GHMB902: Reflective Journal on Healthcare Management Practices

This reflective journal assignment, submitted by a student, explores various aspects of healthcare management using the Rolfe et al. (2001) framework, which utilizes Borton's (1970) model, employing the "what, so what, now what" approach for reflection. The journal encompasses three key areas: new management techniques, critical management incidents, and nursing practice. The student reflects on team dynamics, leadership challenges, and the importance of fairness, consistency, and communication in the workplace, drawing on relevant literature. The journal also analyzes a fire incident in a residential setting, focusing on incident management, early identification, and the restoration of public confidence. Furthermore, the assignment includes a reflection on a nurse-patient confrontation, applying the reflective framework to understand the patient's perspective and the nurse's response. The student draws conclusions about the importance of new management techniques, communication, fairness, and employee empowerment in healthcare settings.

Running head: REFLECTION
Reflection
Student’s Name:
Institution:

REFLECTION 2
Introduction
In healthcare practice, there are numerous theories used in reflection. The study is going
to use Rolfe et al (2001) theory - a framework that employs Borton’s (1970) model. The reason
for adopting this model is that it provides an avenue of questioning on an issue, finding the next
cause and giving a conclusion. It uses “what, so what, now what” propositions. This provides the
ability to give an intriguing reflection starting from novice to a progressive level. The theory
allows the practitioner to reflect on an issue and give description, the second stage encourages an
individual to come up with a theory, and get an understanding of the issue so as to learn. The
third section permits an individual to reflect on the possible action to be taken, seek ways of
improving the situation as well as allowing reflections of consequences of actions taken
(Miraglia, & Asselin. 2015). According to Rolfe et al. (2001), the final stage creates a big impact
on an individual’s practice.
First, the management journal is going to lay emphasis on management theory and
practice because this is one of the units I have been doing this semester. In the course of the
semester, I have been putting each section of the course units in a diary from where I have been
adding new knowledge and theories learned to augment my deeper understanding of the entire
unit. Since the course is very wide, I will reflect only on new management techniques, research
of a specific practice-nursing practice, critical management incidents and give a conclusion.
Journal 1: New Management techniques
During the second week of our studies we were required to work in team of seven people.
We formed a team so that we will be tackling assignments that require group work. After the
formation of the group, I was given the role to be the leader of the group. In our first meeting I
had to arrange a venue and inform all the members to avail themselves in the venue at agreed

REFLECTION 3
time. In the meeting there were contributions from each team member. I the process of the
discussion, members could not agree certain critical areas because everyone needed their opinion
to be the final and the truth. While others agreed, some members felt offended and neglected.
Why…’ (Rolfe et al, 2001). As per Rolfe, we ask the question-why. The incident happen
because members never understood the techniques of management while working in a group. As
a result, members disputed each other over different underpinnings and caused disagreement and
resentment. There was no fairness, openness in giving and sharing ideas with fellow colleagues,
no consistency, no empowerment and no proper communication (Liu, 2015).
‘Now that…’ (Rolfe et al, 2001).As per Seifert, Brockner, Bianchi, & Moon, (2016)
fairness is an aspect in which every one of the employees deserves. The fair treatment has to
come from the top management where all employees get what they deserve based on their roles.
Additionally, there must be fair treatment among the employees themselves (Seifert, Brockner,
Bianchi, & Moon, 2016). The other technique is consistency. Incognizant with the fact that there
are consequences that comes with actions, managers have to take responsibility by the path of the
organization by leading and working in a consistent manner. This is going to make employees
follow suit (Chmiel, Fraccaroli & Sverke, 2017). Openness allowed me to share and learn from
the team members as well as they get to learn from me as well (Ohly, 2015). Empowerment give
people the freedom to carry out the task based on their understanding and abilities and for the
best of the organization (Tharp, 2018). Communication allows passing of information from one
section to another and from employee to employee. It is important to know the group associates
(Adler, Rodman, & Du Pré, 2016). Messaging is one of the easiest ways of communicating
between employees in an organization.

