Gibbs Reflective Cycle Application: Endoscopy Experience Reflection

This assignment is a reflective journal entry from a nursing student detailing an experience during an endoscopy placement. The student utilizes the Gibbs reflective cycle to analyze a specific incident involving a patient undergoing a colonoscopy. The reflection describes the situation, the student's feelings, the evaluation of the experience, and the analysis of what could have been done differently. The student faced a challenging situation where a patient expressed anxiety about the procedure due to a family history of complications. The student reflects on their initial lack of knowledge regarding the patient's concerns and how they addressed the situation, highlighting the importance of communication, collaboration, and emotional intelligence in patient care. The reflection also discusses the student's learning from the experience, including the need for increased knowledge, confidence, and a more patient-centered approach in future practice. The student's reflection emphasizes the importance of adhering to nursing standards, developing professional skills, and continuous learning for improved patient outcomes.

Running head: REFLECTION
REFLECTION
Name of Student
Name of University
Author note

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Reflection: Using Gibbs reflective cycle framework
In order to understand and practice properly and in order to realize from the
experiences, it is very important that the right and appropriate framework is used to reflect on
the experiences (Reumkens et al. 2016). It is very vital to develop a reflective practice and it
is very much vital to understand and realize the mistakes from each and every clinical
experience (Bielawska et al. 2018). The very vital aspect of the nursing process is that the
clinical reasoning is always at pace with the treatment and the diagnosis and the Gibbs
reflective cycle provides the right framework for clinical and professional practice to grow
with every experience (Dressler et al. 2019) – to learn what is needed and discard the
unnecessary anxieties which has arisen from the problems associated with a certain
experience (Waltz 2019). The various stages in the Gibbs reflection cycle refers to critical
analysis of each emotion and understanding associated with parts of the experience (Rezk et
al. 2017). Not only, the reflective analysis by the Gibbs reflective provides the right
opportunity for the health care practitioners to expand their knowledge and awareness about
the case by reflecting on the intricate facets of the case and the most important aim of the
Gibbs reflective cycle is to translate the reflection into a future practice that is ought to be
more effective (Emery and Chang 2017). The stages of the cycle are description of the
incidence, what is the one’s feeling about the experience, evaluating the good and the bad
part of experience, then, this is followed by analysis of the situation and what else could have
been done (Tesh and Kautz 2017). Lastly, the future plans so as to the handle the same or
similar situation properly is discussed. In this reflective study, the same has been done using
the Gibbs reflective cycle (de’Angelis et al. 2018).

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My first placement was in Endoscopy in Basingstoke Hospital. One of the most
memorable incidents was that during my practice in the department, a lady who was around
forty nine years of age, came in for a colonoscopy diagnosis. She was under sedation and was
undergoing a change in her bowel habits. As usual, I went to collect her at first, from the very
waiting room in order to prepare her for the colonoscopy procedure. I as a nurse, went
through the checklists in a very pertinent manner in order in to identify the patient is
appropriate and is undergoing a right procedure. The patient seemed to be nervous and
intended, as a nurse, to build a rapport with the patient for a better collaboration. So, I asked
her if she is doing fine and feeling confident about her state to undertake the procedure. I also
asked if she actually wanted to use the toilet to which she declined (Sekarwinahyu et al.
2019). Using my observation, which is a very important part of nursing assessment, I found
out that she was still very anxious although she was trying to keep her composure. Her
expressions were tense and taut, given she was still nervous about the colonoscopy
procedure. Then, after preparing her, she we were about to reach the procedure room, she
mentioned almost suddenly that her own mom (who was 75 years old) had the colonoscopy
procedure as well and during her procedure she had perforation – which indicated that like
other patients, she was also kind of scared that she might end up having perforation like her
mother. During that time I had no idea what perforation was so I just said everything will be
fine (trying to comfort and counsel, plus trying to motivate the patient) and also told her that
the team which was attending her are very highly qualified professionals and experienced in
their respective professions, so she has nothing indeed to worry about. When we reached the
procedure room, she stopped at the door and i asked her to come in. She just stood still and
started crying. So, as a dutiful nurse, looking at the condition of my patient, I went to inform
the doctor and staff nurse about the lady. I explained what the patient told me and asked my
mentor what perforation was. The doctor went to explain about the chances of perforation is

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very low and gave her lots of reassurance to the patient who was anxious, tensed plus not
comfortable at first with the procedure. After the team of doctor and the nurses has counseled
her and made her understand, she stopped crying and calmed down as well. She was still a
little nervous, however she agreed to continue with the procedure as somehow she understood
the benefits and importance of the medical procedure that is critical to her health and the
planning of right interventions, required for her positive recovery. By this time, on my side, I
have learned and known why the patient was actually so nervous and what perforation
actually was. The next important thing or rather a duty I performed, was that I finally
managed to give her reassurance throughout the procedure (with the newly acquired clinical
knowledge of perforation and how its risks an endoscopy procedure outcome).
As a nurse, it is my duty to attend the patient very carefully and provide her with
particular attention when necessary and it is absolutely critical. From the very beginning, I
was very much adherent to the nursing standards that came under the framework of Nursing
and Midwifery council of United Kingdom. While it is very vital to understand the nursing
principles of beneficence, non-maleficence, autonomy and integrity – it is very much critical
that I translate my principles of care into practice and in the above mentioned case, as I was
both not knowledgeable about the risk and risk related fear of the patient – it made me really
disappointed so as to not being able to address the patient’s concerns, right away from the
very beginning and I was really sad and anxious all the way to the procedure room – for not
being to counsel the patient properly, with my nursing knowledge about the diagnostic
procedure and as I was not being able address the issues of the patient which was both fear
and anxiety, it made me depressed as well. But as because, I was being able to somehow
draw a communication with the doctor and the staff nurse who were attending the case, I
showed adherence to the Nursing and midwifery council values such as cording the care,
preventing ill health of the patient, effective communication and collaboration with the

