Clinical Skills Assessment: Gibb's Reflection on Venipuncture

This report presents a student's Gibb's Reflection on a venipuncture procedure performed in an acute care setting. The reflection follows Gibb's reflective cycle, detailing the student's experience, including the initial description of the procedure, their feelings of nervousness and anxiety, and a positive evaluation of the experience, highlighting effective therapeutic communication and safe practice. The analysis delves into the student's strengths and weaknesses, referencing the Nursing and Midwifery Board of Australia standards, particularly the importance of clinical skills and self-management. The student identifies a lack of organized equipment collection as a critical area for improvement, potentially affecting patient safety. The action plan proposes a SMART goal to improve self-management skills through training, workshops, and clinical supervision within three months. The report concludes by emphasizing the importance of organized clinical practice, safe patient care, and the student's commitment to professional development.

Running head: GIBB’S REFLECTION
GIBB’S REFLECTION
Name of the student:
Name of the university:
Author note

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GIBB’S REFLECTION
Description:
During my clinical stimulation assessment, I was provided with an opportunity by a
general practitioner to conduct venipuncture in order to collect blood samples from a patient who
was admitted on the acute ward for some blood tests such Full Blood Count, C-reactive
protein (CRP) count and white cell count. In order to conduct, venipuncture, I involve my patient
in therapeutic communication and provided the patient with information regarding the procedure.
After communication, I selected the gathered tube, assessed the vain so that no bruises or
infection is present in the vein. After choosing a vein in the antecubital area, I applied a
tourniquet with the assistance of Aseptic Non-Touch Technique and collected the blood.
Throughout these stages, I managed to involve myself in safe and responsive nursing practice
and after my peers and assessor were happy with my performance. However, while receiving
feedback, my assessor highlighted that the collection of equipment could be more organized
which further affected my practice as I experience disturbance. Organization of the equipment’s
before the procedure could prevent the unnecessary choose that further affected my clinical
practice.
Feeling:
As a novice in the clinical practice, I was quite nervous as well as anxious while
conducting the venipuncture as it was a new opportunity to me to exhibit my professional skills,
values, and beliefs while involving patients in the therapeutic procedure. Conducting each step of
the procedure with safety and clinical skills without subjecting patient in potential harm was
challenging to me. Being a nurse, I was also quite apprehensive regarding the procedure as what
it would like to carry out a therapeutic procedure that inflicts pain on another human being?

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Being a nursing professional, we develop values of being compassionate and empathetic in
clinical practice without causing harm to the patient while conducting any clinical procedure and
inflicting pain in another human induces nervousness. However, safe and responsive practice and
appreciation of my peers and assessor increased my confidence and competence. While my
assessor provided me the feedback regarding my practice, I felt at ease since the feedback would
help me to facilitate my clinical practice in the future of providing safe and responsive care.
Evaluation:
While conducting venipuncture, I encountered both pessimistic and optimistic experience
which increased by self-awareness regarding my clinical practice. Considering the optimistic
experience, while general practitioner instructed me to conduct venipuncture, I saw this as an
opportunity for this clinical skills which will further enhance my clinical practice. I was able to
involve the patient in the therapeutic communication and provided information which is another
optimistic experience to me. The appreciation of my peers and assessor regarding my safe
practice is also helped me to gather optimistic experience. However, considering pessimistic
experience, while my assessor provided me the feedback that the collection of equipment could
be more organized, it was a pessimistic experience I failed to develop self-management skills
which further affected my clinical practice.
Analysis:
While conducting any procedure, in a clinical setting (acute care), registered nurses are
expected to exhibit excellent clinical skills in order to provide safe and responsive care. Inability
to exhibit clinical skills may question patient safety and violate nursing ethics. Taking a deep
insight into the situation, according to the standard 6 of Nursing and Midwifery Board of

