Reflective Journal: A Chaotic Trauma Room Incident and its Lessons

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Reflective writing
Contents
Introduction................................................................................................................................................2
Gibbs reflective model..............................................................................................................................3
Description.............................................................................................................................................3
Feelings..................................................................................................................................................3
Evaluation..............................................................................................................................................4
Analysis..................................................................................................................................................5
Conclusion.............................................................................................................................................6
Action plan.............................................................................................................................................6
Conclusion.................................................................................................................................................7
References................................................................................................................................................8

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Introduction
This assignment is reflective writing on an incident at work which was good and bad at
the same time and which also taught me many things in life. The incident took place in
the 2nd year of my working experience as a nurse in a trauma room at the hospital. I
have used the Gibbs model which was developed by Graham Gibbs in 1988, to reflect
my feelings and situation during the incident. The incident is described and reflected by
using 6 stages of the Gibbs model.
(Online source: Oxford Brookes University, 2019)
Gibbs reflective model
Description
This incident happened at work when I was working in my second year as a registered
nurse in the trauma department. It was a chaotic day and patients were rushed in the

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emergency room because of the accident that occurred on the nearby street. It was a
drastic accident involving many casualties and waiting area was filled with families
enquiring about patients and the emergency room seemed immensely busy with nurses
and doctors rushed to help injured patients. I was attending to my patient when I heard
a patient about 18-year-old having a panic attack, shouting screaming and shaking on
the bed. He was shivering and shaking and screaming ‘save us a god' by looking at
other causalities. He started to bang his head against the pillow out of fear and shock.
His scream was very loud with grief which panicked everyone in the room (Finlay,
2008). He was frightened to see so many causalities and blood and was in a state of
shock because of the entire accident and I was standing nearby him attending another
patient but I couldn't manage to calm him down. His scream panicked everyone in the
emergency room and thus it was necessary to calm him down and have a conversation
with him to relax him. His scream caused chaos in the emergency room as all the
patients got scared Nurses and doctors rushed towards the 18-year-old boy explaining
to him that everything is fine and that he will be ok. It took time for others to reach out to
the boy and by that time patients and families of casualties’ panicked causing chaos in
the waiting room. One of the nurses stood by the boy having a long conversation with
him to relax him and divert his mind. I went back to attending my patient but learned a
lot from the incident (Bailey, 2007).
Feelings
During the incident, I was frightened and shocked to see so many casualties at the
same time in the emergency room, I couldn't move for few seconds seeing the chaos
and injured but I immediately gathered myself and started acting. When I went help and
manage the boy I was confused and a little numb about the situation, I was not able to
effectively act and calm him who is probably because I was shocked as well and it was
the first time that I saw such chaotic situation (Hargreaves, 2004). Before this incident, I
always used to feel that I can manage situations well and that I had good
communication skills and was able to manage patients through conversations. Before
this incident, in my nursing practice of 2 years, I was always confident and managed
most of the situations effectively. I felt that I could be good at managing situations by

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communicating with patients but this situation changed my perception and feelings.
After the incident, I felt bad for not acting immediately and effectively. I started to doubt
my managing and communication skill and started to feel like a loser, I realised that if
only I did not fear and was confident, I could have managed the situation effectively and
immediately. For a long time, I had this guilt of not being able to act on time but
gradually I learned that guilt is not going to help but I have to start acting and feel
confident again. After taking training sessions I started to feel better about the whole
situation (Beam, 2010).
Evaluation
It was a chaotic situation with families panicking to see their loved ones and in between
that such scream and panic attack was frightening for everyone but when the nurse
spoke to the patient and calm him down, the situation was much in control and
everyone did their job effectively. The boy survived the injuries and was calmer and
better as the days passed (McGuigan, 2009). The good thing about the incident was
even after so much chaos nurses and doctors were able to calm the boy and managed
the situation effectively which made all the patients at ease and they became
cooperative towards nurses and doctors. It was difficult but every person was doing
their best to save the lives of people and in that this cry of grief and panic attack of a
young boy was panicking and distracting at the same time. It caused chaos not just in
the emergency room but in the waiting room as well. Families waiting for their loved
ones panicked with a scream and started to question doctors and nurses. The staff
members managed the situation by ensuring them of patient safety and effective
treatment at the hands of doctors and nurses. At such a situation, it was important to act
quickly to resolve the issue by the calming patient (Moon, 2013).
Analysis
It was required for nurses to act quickly to calm the patient so that a chaotic situation
can be handled. The 18-year-old boy panicked because of the severity of the accident
and after seeing so many casualties. He was frightened seeing patients around and
doctors working on a patient and couldn't calm himself after seeing so much blood on

