Self-Reflective Essay: Cardiac Arrest and Nursing Leadership

This self-reflective essay delves into the experiences of a newly graduated Registered Nurse (RN), Kim, undergoing a Transition Practice Program (TTP) within a hospital setting. The essay analyzes a critical incident involving a cardiac arrest and the subsequent challenges Kim faced, including a rebuke from a registrar and an insensitive response from the Nursing Unit Manager (NUM). Utilizing Gibb's Reflective Cycle, the essay explores Kim's personality type (nurturer) and performs a SWOT analysis to highlight strengths, weaknesses, opportunities, and threats. It addresses trigger questions to understand the situation and examines issues affecting nursing leaders and professional practice, emphasizing the importance of effective leadership, communication, and adherence to the Code of Professional Conduct. The essay also outlines clinical leadership expectations for new graduate nurses and concludes with an action plan for Kim, focusing on developing resilience, improving communication, and maintaining composure during stressful situations. The importance of supportive elements in effective leadership, such as providing knowledge, evidence, and network support, is also highlighted.

Self-reflective essay on Nursing

Introduction
Reflective essays provide a base for assessing experience gathered from situations, and
reflect upon the various attributes through a critical analysis of manner of improvement. The
main purpose it solves within the healthcare system is to enable nurses and caregivers
understand implications of negative influences and bounce back through reflective learning,
by improving personal and professional development (Adamson and Dewar, 2015). Kim is a
Registered Nurse, having graduated a year back, and is going through a Transition Practice
program, for improving her basic knowledge into practicable skills within hospital setting.
she felt that she was performing well during the training but a case of cardiac arrest and need
for resuscitation of the patient suddenly made her feel that she lacked enough knowledge to
become a successful nurse. Moreover, when the registrar rebuked her during the cardiac
arrest resuscitation procedure, about her lack of understanding of equipments for intubation,
she felt incompetent and was de-motivated, as she was still at her transition-training phase. In
addition, the manner of dealing the incident by the Nursing Unit Manager the next day made
her embarrassed in front of her colleagues, further increasing her doubts of staying in nursing
career.
Through reflection on the overall case, I will try to get a clear understanding on achieving
excellence in nurse leadership. I will make proper use of Gibb’s Reflective Cycle to explain
the situation and create action plans for future, along with trigger questions for improving my
perception and personal development.
Body
Personality Type:
According to the online test, my personality type is more of a nurturer, having more
tendencies to work harder and being a perfectionist to detail. Being a nurturer, I had chosen
nursing profession as my career as my personality type is more of responsibility taking and
less of responsibility giving. I am introvert and like to stay within my boundaries, with a
natural tendency of sensing and being aware of the past experiences and learning from it. I
use my values, emotions and feelings while making decisions and hence like to be organized
and disciplined in work. I sometimes also am drowned with overwhelming feelings when my

work gets defects from supervisors, which de-motivates me and reduces my workability. This
can be one of my major threats to sustain in any environment.
SWOT analysis of personality type:
An ISJF nurturer has certain strengths and weaknesses. They are considerate to people’s
feelings, dependable, stable, focusing on concrete ideas, valuing security and generating a
structure for work (Heydari et al., 2016). The other strengths are being practical and kind
towards other people’s needs. However, some weaknesses of this personality is being
introvert and keeping to one. Moreover, people are less likely to deal with conflict through
direct confrontation, which reduces communication. The main opportunities for improving
oneself is to improve communication skills, being observant to detail and improving personal
development through diplomacy, tact and empathy. Being too emotional, there is a chance of
taking hasty decisions, which might become a threat (Kim and Han, 2014).
Trigger Questions:
Placing myself in Kim’s situation, once the situation had occurred, I would ask myself some
trigger questions, in order to understand the measures to cope up with the problems. Trigger
questions appeals to the inner self, helps in self-evaluation and self-analysis of the needs, and
desires intrinsic to any human. Utilising trigger questions would shape my understanding of
where I currently stand, and will enable me to get a clear view of the situation I am in. I was
feeling de-motivated and was embarrassed. My whole confidence on nursing was shook, and
I could not understand whether this career suited me, as I could not help my fellow
colleagues during an emergency case. I thought all my years of training to be a nurse was a
mistake. However, when I calmed down I asked myself some questions.
 Why did I ever intend to become a nurse?
 What actually led me feeling embarrassed, was it my colleagues and external influences
or my own self-respect hurting?
 What skills do I possess, at this level, which indicates I will prosper in my career and
become a better nurse?
 How to handle with distress from professional field, and manage to de-stress myself?
 How to improve communication in workplace setting, gaining respect, dignity and
leadership skills ?

