reflective writing nursing placement

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Student Day in the Life – Paediatric Burns assessment unit and day-case trauma/plastics/burns surgery

Amy – 3 rd Year – Nursing (Child)

6.45: Arrive at hospital and park up, walk into the ward, get changed into uniform.

7.00: Meet for handover, check in with my supervisor, and plan for the day.

7.30: Elective day case patients arrive, I have a 14-year-old dental patient to admit. I take their height and weight as well as complete a set of baseline observations. With the patient and their parent, I complete the relevant paperwork, get them situated on the ward, and answer any questions they have. Once I have finished an anesthetist and surgeon arrive to complete their paperwork and I observe these interactions. I check in with the play lead about any support they can provide.

9.00: Trauma and burns patients arrive following a negative COVID-19 swab and I help to admit another patient.

11.00: I help take patients to theatres, providing a distraction to the child as they are cannulated as well as support to parents afterward and heading back to the ward. Once patients have been taken to recovery, I help take parents to them and then assist with bringing patients back to the ward when needed. Once patients have returned to the ward, I complete a set of observations, offer suitable food, and drink and complete any relevant paperwork. Once a patient has been discharged, I help to clear their bed space and prepare it for the next patient.

15.00: I am spending the afternoon in the pediatric assessment unit as there are a lot of appointments and no afternoon patients on the ward. I check in with the nurses working here and assist with the clinical holding of a burns patient who has returned for re-dressing.

16.00: Assist with a burn assessment in the pediatric assessment unit. A 3 rd old child has a hot tea burn to their shoulder and arm from pulling down a cup of tea in the kitchen. I help to remove the dressing applied at A&E, clean the wound, and apply suitable dressing. Give burns care advice and book in for a follow-up. Once patient and parent have left, help clean down the room, re-stock supplies and write up notes.

18.30: I check in with the ward staff and hand over anything that needs to be included for the night staff. I also check in with my supervisor to ensure that everything has been double signed off in my paperwork and discuss how my day has been.

Student Reflections – Adult Nursing – Cardiology Placement

Charlotte – 3 rd Year – Nursing (Adult)

I am based on a medical cardiology ward, treating patients with a variety of cardiac conditions from heart failure exacerbation to ACS. A day starts at 07:30 with a comprehensive handover from the night team, highlighting any patients that have high NEWS, are awaiting procedures, or are going home. Then, the day can take any number of turns from there!

The team is incredible, supporting me through learning an absolute multitude of abbreviations and medical jargon – Tavis, and STEMIs, and AS, and BAVs – and carefully explaining procedures and conditions to me. The first couple of weeks involved shadowing my practice supervisor, getting used to the medications and what they were used for, and trying to figure out what the squiggles on the cardiac monitor meant. My practice supervisor had just done a master’s module in ECG interpretation, and at the beginning of every shift we reviewed one of our patient’s ECGs to understand if there had been any changes, and so I could begin to get an insight into how you decipher them! Then, when I felt comfortable, I was given my ‘own’ patients to look after – starting with one, and working up to a whole bay, with my practice supervisor acting as HCA, and generally making sure I was doing the right things. It gave me incredible confidence in my own abilities, and I often left for the day knowing that I had made a difference to patient care, and also massively advanced my learning.

Some days involved discharges and admissions, while some days involved supporting patients arriving back from procedures called Angiograms. Agios can be diagnostic, or what’s known as a +/- – where stents can be placed in occluded coronary arteries – and involves a catheter being threaded through the radial artery to the heart, with a contrast dye injected to look for blockages. One of the spokes for this placement area is the Cath labs, where these procedures are carried out, and you’re able to see the procedure, have it fully explained to you, and follow the patient journey. You then follow your patient back to the ward for recovery care.

We also had days of unpredictability, with patients deteriorating, high NEWS scores, and MET calls. It is an acute area, with patients that can be unstable, or need transferring to higher dependency areas, or even having unrelated conditions develop. One shift, one of our patients developed sepsis and deteriorated very quickly. As this patient was elderly, they didn’t display the classic high temperature, and if the respiration rate had not been counted correctly, and escalated, it could have been easily missed, or mistaken for something else. For me, this highlighted how well nursing teams know their patients, and know something is wrong. We realised they were not themselves, and escalated to the appropriate teams, creating a chain reaction that got our patients the treatment they needed very quickly.

It is impossible to put into words how much I learned on this placement, and how much is transferrable to other clinical areas. I have become more confident in escalating my concerns, in applying pathophysiology, in meds management, and in myself as a nearly third-year student nurse. My advice to you, if you get any cardiac placement, or with any placement at all, is to get involved as much as you can, soak it in, and make it known that you want to learn everything and anything – don’t be afraid to ask things, you deserve to be there. Oh, and maybe take a notebook.

Student Reflections – Mental Health Nursing – CAMHS Placement

Steph – 3 rd Year – Nursing (Mental Health)

I’m writing this as a year 3 mental health nursing student two months from qualifying, reflecting on first placement of my second year.

Before I came to CAMHS I had many preconceptions, mainly from news articles and social media posts on their lacking compassion and care. I was nervous to start because I had (and still have) so much passion for child mental health services (CAMHS) and I didn’t want to become one of these “uncaring CAMHS professionals” (which there are none of, and I explain this later on in the blog).

Everything I had learned so far in the 2 years of my mental health nursing degree revolved around adult nursing. From blood pressure and other vital normal ranges to symptoms of mental health conditions, were only relevant when concerning adults. After a lengthy induction and getting to know the team, I assisted with the ADHD clinic. I was asked to use the automatic blood pressure machine in the clinic room and seeing the measurement of 95/55 felt alarming, but I was reassured that this was healthy for a child of this age. From the first clinic, I realised how lacking I was in knowledge of this age group and how it isn’t always discussed on the course.