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patients. What went wrong was the delay in a calming patient (Bulman, 2013). It was
difficult to manage the patient and other patients at the same time which led to more
chaos. Seeing the patient screaming and banging head I tried to manage the situation
to calm him down and control the situation. Since I was standing close to the patient it
was my duty to try and manage the patient. As a nurse it was my responsibility to
handle situations and manage it effectively that is why I tried to manage the patient to
calm him but the boy was out of control and was difficult to manage (Gustafsson, 2004).
The good thing that happened was that nurses were able to manage the situation by
calming the boy and managing families in waiting room ensuring that effective services
are provided meanwhile in the emergency room as well patients were ensured and
effective treatment was done to save people. The boy eventually was calm and was
cooperating in the treatment. A simple conversation with the boy and the families and
patients was enough to manage the situation. Even in such a chaotic situation, nurses
had good conversations with the patients ensuring them to save the environment and
effective treatment. Good and effective communication skills of nurses helped in
managing panicked child and in turn, helped in controlling the situation (Timmons,
2006).
In such a chaotic situation I panicked as well seeing so many casualties but I gained
strength and started to help the patients and support them. When I heard the boy and
even when I was standing beside him it took me seconds to react and manage but
eventually I tried managing him but somewhere I myself was panicked with the whole
situation. When I observed everyone around me, they all were busy with their patients,
acting immediately to the tray and save people and work effectively. Seeing the boy
panicking everyone around was shocked and doctors and other nurses came to the
patient to calm him down and relax him. Other patients were frightened and were in pain
and this situation caused more chaos and it was to be managed by the staff members
(Boud, 2013).

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Conclusion
This incident taught me a number of things since it were my first time in such a chaotic
situation; I was panicked and shocked seeing the entire situation. It took me some time
to gather myself and started doing my work by helping the patient. From the entire
situation it can be concluded that effective communication skills and management at the
time of emergency is required. It is essential to master the skills to manage such
situations to work effectively. This incident taught me to be patient and to be strong and
mindful in such situations. I should have acted immediately and thus I require polishing
my communication skills and managing skills (Bannigan, 2009).
Action plan
After this situation, I was very focused on polishing my skills to work effectively. As a
nurse it was my duty to act immediately in such situations and not get panicked, this
incident made me strong and thus I decided to work on my communication skills and
management of patients. I started to train myself to manage such situations effectively
and immediately. I started seeking help from my mentors and seniors in guiding me to
act immediately and also I started to observe my colleagues when they had
conversations with other patients and started to learn through observation and guidance
from my mentors (Ghaye, 2010).

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Conclusion
Gibbs model helped me to analyse the entire situation and my feeling and helped me to
work on certain skills. It allowed me to be critical about my work and assess situations
so that my work and skills can be improved. I started to use this model to analyse
different situation and understanding and started acting on the weak points (Davies,
2012).

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References
Bailey, M.E. and Graham, M.M., 2007. Introducing guided group reflective practice in
an Irish palliative care unit. International journal of palliative nursing, 13(11), pp.555-
560.
Bannigan, K. and Moores, A., 2009. A model of professional thinking: Integrating
reflective practice and evidence-based practice. Canadian Journal of Occupational
Therapy, 76(5), pp.342-350.
Beam, R.J., O'Brien, R.A. and Neal, M., 2010. Reflective practice enhances public
health nurse implementation of nurse‐family partnership. Public Health Nursing,
27(2), pp.131-139.
Boud, D., Keogh, R., and Walker, D., 2013. Reflection: Turning experience into
learning. Routledge.
Bulman, C. and Schutz, S. eds., 2013. Reflective practice in nursing. John Wiley &
Sons.
Davies, S., 2012. Embracing reflective practice. Education for Primary Care, 23(1),
pp.9-12.
Finlay, L., 2008. Reflecting on reflective practice. PBPL paper, 52, pp.1-27.
Ghaye, T., 2010. Teaching and learning through reflective practice: A practical guide
for positive action. Routledge.
Gustafsson, C. and Fagerberg, I., 2004. Reflection, the way to professional
development?. Journal of Clinical Nursing, 13(3), pp.271-280.
Hargreaves, J., 2004. So how do you feel about that? Assessing reflective practice.
Nurse Education Today, 24(3), pp.196-201.

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Husebø, S.E., O'Regan, S. and Nestel, D., 2015. Reflective practice and its role in
simulation. Clinical Simulation in Nursing, 11(8), pp.368-375.
Mantzoukas, S. and Jasper, M.A., 2004. Reflective practice and daily ward reality: a
covert power game. Journal of clinical nursing, 13(8), pp.925-933.
McGuigan, D., 2009. Communicating bad news to patients: a reflective approach.
Nursing Standard, 23(31), pp.51-58.
Moon, J.A., 2013. A handbook of reflective and experiential learning: Theory and
practice. Routledge.
Timmons, J., 2006. Using case reports to aid reflective practice in wound care.
British journal of community nursing, 11(Sup1), pp.S14-S20.
Oxford Brookes University, 2019 retrieved from https://www.google.com/url?
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AKHaYlBSEQjxx6BAgBEAI&url=https%3A%2F%2Fwww.brookes.ac.uk%2Fstudents
%2Fupgrade%2Fstudy-skills%2Freflective-writing-gibbs%2F&psig=AOvVaw3_-
bAoDDv0bLtusaEVUPCY&ust=1550862891360545 last accessed on 25/2/2019.