 How to convert negative experiences to positive influences for improving personal
development ?
Issues and factors that affect nursing leaders and professional practice
In the dynamic healthcare environment, leadership paves way for generating new team of
nurses, and motivating future prospective nurses into becoming leaders, and achieving better
quality healthcare services. Nursing leadership does not only depend on administration affairs
but also has to be implemented in patient-care and bedside support. In ensuring highly
developed quality care services, effective leadership is highly critical and in promoting staff
development (Ross et al., 2014). According to Tyczkowski et al (2015), nurse leaders should
be dynamic, creative, having emotional intelligence, empathetic, avid learners, supportive,
intuitive, resilient and purpose driven. In this profession, new nurses are trained on using
latest technology and medical equipments but at bedside, they have less opportunity to
display their skills and leadership principles. Moreover, integrating nursing practices with
research evidence is critical in providing high-quality care. Nursing leadership practices must
imbibe certain characteristics like cultural competency, mentorship, reflective practices,
quality care, capacity generation on evidence-based leadership, dealing with emotional stress,
workplace issues, patient handling, and various situations (Heckemann et al., 2015).
In case I was the NUM, I would adhere to the Code of Professional Conduct For Nurses in
Australia, for respecting individual nurses with dignity, respect, values, and providing equal
treatment of nurses in front of colleagues. In Kim’s case, the NUM asked Kim for
counselling in front of patients and colleagues, making Kim embarrassed. If I were the NUM,
I would have praised her publicly, but criticised her privately, to maintain her dignity in
workplace. According to the Nursingmidwiferyboard.gov.au (2019), while engaging in
nursing care professional relationships through mutual trust and respect is essential, proving
hallmark in clinical leadership, autonomy, and maintaining professional relations for
improving care facilities.
Clinical leadership expectations for beginning new graduate nurses
According to Freeling and Parker (2015), there are certain skills, which are expected by
professional nurses in healthcare settings from new nurse-graduates, while they register
themselves for the first time. These skills include versatility in communication, maintain
privacy, efficient in handling medication products, professional behaviour, ability to work in

teams, having personal care regiment, knowledge of basic nursing skills, clinical competency,
preventing risk. In addition, reflective thinking, conducive learning behaviour, learning
skills, coordinating skills, understanding various job roles of RN, tech savvy, having
educators skills, leadership/supervisory skills, and potent in understanding clinical
interventions (Parker et al., 2014). In the case of Kim, the registrar had understanding that
she lacked basic knowledge of equipments used in intubation of a critical patient during
resuscitation. Although, Kim had graduated a year back, and was undergoing the TTP
training, she knew she had all competencies and knowledge. However, the sudden cardiac
arrest might have made her panic, as this was the first emergency case she was handling, due
to which she might have lost her calm.
The newly registered nurses must also comply with the code of ethics and code of
professional conduct in Australia, for ensuring better goodwill generation of nursing
profession in Australia. Kim should follow the RN Standards of practice, develop her own
plan for nursing practice by listing all relevant information gathered through the training
period, and communicate the plan well in her workplace.
Gibbs model of reflection
Gibb’s Reflective cycle is a clockwise cycle, which envisages in self-reflection and self-
analysis, for improving personal and professional development through analysing a critical
incident (Mahlanze and Sibiya, 2017).