As a student the biggest part of our role (especially in the first and start of second year) is to observe, and in this placement, I manage to observe so many positive aspects from this team, I was privileged to watch children recover from some mental conditions, witnessing families become more functional and even became a part of others recovery.

Reflecting back, the reason I’m deciding to pursue a career with children is the constant technique changes to keep a child engaging. It’s looking after families holistically rather than one person as a patient. I found that there was a lot of anger in the media and from the public towards CAMHS as a service due to the increase of children’s poor mental health and lack of resources. Working from the inside I watched specialised nurses burn out from putting their all into their work, I witnessed their dedication and passion to helping every child overcome their mental health issues, but there was no reward in the media for this, no excitement for every child they managed to keep safe, no acknowledgment for the times they stayed past 5 to talk with a family, or even a round of applause for the workload that toppled over into their personal time and family lives.

I did wonder for a while why nurses went into the service when most of the feedback in the public eye was and still mostly is negative until I met a young girl, she had suffered massively with her mental health without going into details, after months of visits and treatment alongside family therapy this girl who never smiled, began to do just that. She would laugh in sessions and talk about future plans; she became full of life again. That feeling you get when you’ve put time into a person and you see the glimpse of hope and recovery, nothing compares to it. That’s why these nurses continue on through the negativity because seeing a child and their family go from helpless to enjoying life is worth everything else that comes along with the job title.

This is not to say the frustration and anger from the public are not just, but I believe the energy is being poured into the wrong place, these nurses, psychologists, psychiatrists, and carers all care deeply for children’s mental health, but when there is lacking of resources, lacking teams and lacking capacity it all stems down to the funding, and that is where the energy should be placed, to gain more funding to make the services fitter for practice without every nurse burning out.

I’ve now in my final placement, worked with every age group, from children to the elderly, and although in every placement I put my all and every team has been welcoming and just as caring as the last. Nurses in all domains are doing amazing jobs, and the passion that shines through I’m always in awe of, but I’ve never felt more at home and more thriving than when I was working in CAMHS.

Student Reflections – Adult Nursing – Surgery Placement

Rebecca – 2 nd Year – Nursing (Adult)

Walking into a hospital for the first time is one of the most overwhelming yet amazing experiences of being a nursing student. That feeling doesn’t change even on my second placement of the second year. As a student, you will have gained so much knowledge during your first 2 years that you know how to approach each new placement with confidence. It always takes some time to adjust but once you do, everything is familiar, and you feel as though you are a part of the team.

I am currently on a placement at a private surgery placement. The shifts are 12 hours and the day starts off with handover, which is one of the most important parts of the day. Handover provides all the relevant information for patients who have stayed overnight and information about the patients having surgeries that day. Throughout the day you are assigned with a nurse, and about 4 patients.

The day consists of medication management specifically towards post-operative care: pain, nausea management, washing, and any relevant personal care, taking observations, and other monitoring. For example, if a patient has an epidural, they have regular checks, as well as wound care/dressing changes and documentation.

Each day is different and you are faced with a wide variety of patients, personalities, and problems. Having the same patients gives a lot of time to get to know them, something they don’t tell you is by the end of the second year you will have mastered small talk.

As a student on a surgical placement, you have the opportunity to not only spend time with patients and the nurse, but to watch surgeries, small procedures, and scans. This has been fascinating and a completely new experience, seeing someone having a knee replacement is something you will never forget.

The most rewarding part is going home knowing you made a difference to a patient’s day, even if it’s only small, those days are the best.

Finally, your placements will be part of the nursing course that will prepare you the most for working while also being the biggest step forward in building your confidence, expanding your knowledge, and giving you the experience you need for practice.

Student Reflections – Mental Health Nursing – CAMHS Placement

Elisa – 3 rd Year – Nursing (Mental Health)

My current management placement is at a CAMHS (Child and adolescent mental health) in-patient unit. The struggles and diagnoses our patients currently present with are psychosis, self-harm, anxiety, neurodivergence, eating disorders, and depression.

It’s hard to describe a day as it varies so much as we journey through the highs and lows with our patients. However, from a nursing point of view, the day starts with allocating the shift, dispensing medication, and discussing with the wider MDT patient needs. Working in CAMHS you are in close contact with social workers, education, parents, and carers. The range of patient struggles alongside normal teenage hormonal changes can be an intricate process to discern and decide what needs treatment and more importantly how the young person can be supported through normal teenage concerns.

I’ve learned so much here- around emotional boundaries and resilience, however compassionate care has remained in the front of my mind. When I reflected with a nurse around compassion fatigue, they reminded me that when you are with a patient who is struggling and it feels like they aren’t responding to your support, it can feel disheartening, however, every kind of act each person gives builds upon each other so that the young person can feel able to respond to the care. For example, if I’m with a young person who is self-harming and I try to de-escalate them out of it, but they don’t respond to me, yet when another staff comes along they are able to de-escalate, it can quickly feel overwhelming, and that I am not a good enough nurse. In such an instance I must remember that all compassion is remembered and received, it can just take people time to accept it and bring them out of the sadness they are in. This reflection has encouraged me in remembering that recovery and healing take time, and it takes a whole team; no individual staff can be the answer for everyone and that is ok!

Teamwork, time, hard work, and patience are what paves the road towards healing and hope.

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A guide to nursing students' written reflections for students and educators

Affiliations.

