Reflective Practice In Nursing And Midwifery

Being a reflective practitioner is one of the most important aspects of nursing and midwifery. 

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All institutions training new and emerging practitioners will encourage students to start thinking critically, analytically, and reflectively. 

You might be wondering why thinking reflectively is so important in these professions, and how this is implemented in training and during your career. 

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In this article, we’ll be taking a closer look at reflective practice in both nursing and midwifery. We’ll also discuss how reflections form an important part of CPD and the use of these in the revalidation process. 

Why Is Reflective Practice So Important In Nursing And Midwifery? 

Before we get into a discussion regarding why reflective practice is so important, it’s worth defining what we mean by reflective practice. 

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The British Journal Of Midwifery defines reflection as a “process of learning through everyday experiences […]”

This means that when you are engaged in any activity, whether it be caring for a patient or simply going about your daily life, you should be reflecting on what has happened and what could have been done differently. 

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According to Andrea Sutcliffe, the NMC’s (Nursing And Midwifery Council) chief executive and registrar, “Reflective practice helps professionals employed across all manner of heath and care settings”.

Connecting these two quotes we can discern that reflective practice is important because it allows us to learn from our mistakes and improve our performance. This is especially true in healthcare environments where there are many people with varying levels of experience working together. 

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Being a reflective practitioner translates to a higher level of expertise over time. The more reflective you are, the more you learn from situations and experiences. This feeds into your working body of knowledge. 

It’s also important to note that reflective practice is not just limited to nurses and midwives. 

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It is used by other health and social care professionals such as physiotherapists, doctors, pharmacists, dentists, and psychologists. 

As well as being used within professional roles, reflective practice is also used in education. 

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For example, it is widely accepted that reflective practice is an essential component of clinical teaching. 

As a result, it is common for universities to include reflective assignments as part of their degree coursework.

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Revalidation Process 

We mentioned revalidation as an important aspect of nursing and midwifery in the introduction

The process of revalidation is something which all nurses and midwives in the UK and nursing associates in the UK need to follow to maintain their pin and registration to the NMC. 

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The purpose of this process is to ensure that registered nurses and midwives continue to meet the standards set out by the NMC.

To do this, they must complete a number of hours of continuing professional development each year. 

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CPD

Continuing Professional Development (CPD) forms the basis of numerous professions. It is defined as “the ongoing acquisition of new knowledge, skills and attitudes”. 

In the context of nursing and midwifery, CPD refers to the process of developing and maintaining your knowledge base. 

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The NMC states that: 

“Registered nurses and midwives who wish to remain at the top of their profession need to keep up-to-date with developments in their field.”

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How To Perform Reflective Practice In Nursing And Midwifery

There are various ways in which you can perform reflective practice in your role as a nurse or midwife

One way is to use self-reflection. 

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This involves thinking about how you performed during a particular situation. There are numerous self-reflection models and theories out there, we’ve detailed a few below. 

John’s Model Of Reflection

Originally developed within a nursing context, Christopher John’s work on reflective practice has become an influential model of reflection for students and practitioners alike. 

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The model provokes both an outward and inward looking approach to reflection for the practitioner. 

The two processes, looking internally and externally, are linked within the model.

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Atkins And Murphy’s Model Of Reflection

The Atkins and Murphy Model of Reflection was developed in 1994 by Sue Atkins and Kathy Murphy and revolves around stopping and thinking about your work. This mindful approach means that practitioners can consciously analysis their decision-making to change future actions for the better. 

This model is broken down into the following steps: 

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  1. Self Awareness of difficult feelings or thoughts
  2. Descriptive Language 
  3. Building critical analysis skills using logical thinking
  4. The ability to make evaluations on learning, experiences or events
  5. To be able to identify any learning that has taken place

The Atkins and Murphy model, much like John’s Model Of Reflection, was designed for use by nurses and midwives. 

As the main focus of the model is on inner issues or areas of discomfort, it can be challenging to think in the way the model asks us to. However, this is intentional, as it guides practitioners to thinking critically about their assumptions. 

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An Example Of Reflective Practice In Nursing And Midwifery

We’ll now walk through an example of reflective practice. 

Scenario 

Patient Z is attending an appointment for their regular asthma checkup. 

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Patient Z inquires about a new treatment for asthma they have been looking at on the internet. They are wondering if this treatment is available from the NHS. 

You inform them that you are unaware of this treatment and that they should continue taking their prescribed medication. 

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Describe the Nature of the Practice Related, Event, Experience, or CPD activity

This was a routine appointment with a patient in my practice. 

What Did You Learn From This? 

I felt that I had given the patient the correct advice. 

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It’s in their best interest to take their medication rather than look for new treatments. 

I do feel that I dismissed the patient’s query too quickly. There must have been a reason why the patient was looking for alternative treatments, maybe they were experiencing side effects or symptoms with their current medication. 

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How Might I Change/Improve My Practice in the Future?

When I see Patient Z again I will be sure to ask them how they are getting on with their treatment and whether they have any concerns. 

If I am faced with this type of situation again, I’ll be sure to listen to the patient’s concerns and offer tailored support and advice. 

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References

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