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multidisciplinary team and I was somewhat satisfied and content, that finally when the patient
stopped crying – that I being able to, somehow able to draw the attention of other expert
professionals into the case with immediate effect and that I was being able to improve the
levels of patient satisfaction, hence improving the quality of the care delivered. At that point
of time, despite my lack of knowledge about what perforation is and how does it pose risks to
the colonoscopy procedure – I was one minded and that I was thinking just about the state of
well-being of the patient and how I can address her issues. This to me, was a good sign, I was
coping positively and it made me happy.
The bad part of the experience was that I was packing and drooping under the
pressure when the criticality of curing and addressing the exact concerns of the patient arose
and this had me, tensed and extremely anxious under the feeling that I might not be
competent enough to a right health care professional, binding to the exact skill demonstration
standards of the Nursing and Midwifery Council of United Kingdom. The Nursing and
Midwifery Council of United Kingdom provides the standard guidelines for one to become a
competent and a quality good nurse as by adhering to the best practice principles and through
right demonstration of skill and knowledge at every turn of practice and at this point of the
practice where I was managing the patient who was about to have colonoscopy, I was really
scared that my lack on knowledge pertaining to the fear and discouragement of the patient
from taking up the colonoscopy procedure – was really a bad part of experience and I was
running out of ideas so as to how to calm and relax the patient. Mental health is complex
issue and if the patient is panicking, afraid or some type of delusional mind activity is
troubling her a lot, this can even affect and impact the outcome of the colonoscopy procedure
and I was aware of it.
The situation all together gave me different types of understandings which were
adjoined with a lot of emotions and feelings. The experience, in context to my lack of

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knowledge about a clinical procedure and the risks posed from the same – was a very unique
one and the fact, that the patient was afraid and I could not help her – drove me in into
complicated yet disruptive mindset. Demonstration of the nursing skills with respect to
clinical reasoning, critical thinking, problem solving and decision making skills is important
according to the Nursing and Midwifery council of United states and lack of knowledge
about any little or even a minute intervention can lead to disruption of the care process and
surely diminish the quality of the clinical, nursing service delivered and received in a hospital
or a nursing home scenario. Being proactive about the situation of the patient and being able
to understand the patient’s situation comes through a coordinated, collaborative relationship
building with the patient and clinical knowledge along with the understanding of the psyche
of the patient plays a very important role in the prevention and management of the patient’s
fear and withdrawal behaviors (Emery and Chang 2017). My lack of knowledge of
knowledge could have made the clinical diagnostic process, take a discourse but my apt
decision making skills and coordination skills helped the situation, in a positive manner. The
patient was well handled in the end and it satisfied me to some extent. I learned a lot from the
senior supervisors and the expert professionals counseling skills which from the very next
case onwards, started to incorporate into my practice framework and it has helped me a lot till
now, in a great way.
In that situation, I could have been more confident and resilient instead of panicking
and getting nervous along with the patient. I could be researched before about the
underpinnings of the case and about the procedure related risks as I was already in the
endoscopy department and I should have known that anyhow. The very important part I could
have changed was that I could have had a more focused, more empathic patient centered
approach keeping my emotions stable and that is where, I knew I lacked emotional
intelligence.

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I intended to grow and develop my emotional intelligence plus my professional skills
in a more appropriate manner, in the future. I want to work and develop my skills towards a
more holistic care, binding and following the nursing and midwifery council standards very
closely and pertinently. If in the future it happens again I will make sure to do more research
and make sure that i am well prepared, that I am well prepared before any intervention or
diagnostic procedure.
It can be concluded saying that, from the entire experience, I realized that knowledge
and skills pertaining to expansion of knowledge is vital and took the proactive steps to go and
learn about the perforation process and risk associated with the colonoscopy procedure –
from the doctors and nurses only who were present in the department and I decided from then
and there, that I must keep on knowing as a form of continuous learning and applying my
nursing practice, in an appropriate clinical way so as to help the patient and their emotions, in
a very safe manner. Counseling, I understood from that experience, through talk therapy is
very useful and that it must be applied with firm belief in the knowledge and that’s how, a
nursing skill of building patient autonomy, beneficence and non-maleficence is developed.
As it was aware of the situation and the ways that could lead to deterioration of the care
process, that is why from there and then, attributing to my situational attention to details and
problem solving skills – I started immediately to search for the attending doctor plus staff
nurse who would help me coordinate the care process around the frightened patient.

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