• 1 Murray State University, United States. Electronic address: [email protected].
• 2 Murray State University, United States. Electronic address: [email protected].
• PMID: 28437690
• DOI: 10.1016/j.nepr.2017.04.004

Experiences from the clinical setting are ideal for building critical thinking skills if reflection is used as a teaching tool. Reflective writing is the purposeful and recurring inspection of thoughts, feelings, and occurrences that coordinate with experiences during practice. Reflecting on clinical experiences develops critical thinking ability, fosters self-understanding, facilitates coping, and leads to improvement in clinical practice (Kennison, 2006). Reflective writing allows students to combine clinical experiences and takeaways with didactic material to better understand both practice and instruction. Reflective writing is defined as an assignment that is focused on students' experiences, like textbook readings, clinical experiences, or group activities, that highlights what the student has taken from the activity (McGuire et al., 2009). This study will explore reflective writing from the perspective of the nursing student and the nurse educator. The following questions will be answered: What are the benefits of reflective writing? Why would nurse educators want to use reflective writing in their nursing courses, both clinical and didactic? What are the barriers to using reflective writing for students and educators? What is the role of the nurse educator in student reflection?

Keywords: Clinical education; Critical thinking; Reflective writing.

Copyright © 2017 Elsevier Ltd. All rights reserved.

• Education, Nursing, Baccalaureate
• Faculty, Nursing / psychology*
• Nursing Education Research
• Problem Solving
• Students, Nursing / psychology*

How to Write a Nursing Reflective Essay (Guide for Nurse Students)

If you are a nursing or medicine student, you are aware that you will come across or have already come across assignments requiring you to write a nursing reflection essay. At first, such a task always appears challenging, but given the understanding of the steps, things flat out, and you can write reflective essays and get better grades.

Reflective practice is highly encouraged in nursing. Reflection entails making sense of situations, events, actions, and phenomena in the workplace.

As a nursing student, you will be asked to write a reflective essay on your clinical placement, practicum, shadowing experience, shadow health DCE activities, personal nursing philosophy, why you want to become a nurse, nursing program, ethical dilemma, knowledge, skills, and abilities, systems, and processes.

The easiest way to complete the reflective essay assignment is by first determining what reflective writing entails, its significance, its steps, and some of the best tips that form the core of this ultimate guide.

Basics of Reflective Writing in Nursing

Reflective writing is an analytical writing practice where the writer describes a real or imaginary event, scene, phenomenon, occurrence, or memory, including their takeaway. It entails the critical analysis of an experience, including recording how it has impacted you and what you intend to do with the new knowledge or how to act when such an occurrence recurs.

As you document the encounter, you can use first-person pronouns and write subjectively and objectively. This means that you can decide to either use personal experiences alone or support these experiences using citations from scholarly sources.

When writing a reflective essay in nursing, you must recount the events and give critical detail of how the events shaped your knowledge acquisition. Reflection helps nursing students develop skills in self-directed learning, which is directly associated with high motivation and improved quality of care .

In most cases, reflection occurs on what went well and what went wrong. It could be a successful operation, a thank you note from a patient, a patient who regained their health faster, or a new nursing care plan that worked. However, it can also be about adverse events such as death, postoperative complications, death of an infant at birth, dissatisfied patient, medical error, or a failed procedure.

As a nursing student, when you learn to reflect on situations, you grow to become a professional nurse who diligently does their noble duty.

When writing a reflective essay, you begin by setting the scene (explaining what, where, how, and who-the situation), detailing how you felt (emotional state), why it happened (making sense of the situation), critical review and development of insights, a note on what was learned, and strategies to address future recurrence.

Your professor may ask you to write a nursing reflective paper about various topics in your course or your experience working in a group, how you solved a problem, a healthcare issue, or clinical practice. Consider the following example of a reflective statement in nursing; in my clinical practices, I realized I focused more on the technical aspects but failed to explain what it was doing to improve their health. I would like to understand more about listening to patience and their concerns to better care for them.

As you will notice later, these reflective stages are structured into different reflective models and frameworks that we will explore in-depth. So, with the understanding of what comprises reflective writing and its importance in nursing, let's now get solid on the structure.

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Structure of a Reflective Essay in Nursing

A reflective essay is an analytical writing piece describing and evaluating encounters or experiences. When asked to write one, you should know that an excellent reflective essay consists of different parts, just like a typical academic essay. It comprises the cover or title page, introduction, body paragraphs, conclusions, and a references page.

The title page contains information about the assignment. If you are writing the reflective essay in APA, include these on the title page:

• Title of the reflective essay
• Course code and name
• Instructors name
• Name of your institution
• Date of submission

When writing in Harvard format, the title or the cover page will consist of the following:

• Title of the essay in title case and the page number (upper right margin),
• Title of the essay in CAPS,
• Name of class or course,
• Name of the instructor,
• Name of your school,
• City and state where your school is located and,
• The date of submission.

Introduction

The introduction begins with an attention grabber or a hook sentence to attract readers' attention. It should then explain the essay's purpose and signpost the ideas that will come later in the essay. The introduction also has a thesis statement at the end of the paragraph- the last sentence. The thesis is concise, clear, and relatable and should reflect your position.

Body Paragraphs

The body paragraphs of a reflective essay can be three or more, depending on the length of the essay. Essentially, the body comprises 80% of the total word count.

The first paragraph is where you describe the situation, including the events, why they occurred, how they occurred, and those involved.

The second paragraph entails your personal feelings or reaction to the situation and how it made you feel.

The third paragraph can include making sense of the situation. You have to think about why things happened the way they did. You should also critically review and develop insights based on the situation. Finally, think of the factors that could have influenced the situation.

The next paragraph should explain how the event or situation will change your practice, approach, decisions, perspective, or perception. This is where you evaluate the experience by detailing the knowledge and skills you took from the experience.