REFLECTION 4
The managers have the mandate of enlightening employees through creating awareness
and communication. The leader is empowered to make the agenda, creates items, host the
meeting and not down the minutes. Through the involvement of each member in a team one get
empowered (Ruesch, Bateson, Pinsker, & Combs, 2017).
‘So what…’ (Rolfe et al, 2001). In working in a team, it is very interesting to know the
creativeness as well as resourcefulness when confronted with difficult tasks that require
solutions. Thompson & Thompson (2008) asserted that in group individuals have the chances to
learn and share from one another. Additionally, teamwork is powerful since it boosts the morale
and motivation of the team members (Li, Cropanzano, & Molina, 2015). In the process of
learning the unit, when in a team, I learned that individual team members when under no
restrictions deliver the best out of their understanding and ready to be corrected and learn Yuesti
& Sumantra, (2017). Communication comes in handy especially when an employee has been
having the negative performance for quite some time and messaging by giving encouragement to
work hard assist. Irrespective of the format employed, it is essential to check in with the team
members so that they provide time and opportunity for questioning and clarification (Lewis,
2019).
The use of all these techniques in an organization strives to create an amble environment
amongst the employees and within the organization. When the team members are in fear of
rejection, then mediocrity set in, create limited thinking which results in moderate success. In
order to evade this, a team leader must be approachable so that communications become
productive (Lewis, 2019).
Journal 2: Critical Management of Incidents

REFLECTION 5
In my residents place there was an incident of fire outbreak that was occasioned by
electricity fault. The fire erupted and spread very quickly to the near building. Efforts to reduce
the spread became difficult and overwhelmed the neighbors because the fire was huge. The fire
brigade saved the situation even though they arrived late.
Why…’ (Rolfe et al, 2001). The incident happened due to electricity fault that busted
resulting into huge flames of fire which spread very quickly across the neighbors’ houses. Tragic
unplanned incidences do occur in our daily day duties an in our surroundings
‘Now that…’ (Rolfe et al, 2001). The aim of managing critical incidents is such that a
response gets provided which is able to satisfy the need of the affected person, the family or the
society. It serves also to provide a proportionate outcome that is effective to the incident. This
recognizes the importance of the family’s and the society’s self-assurance and belief in the expert
reaction to the critical incident. Even though large scale incidents may develop into multiple
critical incidents, less severe occurrences and inner occurrences can, also do, intensify, but even
so there are warnings prior to the occurrence of the incident (Adam, Osborne, & Welch, 2017).
The management of incidents in an organization is critical and calls for the consideration
of early identification of incidents. This encompasses processes in order to ensure proper and
early notification of incidents to concerned persons so that they are effectively managed.
Additionally, the restoration of public confidence is paramount. This is done through team
participation/community putting into consideration the incidences that occurred earlier and
caused a significant impact on the society (Chipeta, Bradley, Chimwaza-Manda, & McAuliffe,
2016). On top of the management of incidents, decision making is another aspect wherein a
given critical incident, the effective decision has to be made and comprises of accepting some
decision that best suit to solve the incidents while at the same time disregarding decisions that

REFLECTION 6
deem of not assistance (Power & Alison, 2016). At the end of decisions made, there is the need
for accountability and entails the expert in giving an account on how and why a particular
decision was made (Karasouli, Munday, Bailey, Staniszewska, Hewison, & Griffiths, 2016).
So what…’ (Rolfe et al, 2001). It is through this that one can appreciate that critical
management incidents provide a proportionate outcome that is effective to the incident when
effectively managed. It is critical and calls for the consideration of early identification of
incidents as it encompasses other processes. This is to ensure proper and early notification of
incidents to concerned persons so that they are effectively managed. Additionally, restoration of
public confidence is paramount and effective decision has to be made and comprises of accepting
some decision that best suit to solve the incidents while at the same time disregarding other
inconsequential decisions (Power & Alison, 2016).
In a team, given that there are complex cases that may prove to be difficult to handle,
invoking the power of colleagues solves the situations through getting assistance from the
superiors and learning in the process (Power & Alison, 2016).
Journal 3: Nursing Practice
In nursing practice, I will use a case where there was a confrontation of the nurse and the
patient. The patient was an elderly was no longer happy in staying in the hospital and required
discharge to go home. She has suffered a head injury and was observed by the surgical team after
a CT scan was done. The doctor was going round to check on patients told her that she was fit to
go home, however, her house was not conducive and she was to wait for social services to install
banisters and the nurse on duty was informed who later told her the same issues but she became
annoyed. The nurse tried to let her comprehend and wait but she did not need any clarification.

