By Lucy Osborn MACN (ENL)

This column, The Scrubs that Fit, is all about the highs and lows of being a junior nurse, from the perspective of an ACN Emerging Nurse Leader. The aim of these blog posts is to help ease the transition from university to grad years and beyond. Find Lucy on ACN’s neo and on Instagram @aussie_nurses.

Throughout high school and university reflections were one of my most hated things. I found them so forced and useless; I’m not sure whether this was because I was already self-reflecting well or writing it down for another to read was uncomfortable. I think the most likely reason was I just didn’t like the extra work and I didn’t understand it’s importance. I would like to share some of my thoughts and practices that I have learned regarding reflection to highlight how it can be a highly valuable process for nurses to undertake.

What reflection looks like to me

I believe the basic principles of reflections are to examine yourself or a situation to grow and develop from past events, good or bad. Reflecting does not have to be a drag hard to do, it can take 10 seconds or 10 minutes and is completely guided by your own personal preferences. In my professional life, I break this process down into three areas:

  1. Goal setting and evaluation: I pick short and long term goals, follow them over time and evaluate the progress and achievement.
  2. Post event evaluation: After an event (good or bad) I go over what happened and how it made me feel and what I can learn from it.
  3. Ongoing learning and development: For more this is more long term goals. I look at my career and development as a whole to find knowledge or skills gaps and examine how I can close them.

Importantly, reflecting doesn’t have to be formal, written or shared. It was a big step forward when I realised that I was doing some sort of reflection everyday whilst on university placements or nursing and when I did I noticed a shift in my thinking. I still am averse to writing formal pieces for viewing by my managers, but I still do them and try to make the most of it.

Don’t forget the good stuff!

I think it is easy to reflect on many situations that happen in nursing that are sub optimal or have a negative outcome. It’s not usually pleasant to do, but it is easy to be critical. Some universities teach it within their practice laboratories and once working there are often designated staff members to run debriefs of education sessions on specific cases. What’s hard is reflecting on everyday practice and on positive things that we tend to just forget about it. I do believe this step in the reflection process is the most important as not only does it improve your practice, it also helps combat compassion fatigue and burnout ​(Hannigan, 2008)​.

How I reflect

Below is an example of how I integrate reflection into my daily work routine.

Arriving at work
Am I tired, grumpy or cheery? Do I have unresolved feelings from yesterday? Plan ahead for these feelings (goal setting) and take advantage of those days where you have a little extra energy. ​😊

If you are taking the same patients from a shift before, take note of any events that happened in the shift between your shifts. This can help you understand if there was something you could have done to make their shift easier or flow better.
When giving a hand over or preparing a handover you can have a look at patients vital sign trends and event/causations. This is a great step in clinical development and can be started as soon as you enter the workforce. Think about the patient as a whole, how your care worked and their own unique journey.

Leaving Work
Acknowledge how you are feeling and explore why. Sometimes this will stimulate enough reflection but sometimes you need to dive further. No matter how you get to work there will be sometime between works and home where you can take some time to yourself to work through your day. again, it doesn’t have to be formal or take long. I usually find myself briefly going over my day whilst walking to the tram, it’s only about a 100 metre walk. By the time I get on the tram I can forget about the day and relax. oIf you find yourself dwelling on the negative, find one or more positive for every negative. They can be as simple as, “today I made a crying child laugh” or “today I noticed I had better time management”. This doesn’t have to be a skill, it can be a feeling or anything that is a win.

My final advice is if you find yourself overthinking about something work related when you are at home, stop, reflect and work through it. Let it go, use it for development or set a goal surrounding it so you can move past it while off shift. This is a great example of how engaging in the process of reflection can ensure work doesn’t consume you out of hours and you can enjoy your days off.

Reference List

Hannigan, B. (2008). A discussion of the strengths and weaknesses of ‘reflection’ in nursing practice and education. ​Journal of Clinical Nursing, 10 (2), pp.27-283.

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