The last body paragraph should entail a critical reflection on the learning opportunities. First, describe the situation and what it made you learn. Next, elaborate on how you intend to make yourself better poised to address such situations.

Mostly, you should structure the body of your essay as per the preferred nursing reflective model.

After everything else falls into place, you need to summarize the information you presented in the essay. Then, finally, restate your thesis and have a call to action to bring a sense of closure to your readers.

Steps for Writing a Nursing Reflection Essay � The Guide

When assigned to write a reflective essay for your nursing class, here are the surefire steps to get you to success.

Read the instructions

The first step after receiving an assignment is to begin reading the instructions. as you read, note what your instructor or professor expects in the paper you will submit for marking.

Reading instructions helps you to get informed on the scope of the paper, word count, number of references and pages, and the formatting style to use.

Besides, you also get to plan your paper with the deadline highlighted in the instructions.

You need to get a conducive environment where you can start writing.

The first step of writing is to brainstorm about situations during your clinical hours when you were shadowing a Nurse Practitioner or one you have read about.

Assess whether the situation or scenario you have thought, encountered, or chosen can help you write a reflective essay that meets the requirements.

Research and Plan

After choosing a scenario, the next step is researching the best reflective model.

You can use your class text, the instructions, the college library, course readings, and online nursing journals to get articles and resources with information about specific reflective models.

Select the best reflective model and take notes on the steps it entails.

As you research, write down notes on how to address your paper based on your selected framework or model of reflection . Additionally, research nursing journal articles with information you can use when critically analyzing a situation.

Plan how you will handle the paper as well. For instance, as you research, develop a thesis statement that grounds your entire paper, then draft an outline on how to develop the thesis.

Write an Outline

Outlining is a crucial aspect of writing. It helps you envision how you will meet the objective of writing a reflective essay. As an essential part of the essay writing process, outlining helps create a good flow of ideas and can come in handy in helping you overcome writer's block. Your outline should comprise the following:

• The hook or attention grabber
• Thesis statement
• Main points of each body paragraph (topic sentence, evidence, examples, illustrations, etc.)
• Conclusion (restated thesis and call-to-action)

With the outline done, you should take a break and resume writing your first draft of the nursing reflection essay. Writing with an outline helps avoid mistakes and also helps you write faster.

Describe the Experience

Once you have identified the relevant experience, begin describing it chronologically.

Describe the experience that prompted you to consider nursing your ideal career goal. Think of this experience's key elements, such as the setting, patient demographics, and significant events that impacted you.

Show how these events changed your perspective on life. Ensure you are as descriptive as possible to paint a clear picture for readers.

Consider the following questions to come up with a good description:

• What happened?
• Was there someone involved? If yes, what part did they play?
• Where did the event take place?
• What actions did you take?

Set the context of this experience by giving relevant background information. Ensure you are objective and pay attention to the facts.

Provide a Reflection

Talk about your feelings and thoughts concerning the particular experience you went through. You have to be honest and open up about your initial expectations and challenges you faced at each stage of the experience. The following questions can help you come up with a good reflection:

• What was I trying to achieve?
• What prompted me to act the way I did?
• Are there any consequences for my actions? If yes, what are they?
• How did I feel about this event as it was happening?
• How did those around me react to it?
• How do I know how those around me felt about it?

Analyze the Experience

Description of an experience is essential, but so is analysis. You have to move beyond the surface and give a critical analysis of your experience.

State your actions, and your overall experience will give insights into your experience. Think of how the experience has impacted your actions, feelings, and thoughts.

Give an Evaluation

Evaluate the skills and knowledge you got from the experience. Show how you can apply these skills and knowledge in your nursing practice. Also, state the actions and interventions you took during the nursing experience.

State whether you achieved the desired outcome and if there are any specific areas that you need to improve on.

Talk about how you built or improved skills like communication, teamwork, and critical thinking.

As you evaluate the experience, identify what you believe to be your strengths and weaknesses in the nursing experience. What have you learned from the experience? State the areas where you excelled and what abilities contributed to your success.

Talk about how those you were with during the clinical experience complimented you. Similarly, acknowledge your weaknesses.

What kind of mistakes did you make, and how did you improve them? Talk about the tasks that drain you most during the experience.

Illustrate Learning

Demonstrate elements of deeper thought and reflection levels. This is a great point to include nursing theories in your reflection essay to support analysis of your experience.

Relate your experiences to the theoretical frameworks you were taught in class. This is effective learning and will demonstrate your ability to apply knowledge to real-life nursing situations.

Doing this will also show that you can effectively deduce different things from observations made during the reflection process.

Ensure you also demonstrate a change in perspective, as this will prove that you learned something from the experience.

Write Your Conclusion

Conclude by summarizing your points and highlighting the lessons learned.

The lessons you reached as part of your reflection should support your overall conclusion.

Also, restate your thesis statement.

Come Up with an Action Plan

Now that you have learned from your reflection develop an action plan for future nursing practice.

This part should contain all the details you have learned and actions needed to improve when faced with a similar situation. Consider the following questions:

• What would I change if faced with a similar situation?
• How can I develop the necessary skills needed to face this situation?
• How can I act differently in a similar situation?  

Ensure you identify areas to improve and set realistic goals to enhance your nursing skills. Discuss how you intend to seek additional education, training, or mentorship to address your shortcomings.

Finally, end the essay with a happy note so readers know you learned something from the experiences.

Proofread, Edit, and Polish

After doing your first draft, take a break to relax and get out of the writing mood - it helps you to become objective.

You can then resume reading out loud to yourself, make necessary tweaks, and ensure that every part you include meets the rubric requirements.

Edit for grammar, punctuation, tenses, voice, spelling, and use of language. You should also proofread the essay to adhere to the style, organization, and presentation requirements.

