The first step of the Reflective Cycle is to describe the events without judgment or conclusions. In this timeline, the nurse begins the day with a list of clients to assess before surgery. The day included unexpected events when assessment of the second client was interrupted by another healthcare provider, and a schedule change initiated quickly.
When describing emotions during reflective practice, stay focused on feelings and don’t analyze—just describe. In this situation consider that the nurse may have experienced anxiety when unable to assess the second client in progression or during the sudden change in the operating room schedule. Perhaps the nurse was frustrated when the physician was upset regarding the schedule change.
Evaluation is the time to analyze how the nurse perceived the experience. During the evaluation phase of reflective practice, focus on no more than two encounters and identify the most concerning events during the experience. Trust intuition at this time and choose based only on individual perceptions of the experience. Were the encounters with team members and clients positive or negative?
During the critical analysis phase of reflective practice, compare the experiences of others and analyze what occurred in this situation relative to prior experiences. What was different? What was the same? For example, did negative encounters with team members or abrupt schedule changes produce negative outcomes in the past? What themes are emerging from the critical analysis? For example, this nurse might identify the lack of communication and collaboration among team members as an ongoing issue, placing clients at risk.
In this phase of the Reflective Cycle, the nurse must identify knowledge gained and propose recommendations for practice change. The nurse must own inappropriate actions and remain aware and open to the need for positive change. In this clinical situation, the nurse should not have interrupted an assessment to accommodate another team member and compromise the safety of the client. The nurse should have followed policy and reviewed the procedure with the second client, providing ample time for discussion regarding the procedure and marking of the affected body part. Finally, all team members should have paused during the schedule change to assure client safety before proceeding.
The final step in reflection is the creation of an action plan. This action plan may include recommendations from supervisors but must also contain personally identified actions to strengthen future practice. Consider actions the nurse should take if this situation occurs again. Remember to include strategies to determine if the nursing practice has improved as a result of the action plan. Reflective practice is a synthesis of ideas connected to knowledge, feelings, and attitudes. The goal of synthesis is new insights and perspectives as well as meaningful practice change.