Figure: Gibb’s Reflective Cycle
Source: (Mahlanze and Sibiya, 2017)
Description- admonished for not knowing the equipments needed for performing
resuscitation intubation on critical patient, during an emergency. This has led her feeling
down, hopeless, useless and feeling incompetent. She is thinking of changing her career, as
her confidence is lost. In next day, she was called by her NUM publicly for discussing events
of prior day and counselling, which made her embarrassed in front of her colleagues.
Feelings- she is feeling incompetent in nursing activities. Her confidence is lost, and she feels
hopeless and useless, making her aware of her own mistakes, further de-motivating her. Her
feelings are making her more susceptible to embarrassments, decreasing her confidence and
workability. Moreover, she is upset over her own act of the day before, which is causing her
more embarrassments. She feels like a liability for her other colleagues, who have to share
her burden of work, while she goes to counselling with NUM.
Evaluation- the whole experience was negative for Kim, as now she is starting to doubt her
choice of career. At first, everything was going normally, from the TTP duration and she was
feeling she could manage situation well. However, a stressful emergent condition had her
panicking. Other’s contribution was more than Kim contributed, as she was admonished for

her lack of knowledge in resuscitation. Although she graduated last year, she had all basic
knowledge, but lost focus and panicked during emergency.
Analysis- the whole learning from the situation is to remain calm during tricky procedures in
a hospital setting. Being calm, composed and effective in mind are the greatest controls a
nurse has to possess in working alongside a doctor and in addressing patient problems. To
enable better care in the ward, the nurse must have the ability to cope with stress and ward off
negative emotions and stresses (Kerr et al., 2014). The main area of improvement and
learning is to be calm and composed and do right things at right moment. Having a sense of
responsibility and keeping composed during stressful situations are the main takeaways from
this case.
Conclusion-if the event is to occur again in future, Kim must remain calm. She knows all the
procedures for working as a registered nurse in a ward setting. She needs to remain calm and
her mind needs to work properly during stressful and emergent situation. She should not get
de-motivated, as this was a first time dealing with an emergency, and she could have handled
it better if she had kept calm. Her main lesson from this case is to improve her knowledge
more, apply her knowledge in practical situation through practise and maintain calm-
composition during stressful events to think.
Action plan- the action plan for Kim is to develop professional resilience during tough
situations and stressful events, and handle pressure well. She has to endeavour in better
communication, remaining calm and ability to handle huge pressure. Nursing sector has
tremendous pressure during emergencies, which has to be coped through individual and
professional development and recovering from the issues, challenges and setbacks to remain
in game. Kim has to improve her resilience to improve her personal development and to
become a better nurse in future. Resilience is needed to dealing with diverse situations in a
critical hospital setting, and bouncing back from the difficulties faced during emergencies,
keeping level headed and calm during stresses (Turner, 2014).
Supportive elements in effective leadership
The nurse leaders should provide sufficient knowledge, communication, evidence and
network support to new graduate nurses for improving their efficacy as leaders. The NUM
should firstly know their nursing staff well, and focus more on relationship creation, in order
to influence decisions of the nursing staffs. Clear guidelines and code of ethics must be

prescribed upon the nurses for efficient communication and activities. Nurse leaders should
lead through practicing own examples and offer for feedback to improve their own leadership
strategies (Cross, 2015). NUM should understand varying levels of experience and
professional capacity of the nurses, personality, and age differences to promote workplace
diversity, trust, collaboration, confidence-boosting, generational variance etc. NUM should
be passionate, sensitive to needs of nurses, supportive to graduate nurses and maintain
everyone’s dignity and respect in workplace. This would collectively motivate new graduate
nurses, increase confidence and make them more practical oriented in workplace increasing
their leadership in clinical practices (Rushton et al., 2016).
Conclusion
Empathising with the case of Kim, I have also acknowledged that similar situation might also
occur in my workplace during nursing practices, which I need to tackle. Through the Gibb’s
Reflective learning cycle, it was found that Kim lacked resilience in performing in adverse
situations. Taking the learning from her experience, I will try to assimilate this characteristic
in my own personality, so that I have a resilient attitude during stressful situations, so that I
can cope under stress and yet perform well. Being a nurse leader also needs dynamism and
sacrifice in workplace. There also exists a need for following a self-care regimen for nurses,
which should be followed to cope with the stressful situations in work, as it helps in
promoting better work-life balance, and thereby increase the nurse’s resilience to work in a
tepid environment (Hart et al., 2014). Planning healthy balanced meals, taking breaks,
finding an exercise past-time, being mindful and relaxing with friends/family are some
routine self-care habits (Blum, 2014). Emotional resilience is an essential necessity for all
nurses, through having positive beliefs, embracing change, being optimistic, problem-solving,
generating goals for personal development and improving skills.

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