Ensure that all the in-text citations are accounted for in the reference list and are up-to-date. You are good to go when you have an essay that meets all the instructions.

Finally, you can submit the paper for grading.

Writing is not everyone's cup of tea. For that reason, you can hire a nursing reflection essay writer from our website to assist you in crafting a top-grade paper. In addition, we have nursing writers whose forte is writing various nursing papers.

Choosing the suitable Reflective Model or Framework

As you can see above, many reflective models are used for your reflective essay. We have not exhaustively listed and expounded on all of them. Other reflective models and frameworks you can also consider when writing a reflective essay in nursing include:

• Bouds Reflective Model
• Brookfield Reflective Model
• Pender's Health Promotion Model
• Roper Logan and Tierney Model
• Driscoll Reflective Model
• The Johari window model

Note that most nursing instructors will often suggest the models they prefer for you to use in your essay.

For example, in most nursing reflective essays. Whichever the case, readily available information expands on each model to make it easier to write a reflection essay on a specific aspect of nursing education or practice.

Read the assignment rubric and instructions to understand the specific model. If it is unclear, ask for clarification from your instructor early enough.

Tips for Writing a Good Nursing Reflective Essay

As you try to figure out how to write a nursing reflective essay, keep the following tips in mind.

Choose the Right Topic

If the instructions from your professors involve choosing a topic for the reflective essay, you must select one that is meaningful to you.

This will ensure you can easily write and easily develop relevant elements about the topic. Therefore, take time to pick a topic that you find interesting.

As you write, ensure you stay on topic, whether sharing a one-off event or a recurrent story.

Use the Right Tone

A reflective essay is more personal, unlike other types of academic essays. This means you don't need a strict or formal tone.

Since this is about your experiences, use personal pronouns such as I and Me.

Be Vulnerable

You must be extremely vulnerable to learn how to write a reflective essay in nursing.

Be open about your thoughts, feelings, and beliefs about something you went through that sparked an interest in nursing.

It's okay to share mistakes or things you did wrong that eventually led you to this career path.

Choose the Right Focus

A reflection essay is all about narrating your experience during the nursing experience.

While including other people in your experience is okay, please let them not be the center of your reflection.

This is your essay, so you should be the focus of attention.

Keep it Brief

A good nursing reflection essay should be between 300 and 800 consciously written words. Because of this length, you must only write relevant information about your reflection. Refrain from lengthy reflections, as they make it difficult to pass your points across.

Convey Your Information Wisely

Even though a nursing reflection essay is about your personal experiences, it doesn't mean you should reveal everything about yourself. Ask yourself whether something is appropriate before including it in your paper.

Mistakes to Avoid When Writing a Reflection Essay in Nursing

A good reflection essay involves reflecting on your nursing studies and practices throughout school and career to demonstrate your competence. For this reason, there are certain mistakes you should be aware of when writing an essay.

Not including a Personal Story

Like food tastes bland without salt, so does a reflection essay without a personal story. At the center of a reflection essay is You. This means the essay should focus on your personal story that led you to want a nursing career. A lot of times, students miss out on this instead of talking about their story. You need more than just the personal qualities you think will be a great fit for the nursing program; you must also share a story that shows how well you contributed to nursing care.

Failing to Share Your Experience

You will lose points when you fail to include nursing-related experiences in your reflection essay. Mentioning that you want to be a nurse is great, but failing to show specific events that led to the desire will cost you a great point.

Plagiarizing Your Essay

Plagiarism is a serious academic offense because it is considered taking other people's ideas and using them as your own without crediting the author. So, provide relevant citations and references for any ideas that aren't your own. Also, an AI will not write your essay as a human writer would. 

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Sample of a Nursing Reflective Essay 

The following is a sample of a nursing Reflective essay using Gibb's Model of Reflection. Use this sample to guide you when writing your own.

Introduction  Communication is an important element in healthcare practice as it determines patient satisfaction and treatment outcomes. This essay will focus on reflecting on an experience I went through with a 40-year-old diabetic patient who also had a foot infected with an ulcer. When I approached the patient to sign the consent form, I noticed that he wasn't happy because of the news given to him about his health. I concluded that there must be a communication dilemma. I will reflect on the experience using Gibb's Model of Reflection. Using this model, I will identify and discuss the actions taken to resolve the issue. Description  This incident happened a few months ago when I was working as a wound nurse in a Methodist hospital in my hometown. I was part of a care team handling the case of a 40-year-old male patient with diabetes and an infected diabetic foot ulcer. After careful examination, a team comprising various specialists concluded that his leg needed amputation below the knee. After making this decision, the team left, and I was asked to give the patient a consent form to sign. When I came back from retrieving the form, I noticed the patient looked sorrowful because of the news given to him. Feelings  As soon as I saw the patient, I knew what he was going through. He perceived the situation to be irreparable, but I wasn't sure whether to console the patient or not. I was powerless and couldn't imagine what he was going through. At the same time, I was startled that the team left without showing any compassion. They could have handled the situation more delicately. I, on the other hand, could have relayed the information better. I wasn't sure whether my approach would be acceptable or appropriate. Evaluation  I always go back to that particular situation and wonder whether I could have acted better. The situation helped me better understand the importance of good communication in patient care, particularly in therapeutic care. Before the incident, I didn't acknowledge the role of nurses play in caring for patient's emotional needs. I realized nurses must show compassion and console patients in their low moments.  Analysis  Most healthcare professionals do not know how to deliver bad news to patients. They find the process extremely challenging and always feel psychologically unprepared. This has a negative impact on patients and could lead to bad health outcomes. Furthermore, how information is relayed could impact a patient's adherence to treatment. Because of these effects, multiple protocols and approaches were developed to help with communicating bad news to patients. One of the approaches that was proposed is emotion-centered. This proposes that a healthcare provider acknowledges how sad the patient is and builds a professional relationship based on empathy and sympathy. Action Plan I now understand the essence of communicating bad news with compassion. The experience allowed me to look closely at different aspects of my professional development that needed more improvement. Thus, I plan to be more empathetic and speak up in support of patient's emotional and psychological well-being, especially when presented with traumatic news about their health. Additionally, I now understand I am not powerless when dealing with a sorrowful patient. I believe I have learned from my experience, and I'm not able to communicate well with patients any more. Conclusion  The experience allowed me to value good communication in nursing and the need to incorporate it into daily nurse-patient interaction. Nurses must learn how to deliver bad news and manage patient's sorrow. This has been and will continue to be my biggest priority in patient care. References Street Jr, R. L., Makoul, G., Arora, N. K., & Epstein, R. M. (2009). How does communication heal? Pathways linking clinician–patient communication to health outcomes. Patient education and counselling, 74(3), 295-301. Buckman, R. (1992). Breaking bad news: why is it still so difficult? BMJ: British Medical Journal, 304(6842), 886. Ptacek, J. T., & Eberhardt, T. L. (1996). Breaking bad news: a review of the literature. The Journal of the American Medical Association, 276(6), 496-502.