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Australia, a registered nurse is responsible for ensuring quality and ethical practice based on
comprehensive assessment and use appropriate procedure, time direction and supervisor to
ensure the practice is safe and correct (Nursingmidwiferyboard.gov.au, 2019). In this current
context, while I was able to show competency in meeting the criteria of standard 2
(communicates effectively with patient and being respectful of a person’s dignity, culture,
values, beliefs, and rights) and standard 3(provides the information as well as education to the
patients for enhancing control of individuals over health) by conducting proper practice and
involving patient in the therapeutic communications, I failed to meet the criteria of standard 6.
There are 15 steps of venipuncture such as Step 1 Labeling the tube with the patient’s particulars,
Putting tourniquet on the patient, ask patient to make fist, finding veins and clean it with alcohol
using circular motion, assessable needles and vacuum holder, inserting the collection tube into
the holder until tube reaches to the needle, removing cap of the needle, inserting the needle into
the skin , placing dry gauge over the venipuncture slide, applying bandage to the site until it
stops bleeding and properly disposing the needle in the biohazard bag (Bueno et al., 2016).
While I was able to show my clinical competency in each step such as involving patient in the
effective therapeutic communication, providing the relevant information of the procedure
regarding the process and assessment of the skin for choosing vein, I failed to collect equipment
for collecting blood in organized way which further affected my clinical practice of providing
safe and responsive care to the patient. The underlying reason is that lack of self-management
skills affected organization while collecting the equipment which further interrupted the
procedure and could subject patient in the potential harm. This problem could be prevented with
proper self-awareness and self-management skills while collecting the equipment (Rasheed,

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2015). Hence, to perform accurate clinical procedures, the development of self-management
skills are crucial for nursing (Carragher & Gormley, 2017).
Action plan:
In a concluding note, it can be said that while performing venipuncture, I was able to
involve the patient in the therapeutic communication and able to provide her crucial information
regarding the procedure which facilitates my clinical practice. While performing, I was able to
do safe practice which prevented me from violated nursing ethics. However, due to lack of
organization, while collecting equipment for a blood sample, the procedure was disrupted which
could subject patient to greater harm. Hence, I was failed to meet certain criteria of NMBA
standard. Designing the action plans and involve in the action plans not only improve
professional skills but improve practical experiences (Nicol & Dosser, 2016). In order to achieve
self-management skills and become more organized, the SMART goal can be designed. The
significance of SMART goal is that help focuses your efforts and increase the chances of
achieving that goal (Jakubik et al., 2016). In this context, the SMART goal is to achieve self-
management skills with the help of training and workshops and clinical supervision within the
next three months.
Black et al. (2015), highlighted involving in the training and workshops facilitate the self-
management skills as training and workshops provide an opportunity to gather evidence-based
knowledge and practical knowledge required for conducting successful clinical practice.
Moreover, Ford et al. (2016), clinical supervision assist health professionals to achieve goals by
evaluating skills and ensure that while handling patient, nurses must use proper skills in order to
avoid any ethical issue which can impact patient safety. Hence, this is the case these action plan

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would be most suitable to achieve the goal. After involving myself in the training and
workshops, I would be able to gather appropriate management skills and ability to be more
organized when the same situation will arise in my future practice. Consequently, I would be
able to provide safe and responsive practice to each patient by following proper technique.

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References:
Black, A. T., Balneaves, L. G., Garossino, C., Puyat, J. H., & Qian, H. (2015). Promoting
evidence-based practice through a research training program for point-of-care
clinicians. The Journal of nursing administration, 45(1), 14.
Bueno, M., Nishi, É. T., Costa, T., Freire, L. M., & Harrison, D. (2017). Blood sampling in
newborns: a systematic review of YouTube videos. The Journal of perinatal & neonatal
nursing, 31(2), 160-165.
Carragher, J., & Gormley, K. (2017). Leadership and emotional intelligence in nursing and
midwifery education and practice: a discussion paper. Journal of advanced
nursing, 73(1), 85-96.
Ford, K., Courtney-Pratt, H., Marlow, A., Cooper, J., Williams, D., & Mason, R. (2016). Quality
clinical placements: The perspectives of undergraduate nursing students and their
supervising nurses. Nurse Education Today, 37, 97-102.
Jakubik, L. D., Eliades, A. B., Weese, M. M., & Huth, J. J. (2016). Mentoring practice and
mentoring benefit 2: mapping the future and career optimism--an overview and
application to practice using mentoring activities. Pediatric nursing, 42(3), 145-147.
Nicol, J. S., & Dosser, I. (2016). Understanding reflective practice. Nursing Standard
(2014+), 30(36), 34.
Nursingmidwiferyboard.gov.au (2019). Nursing and Midwifery Board of Australia - Professional
standards. [online] Nursingmidwiferyboard.gov.au. Available at:
https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-
standards.aspx [Accessed 28 Jul. 2019].

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Rasheed, S. P. (2015). Self-Awareness as a Therapeutic Tool for Nurse/Client
Relationship. International journal of caring sciences, 8(1).