Application of Gibbs Reflective Model: A Nursing Case Study

This case study employs Gibbs' Reflective Model to analyze a nursing interaction with a 16-year-old patient experiencing low self-esteem due to acne. The reflection covers the initial description of the encounter, the nurse's personal feelings triggered by the patient's situation, an evaluation of the consultation's successes and shortcomings, and a deeper analysis of the factors influencing the interaction. The conclusion outlines potential improvements in future similar scenarios, including referral to support services and extended patient interaction time. The action plan details concrete steps to enhance future consultations, such as providing mental health resources, ensuring patient confidentiality, and maintaining objectivity when dealing with bullying victims. The nurse's reflection highlights the importance of emotional awareness, empathy, and continuous learning in nursing practice, and the need to address both the physical and psychological well-being of patients. Desklib provides this and many similar solved assignments for students.

Running Head: GIBBS REFLECTION MODEL, CASE STUDY 1
GIBBS REFLECTION MODEL, CASE STUDY
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Introduction
There are various models used by professionals to evaluate their past experiences.
Broadly, they are classified into two categories: reflection in and reflection on action. The first
category reflection on the action inspires people to re-live past events mainly emphasizing on
coming up future action plans which are more effective to deal with similar events which might
occur. It is a type of reflection which rarely focuses on the negative side of the current action
plans but rather the positive side demonstrated during an action plan being reflected (Paget,
2001). On the other hand, reflection in action is a deeper and a more interactive version of
reflection on the action that emphasizes on individual observation and reflection on past events
from their point of view and that of others around them at the time of a certain event. Self-
reflection, as well as the reflection on events which takes place within the working environment,
is very important for a medical professional because they challenge practitioners and make them
improves their existing skills to maximize their learning opportunities and avoid past mistakes
(Royal College of Nursing, 2012).
The Gibbs (1988) model of reflection simplifies the reflection process in a systematic and
step-wise form in order to make the flow understandable. This model is formal in nature and
draws on research and theory to make the reflection process effective. The model has been
broken into six steps which are a description, feelings, evaluation, and analysis. The description
step explores and explains the event context in fine details such as the people who were around
during an event, where an event took place and what transpired before the event. The second step
is the feelings step which describes and explores the feelings as well as the thoughts of the
reflector at the time an event took place. The third step is the evaluation step which describes the
individual judgment of a nurse about an event. Considerations on what went wrong and what

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went right in the course of the event are also described in this step. The fourth step is the analysis
step which delves deeper into the reflection by breaking an event into sub-episodes to facilitate
quick analysis. The fifth step is the conclusion step which explores the potential alternatives that
can be used to counter the event being reflected. Finally, the action plan which is the final step
gives a suggestion on the measures which can be put in place to effectively deal with such events
in the future.
The Royal College of Nursing (2012) considers the Gibbs model as a superior model of
reflection because it emphasizes the important role of reflector’s emotions. Nursing is an often
emotionally charged career which calls for persistence and emotional control especially for the
nurses who work in the departments of palliative and psychiatric health. Such working
environments are accompanied by strong emotions which must be managed and improved to
minimize cases of depression.
Case Study
Step One (Description)
A young female patient with an age of 16 years visited the clinic around two weeks ago.
She was complaining of low self-esteem and depression feelings because of some pimples which
had left spots on her face. The girl was so worried that boys would not be attracted to her
because of her ugly appearance which had been left by the pimples in the form of black spots. At
the time she arrived for her appointment, there was no other nurse in the room. I was therefore
supposed to carry out the consultation alone in the room. The consultation took two hours, where
we discussed the history of the girl’s skin problems as well as the emotional distress which was
as a result of the spots. The girl disclosed to me that her pimples started to appear on her face at

GIBBS REFLECTION MODEL, CASE STUDY 4
the age of 14 years at her puberty stage and had made her develop extremely feelings of self-
conscious. Also, the girl explained the negative impacts that the acne had on her. For instance,
she had been bullied in school and was feeling apprehensive to start her sixth form in the same
school because she believed that she will be the only one in the class with spots. Considering her
long history of acne, its presence on her face as well as the negative emotional impacts that the
acne had caused on her, I prescribed a four-month oxytetracycline dosage to help reduce the
impacts of the pimples on her face.
Step Two (Feelings)
In the course of the consultation, I had developed some emotional feelings. Her situation
had reminded me of my age as a teenager which made me sympathize with her. As a teenager at
the age of 15, I had suffered a severe skin infection which made me look like an old person. That
had highly affected my self-esteem to the extent that I could not argue with my classmates who
had healthy skins. According to research by Dunn, O’Neill & Feldman (2011), patients who
suffer from acne have high chances of suffering from depression and other psychological related
disorders. However, the study revealed that treatment of acne could improve some of the
psychological disorders which were often co-morbid.
The assurance from this research that acne treatment could improve the girl’s self-esteem
made me perceive my decision to prescribe oxytetracycline to her as the right thing I which I did.
My personal experience as once a victim of acne enabled me to relate well with the patient's
experiences. From the girl’s explanation of what she was going through I realized that I was
getting angry, specifically with the girl’s peers who according to me were a very cruel tease and
taunt her because of her acne. After she left the clinic, I developed a feeling of guilt and regret. I