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Chapter 4: Types of Writing

Reflective Writing

What it is.

Have you ever been asked to reflect on a text or an experience?

Reflective writing is used by different healthcare professions in various ways, but all reflective writing requires that you think deeply and critically about an experience or a text. At the centre of reflective writing is the “self” – including a deep analysis of you in relation to the topic. Reflective writing is a process that involves recalling an experience or an event, thinking and deliberating about it, and then writing about it.

You may be asked to engage in reflective writing related to an array of topics: the reading you are doing for a course, your experience working in a group, how you solved a problem, how you prepared for class or for an exam, a healthcare issue or a new theory. You will be expected to reflect on your clinical practice often throughout your nursing studies and for the rest of your nursing career to grow, learn, and demonstrate your continuing competence.

In nursing, reflective writing is part of what is called “ reflective practice . ” Early in your nursing program, you will become familiar with the College of Nurses of Ontario requirements for nurses to engage in reflective practice: this legislated professional expectation involves an intentional process of reflecting to explore and analyze a clinical experience so that you can “identify your strengths and areas for improvement” with the aim of strengthening your practice (College of Nurses of Ontario, 2019).

Figure 4.3: Reflective writing

How to do it?

There are many approaches and frameworks to guide reflective writing as related to reflective practice in nursing. These approaches guide you to reflect on an experience, what happened, how you felt, what actions you took, what you learned, and how you might do things differently in the future (Mahon & O’Neill, 2020). One common framework called LEARN was developed by the College of Nurses of Ontario (1996). See Figure 4.4 .

Figure 4.4: Writing reflectively

Variations of this acronym have been taken up, but it essentially stands for:

Look back. Recall a situation that was meaningful to you in your practice.

Elaborate. Describe the situation from both an objective and subjective perspective (e.g., what did you see, hear? Who was involved and what interactions were observed? What did you think and feel?)

Analyze. Examine how and why the situation happened the way it did. Think about it in the context of your nursing courses and the literature.

Revise. Consider how and why your practice should remain the same and how it should be changed.

New trial/perspective. Think and move forward. What will you do differently when a similar situation arises?

More recently, reflective writing has been described in the context of narrative writing in which you engage in personal and professional storytelling. A narrative approach to reflective writing asks you to think about storied elements (e.g., characters, events, setting) of an experience: What happened? How did the situation begin? Who was involved? Where did it take place? What emotions were people feeling? How did the situation end? As you can see, these types of questions can easily be integrated into the LEARN framework too.

What to keep in mind?

You will be expected to engage in reflective writing throughout your nursing program. Sometimes you will be asked to use the LEARN framework or another approach. Here are some tips on good reflective writing:

• If possible, choose a topic or situation that is meaningful to you.
• Be vulnerable in your writing and share your thoughts and feelings (you don’t need to write about a sanitized version of yourself – it’s okay to ponder mistakes or areas for improvement).
• Description is important, but so is analysis so that you can gain new insights.
• Think critically about your experience and be open to new perspectives.

Student Tip

The growth of reflection

Graduates or senior-level students will tell you that reflective writing changes over the course of your program. As you advance, your forms of reflective writing will evolve from descriptive to more analytical. You will be expected to refer to the literature to explain your analysis and support your claims. You should also always engage in reflection in the context of the courses that you are taking. Some courses focus on the personal self; others focus on the professional self, as well as nursing in the community or on a broader societal level.

Activity: Check Your Understanding

Think about a healthcare event that you encountered or a health and illness experience of a friend or relative that is meaningful to you. In reflecting on this experience, how could you apply the LEARN format?

College of Nurses of Ontario (2019). Self-Assessment. Retrieved from: http://www.cno.org/en/myqa/self-assessment/

College of Nurses of Ontario (1996). Professional profile: A reflective portfolio for continuous learning. Toronto: CNO.

Mahon, P., & O’Neill, M. (2020). Through the looking glass: The rabbit hole of reflective practice. British Journal of Nursing , 29 (13), 777-783. https://doi.org/10.12968/bjon.2020.29.13.777

Thinking deeply and critically about an experience.

Exploring and analyzing a clinical experience.

The Scholarship of Writing in Nursing Education: 1st Canadian Edition Copyright © 2019 by Jennifer Lapum; Oona St-Amant; Michelle Hughes; Andy Tan; Arina Bogdan; Frances Dimaranan; Rachel Frantzke; and Nada Savicevic is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License , except where otherwise noted.

