-off tool SBAR on patient safety: a systematic
review. BMJ Open, 8(8), e022202. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6112409/
Nursing and Midwifery Board of Australia (NMBA) (2016). Registered nurse standards for
practice. NSW Nurse and Midwives Association (2019). Scope of practice. Retrieved
from https://www.nswnma.asn.au/scope-of-practice/
Pascoe, H., Gill, S. D., Hughes, A., & McCall-White, M. (2014). Clinical handover: An audit
from Australia. The Australasian Medical Journal, 7(9), 363–371. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4185328/
Flanigan, K. (2016). NSQHS standard-patient identification. ACORN: The Journal of
Perioperative Nursing in Australia, 29(1), 23. Retrieved from
https://search.informit.com.au/documentSummary;dn=883877754554045;res=IELHEA
Greenfield, D., Hinchcliff, R., Banks, M., Mumford, V., Hogden, A., D(2015). Analyzing 'big
picture' policy reform mechanisms: the Australian health service safety and quality
accreditation scheme. Health Expectations: An International Journal of Public
Participation in Health Care and Health Policy, 18(6), 3110–3122. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5810648/
Lee, S. & Dorman, T. (2016). Handoffs, safety culture, and practices: evidence from the hospital
survey on patient safety culture. BMC Journal of Health Services Research, 6(254).
Retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-
016-1502-7
Muller, M., Jurgens, J., Redaelli, M., Klingberg, K., Hautz, W. E., & Stock, S. (2018). Impact of
the communication and patient hand-off tool SBAR on patient safety: a systematic
review. BMJ Open, 8(8), e022202. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6112409/
Nursing and Midwifery Board of Australia (NMBA) (2016). Registered nurse standards for
practice. NSW Nurse and Midwives Association (2019). Scope of practice. Retrieved
from https://www.nswnma.asn.au/scope-of-practice/
Pascoe, H., Gill, S. D., Hughes, A., & McCall-White, M. (2014). Clinical handover: An audit
from Australia. The Australasian Medical Journal, 7(9), 363–371. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4185328/
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