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regretted because I did not refer the girl to a psychologist who could support her emotionally and
for not taking enough time to explore her psychological impacts in a detailed form. Also, I
developed a sense of pride on the girl because of her courageous step to visit the clinic and seek
help by herself. I recall how the situation was upsetting to me as a teenager to an extent that I felt
embarrassed to visit a clinic or seek help from any professional.
Step Three (Evaluation)
From what I experienced throughout the consultation period, the event was successful in
a number of ways. First, it equipped me with the experience on how to handle teenagers with
unique problems that require attention and expression of emotional feelings on them. This is in
consideration of the fact that in my career as a nurse I have not dealt with teenagers and getting a
chance to listen to the young girl was an opportunity for me to gain experience. Additionally, it
re-affirmed my choice in nursing career. In any career, people tend to doubt whether they made
the correct choice of career. However, there is a time when a person starts to be sure that he
chose the right career. However, there were some negative elements in the event. First, the
appointment took a very short period of time which later on made me feel worried that the
patient was uncomfortable or was rushed. The feeling came after I read an article by Purvis,
Robinson, Merry &Watson (2006) which indicated that teenagers with acne are suicidal and
hence necessary attention must be given to them in order to control their mental problems. The
research had also indicated that asking victims of acne whether they have had suicidal thoughts
was very important because that would enable them to open up. This made me feel anxious and
wished to have had the information before interacting with the patient.

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Step Four (Analysis)
Having undergone a similar condition during my teenage age helped me relate and deal
with the patient more effectively. Also, the patient explained her concerns openly because she
felt that I was sympathizing with her and her experiences as well. According to Randall & Hill
(2012), a close connection with a patient is very important because it makes them feel more
comfortable and hence open up. My expression of sympathy towards the girl and her experience
hence made her express her concerns openly. I am also convinced that taking a step to come and
see me was a positive event. This is because the girl could have chosen to suffer in silence and
not to open up to anybody about her problems. This is in consideration of research by Gulliver,
Griffiths, & Christensen (2010) which indicated that stigma and embarrassments were barriers
for young people to access health. My empathy feelings and emotions also reaffirmed me that
nursing was my right choice of career.
Step Five (Conclusion)
In summary, if a similar event occurs to me in the future, I would deal with it in a slightly
different way. I regret to have not referred the patient for further support services. This is in
consideration of the fact that the patient had mentioned that she felt that spots made her
unattractive to the men. Apart from a biological and physiological solution which I had provided
to the girl, I think I could have also shared with her some information on organizations which
offered self-esteem and confidence building services to help her regain self-esteem and
confidence. I also feel that I limited the time for interacting with the patient to the extent that we
were not able to explore the psychological impacts of her acne in a detailed way. According to
Coyne (2008), teenagers rarely contribute in decision making when consulting and therefore I

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was supposed to provide more information to the girl in order to keep the discussion live, which I
did not do.
Step Six (Action Plan)
My action plan has a number of elements. First, I will ensure my consultation room has
some leaflets and information related to teenage mental health problems. This way, teenagers
will be in a position to access any information without feeling embarrassed to talk about it.
According to Hayter (2005), teenagers who access health clinics usually put a high value on non-
judgmental approaches by clinicians. Therefore, I would strive to ensure that am aware of my
attitude in the future so as not to make a judgement on patients. According to Hayter (2005),
teenagers have serious concerns about their confidentiality when visiting clinics. Therefore, I
would ascertain and reassure teenagers of confidentiality of their information as the first thing
before proceeding with consultations. As an assurance, I will also ask them to sign a
confidentiality form and which I will also sign before them. This will enable then be open about
their concerns. I will also put more focus to be objective when interacting with patients who have
been victims of bullying.

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References
Coyne, I. (2008) Children’s participation in consultations and decision-making at health service
level: A review of the literature. International Journal of Nursing Studies, 45(11), pp.
1682-1689.
Dunn, L.K., O’Neill, J.L. & Feldman, S.R. (2011) Acne in adolescents: Quality of life, self-
esteem, mood and psychological disorders. Dermatology Online Journal, 17(1).
Available at: http://escholarship.org/uc/item/4hp8n68p [Accessed 20 October 2013].
Gibbs, G. (1988) Learning by Doing: A guide to teaching and learning methods. Oxford: Further
Education Unit.
Gulliver, A., Griffiths, K.M. &Christensen, H. (2010) Perceived barriers and facilitators to
mental health help-seeking in young people: a systematic review. BMC Psychiatry, 10(1),
pp. 113.
Hayter, M. (2005) Reaching marginalised young people through sexual health nursing outreach
clinics: Evaluating service use and the views of service users. Public Health Nursing,
22(4), pp. 339-346.
Paget, T. (2001) Reflective practice and clinical outcomes: practitioner’s views on how reflective
practice has influenced their clinical practice. Journal of Clinical Nursing, 10(2), pp. 204-
214.
Purvis, D., Robinson, E., Merry, S. &Watson, P. (2006) Acne, anxiety, depression and suicide
in teenagers: A cross-sectional survey of New Zealand secondary school. Journal of
Paediatrics and Child Health, 42(12), pp. 793-796.

GIBBS REFLECTION MODEL, CASE STUDY 9
Randall, D. and Hill, A. (2012) Consulting children and young people on what makes a good
nurse. Nursing Children and Young People, 24(3), pp. 14.
Royal College of Nursing (2012) An exploration of the challenges of maintaining basic human
rights in practice. London: Royal College of Nursing.