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Reflective journal writing: how can it help?

Discover the benefits of writing down your thoughts and how to get started

Reflective journal writing is a way of documenting what you’re thinking and feeling in the moment, and can be a useful tool to help manage stress and anxiety.

Dr Christopher Westoby, author of The Fear Talking: The True Story of a Young Man and Anxiety, is a strong believer in the power of stories to educate, improve understanding and benefit the wellbeing of the storyteller.

We spoke to Chris about the benefits of writing for your mental wellbeing.

Can reflective writing help nursing staff?

Absolutely. Regardless of your background, and wherever you work, everyone has this universal need to reflect upon their own experiences and one of the best tools we have for that is writing. It is similar to the process of opening the windows to a room and letting some air in.

Everyone has this universal need to reflect upon their own experiences 

We all have so many thoughts and memories whirling round our head at any given time – especially in the current climate. Sometimes the cloud of everything happening at once can be more overwhelming than any one event itself. Reflective journal writing can help with that.

How does it help?

We often struggle to come to terms with whatever it is we’ve been through unless we take a second and address these things head on. And while it may not always be an easy thing to do – or a quick fix – by writing what’s going on internally, what you’re doing is externalising something that has been haunting you or playing on your mind. Once it’s out there on the page, it’s like you can lay it to rest. 

You also now have a choice on what you want to do with it. Are you going to delete it or keep it for yourself? Are you going to let someone else read it? As you make those decisions, you’re taking control of your emotions and the clouds may start to clear.

So, what are the benefits?

The sense of control over your own experiences can be empowering and help relieve any stress or anxiety you’re experiencing. You’ve let it be acknowledged that what you’re feeling is something, it’s being validated and now it’s written down, it may no longer feel quite so insurmountable.

Any tips to get started?

My first tip is to use whatever format works best for you – whatever it is that will help get you in the habit of doing it. Don’t use handwriting if you’d rather type, and vice versa. 

I’ve worked with students before who have talked about using voice memos. They’ve just hit record and then they either deleted it or transcribed it depending on what they’ve found most beneficial. 

My second tip is to think of prompts. Maybe ask yourself questions to help get you started – what am I grateful for? What have I found difficult? Perhaps focus on one part of the day – how did I feel after my shift? On the way to work? Going to bed?

Finally, think about setting yourself some restrictions. Try setting a timer on your phone and then keep writing until it goes off. The more restrictions you set, the less daunting writing can be. You might actually find yourself more inspired.

How often should I write?

It’s a good thing to try and do every day – even if it’s only a few sentences – for as long as you find it useful. I’d suggest giving it a go for two weeks and see how you’re finding it.

What if I find it hard writing about myself?

If it seems too difficult writing about yourself, try writing about someone else or something you observed today – perhaps something you noticed on your journey home or through your window. If you write about something else, you will inevitably find yourself beginning to include elements of yourself. 

If you’re finding it too emotionally draining to revisit certain memories, remember this writing is your property – you can change what you need to, you can change the details and you can just talk about a small part of it. The key is to remember that you’re in control and it’s up to you how you document it.

The key is to remember you're in control

There are fewer ways to offload to one another at the moment, to distract ourselves and to blow off steam, so even if journal writing doesn’t work for you, it’s worth a try.

The benefits might surprise you.

About Chris

Chris is Programme Director of the Hull Creative Writing MA (Online). His book The Fear Talking: The True Story of a Young Man and Anxiety was published in December 2020. He led the RCN’s workshop “Time to Write for Yourself” last year.

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Reflective practice in health care and how to reflect effectively

Kiron koshy.

a Brighton and Sussex University Hospital

Christopher Limb

b Western Sussex University Hospitals, Worthing

Buket Gundogan

c UCL Medical School, University College London, London

Katharine Whitehurst

d Royal Devon and Exeter Hospital, UK

Daniyal J. Jafree

Reflective practice is a paper requirement of your career progression in health care. However, if done properly, it can greatly improve your skills as a health care provider. This article provides some structure to reflective practice to allow a health care provider to engage more with reflective practice and get more out of the experience.

Introduction

Reflective practice is something most people first formally encounter at university. This may be reflecting on a patient case, or an elective, or other experience. However, what you may not have considered is that you have been subconsciously reflecting your whole life: thinking about and learning from past experiences to avoid things that did not work and to repeat things that did. For example after tasting a food you do not like, you remember that experience, think about it, and when you next see that same food you know to avoid it. In medicine it is one of the best approaches to convert theoretical knowledge into practice.

As you progress through medical school and into foundation years as a doctor it becomes even more common. It is now expected to provide evidence of your reflections through your training on the ePortfolio and then throughout the rest of your professional life in revalidation. Hence, it is a good idea to get it right from the beginning.

First and foremost the biggest mistake you can make when reflecting is to treat it as a tick box exercise and a waste of time. With a bit of thought reflections can be a very useful tool in learning. Would you remember a generic case from a book? Would hanging all of those facts on a patient you have met make it more memorable? It allows you to recognize your own strengths and weakness, and use this to guide on-going learning. By reflection you will develop your skills in self-directed learning, improve motivation, and improve the quality of care you are able to provide.

What to reflect on

This can be anything.