REFLECTION 7
In examining the case as a nurse practitioner, I will employ the reflective framework: why…, so
what…, and now that…, as per the Rolfe et al., (2001) model.
‘Why…’ (Rolfe et al, 2001). The incident occurred due to the patient not being given the
right information on time before making her mind to get discharged and go home. The nurse who
was told to let the patient stay a little while delay in giving the information. Even though when
under such a situation, it feels embarrassing and frustrating. The patient should have understood
after having been given all the explanation of the issues and requested to wait for fixing of
banisters in her house so that is become conducive for her as she recovers (Barr & Dowding,
2019).
‘Now that…’ (Rolfe et al, 2001). Given that the patient has been given all information
and that the request to stay a little bit longer is because of the concern of her health given the
state of her house. Everything is done not because she is compelled to stay in the hospital but
because a good place is a must due to her health condition (Schön, 2017).
‘So what…’ (Rolfe et al, 2001). The next step now is to get the patient and taken to a bed
to rest as she waits for social workers to come and assist in the next task prior to her going home.
In this process of waiting for discharge, I will go and talk to the patient, apologize for not getting
information early enough, and ask if she was contented with the explanation given. Also, I might
be of help in getting to know why she behaved that way and offer help if she was under any
frustrations (Redmond, 2017).
Conclusion
I have learned that new management techniques are paramount in any establishment.
Communication comes in handy especially when an employee has negative performance for
quite some time and messaging by giving encouragement to work hard will assist. Fairness is

REFLECTION 8
prudent in the sense that it creates an environment where there is motivation, productivity, and
ensures excellence. Employees have different skills and capabilities and when given the freedom
to exercise what they have, then they are prone to ensure great performance in the organization.
Managers have to take responsibility for defining the part of the organization by leading and
working in a consistent manner and set consistency in the organization.
In addition, I have learned that critical management incidents offer a balanced result that
is effective for the incident when effectively managed. It is critical and calls for the consideration
of early identification of incidents as it encompasses other processes. It is to ensure proper and
early notification of incidents to concerned persons so that they are effectively managed. Also,
restoration of public confidence is paramount and effective decision has to be made and
comprises of accepting some decision that best suit to solve the incidents while at the same time
disregarding other inconsequential decisions. Moreover, given that there are complex cases that
may prove to be difficult to handle, using the power of colleagues solves the situations through
getting assistance from the superiors and learning in the process.
The route of the problem in nursing practice scenario is communication. If the nurse had
given the message to the patient early in the morning, the patient would have contended and such
issues and frustrations to the patient would have been prevented. I have learned that there is a
need for proper communication in time and also that occupational interventions as well as
community interventions ought to be arranged early enough. There is a need to know the
duration they take after an invitation to come to the hospital to avoid them becoming an issue
when it is too late. I am going to see ways of improving situations like these should it occur
while in my profession in my place of work.

REFLECTION 9
References
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Barr, J., & Dowding, L. (2019). Leadership in health care. SAGE Publications Limited.
Chipeta, E., Bradley, S., Chimwaza-Manda, W., & McAuliffe, E. (2016). Working relationships
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Li, A., Cropanzano, R. S., & Molina, A. (2015). Fairness at the unit level. In The Oxford
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REFLECTION 10
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