Most reflections are on things that go wrong. These situations stay in one’s head and force us to begin to think about whether they could have done anything differently. For example:

• Postoperative complications
• Missed diagnosis
• A dissatisfied patient
• Failed procedure

However, reflecting on things that went well can often be more rewarding and be just as useful. It can build confidence and help you to repeat it again on another occasion. For example:

• A well-managed cardiac arrest
• An interesting seminar or conference
• A patient thank you letter
• A difficult but well performed procedure

Stages of reflecting

There are numerous models for reflections, but it is important to understand why you are asking each question and how that will help you to reflect 1 . This an integration of many concepts but the broad process is similar in all models: what happened, why does this matter and what are the next steps? 2

What, where, and who—the situation

Think about the situation in detail: What happened exactly and in what order, where were you at the time and who else was involved? What part did you have to play? What was the final outcome?

How did it make you feel—your emotional state

What was running through your head and how did you feel about it? Be honest with yourself: were you afraid, confused, angry or scared? If you can understand how you were feeling at the time it will help you put together why things happened as they did, and help you to recognize similar situations in the future.

Why did it happen—making sense of the situation

Now you have thought about the situation in greater detail, and probably recognized things that would have otherwise gone unnoticed, think about why things happened as they did. How did the situation, yourself, and others interact at the time. Did the situation go well or was there room for improvement?

Could you have done anything differently—critical review and development of insight

With the help of hindsight how would you have managed the situation differently? Think about what factors you could have influenced: is there anything you could have tried that may have improved the situation, or is there anything you did that was particularly important in the situation? It is easy to remember the things that you did not do and it is often the things that you did well that are forgotten.

What will you do differently in the future—how will this change your practice

This is arguably the most important stage in reflecting. You need to pull together everything you have thought of before to learn, change your own practice, and improve 3 . Do not only think about what you would do differently in that specific situation, but think whether you have thought of any transferable knowledge or skills you can utilize elsewhere. For example: if you reflect on a postprocedural complication do not only think of how you would manage this again but also how you would prevent it happening if you performed the procedure yourself! If you are a part of a well-led cardiac arrest do not think only of what you would do next to help, but also how you would lead an arrest in the future, or even how you would lead a team in any other situation!

Re-enforcement—what happens when you put this into practice

Test your reflections: When comparable situations happen again, do things change as you would expect them to? This is a chance to repeat the reflective cycle to refine and develop your understanding.

How to make the best use of reflective practice

As mentioned previously most people see reflective practice as a tick box exercise, but it does not have to be.

Over the next day take note of any interesting situations that arise. Later in the day try mentally reflecting, following this framework, and if you think any will be particularly useful to you write them down. If you try this for a week you will begin to see similar situations arising and how your reflective practice is positively affecting you.

Remember: you do not always have to learn only from your own experience; learn from others’ mistakes as well. Reflect on situations that you have witnessed to work out why things happened as they did, and how this can influence you.

It can be useful to take these reflections for peer or senior review: others may be able to draw light on things you have not noticed. This can allow you to recognize points for improvement and work on them. This can also be a useful learning opportunity for the other involved!

An example to put this into practice

I was involved in a patient confrontation; the patient was unhappy with her hospital stay and wanted to be discharged home. Unfortunately she required a package of care and so could not be discharged. I explained this and she returned to her bed. I was happy I had explained everything to her and continued with my other jobs.

Who, what, and why

I was involved in a patient confrontation; an elderly patient was unhappy with hospital stay and wanted to be discharged home. She was under our general surgical team for a head injury and observation after a normal CT head. She had been seen on our ward round and told that she was medically fit for discharge but still awaiting social services: her house had been reviewed and deemed unsafe so she was waiting for banisters to be installed. The issue was raised with me by chance as I was doing other things on the ward. I explained this to her and although she remained annoyed I was able to make her understand what the delay was and she returned to her bedside. She did not seek further clarification that day.

How did it make you feel

At the time I felt rushed and frustrated. I had a lot of other work to be done and this was distracting from that. She had already been told she was waiting for social services in the morning. I understood why this was difficult for her but did not think I would be able to do anything to help.

Why did it happen

The morning ward round was quite rushed and so our explanation was limited to telling her we were waiting for social services. I can understand from her point of view this may have meant very little, and so my explanation of what exactly we were doing may have relieved some frustration. Having been waiting up to this point, it is no surprise she continued to be angry but may have been accepting of this plan.

Could you have done anything differently

I think my explanation was very good, and the patient seemed happy with this, although I did not give a rough idea of how long this would take. It may have been useful to have spoken to the sister in charge to ask for what progress had been made to feed back to the patient. Also I did not ask her whether she was happy with this explanation: I may have been able to satisfy her frustration further by answering a few more questions or even recognize any other issues at home that may need addressing before discharge. Although the information given in the ward round was correct, it was not understandable to the patient. If this had all been quickly clarified in the morning, the patient would have been happy throughout the day and not caused a problem later on.

What will you do differently in the future

I think that the route problem in this situation was our explanation on the morning ward round. Furthermore, I am not sure how long such issues take to be addressed. To avoid a similar situation in the future I will speak to the other health care professionals on the ward to get a round idea of how long occupational interventions such as this and other community interventions take to start. This means when future patients are medically fit I can spend a moment in the morning informing them of what needs to be done and how long it may take. Hopefully this will allow me to address patient concerns early to avoid them becoming an issue when it is too late.

Re-enforcement

I will reflect on how future situations similar to this develop, looking for an improvement in the quality of my patient care.

Following a structure helps to focus a reflection: I am sure you will agree the learning points are much clearer from a good reflection!

Conclusions

To summarize, the benefits of reflecting are clear: it may be difficult to do initially, but through practice you will develop your own skills and become a better learner. Many structures are available so choose one what works for you. Reflective practice is an important part of your career progression on paper, but if done well, can greatly improve your skills as a health care provider.

Conflict of interest statement

The authors declare that they have no financial conflict of interest with regard to the content of this report.

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Published online 15 June 2017