This workshop will help you to understand what reflective practice is, and introduce models to help structure your writing and tips to get you started. We run two sessions each month, one tailored for Medical Staff and one for Nurses, Healthcare Scientists, and AHPS.
Upcoming Dates
All sessions take place via Teams
Medicine
Sessions (for a group or 1:1) are available on request.
Please email esneftlibrary@esneft.nhs.uk
Nurses, AHPs, Healthcare Scientists and other staff
2025
Fri 13th Jun 10-11.30am
For more information tel. 01206 742146 ext. 2146 for Colchester and 01473 702544 ext. 1544 for Ipswich
About a week ago I went to see Mrs X about getting a bed and a commode for her downstairs which is what her GP (Doctor Jay Jones) said she needed. I knew that her mobility was poor as her doctor had told me this and she was having problems getting up and down stairs. I don’t really know why people have to live in such unsuitable houses, but it was not my business to say this. I was short of time but asked the key questions. Her husband was out at the time or not around, anyway which was strange considering she said that he was really good. I expect he got fed up with her dithering about.
I got a rather muddled response and the lady seemed to be working herself up into a bit of a state, which was completely unnecessary. I think she might have had a bit of Alzheimer’s as she did not really understand that the GP had clearly said she needed a bed and a commode downstairs. Basically, if she didn’t there was a good chance of her ending up in the ED with a #NOF and needing a protracted LOS. I was able to reassure her that having such equipment to hand was something lots of people did.
I really don’t know why the complaint came through, except to say that her husband Jim is a difficult person at the best of times.
Updated 10/03/2025.
Last week I had an appointment to see Mrs X (name and personal details anonymised for reasons of confidentiality and data protection). I had assumed that the visit was organised in advance by her GP and communicated to her and her husband by our admin team, which turned out not to be the case. I now understand that this should have been checked before I arrived.
I was told to do a quick assessment about getting a bed and a commode in downstairs for Mrs X. Her husband was not present and I did not ask where he was, but I did ask her about how he was managing. It would have been better if I had spoken to him directly, either when the patient was present or in some other way, possibly by telephone just before or after the visit.
There were some basic details on the computer and I needed to read as I went along; I now realise that I should have read more about the case before I arrived. What happened subsequently has made me think very hard about my communication and listening skills, at the time I felt annoyance because it seemed that the patient was not listening to me, in fact it should have been me that was giving a willing ear to the patient.
I did not question the suggestion that a downstairs bed and commode would be the best arrangement for the patient and I was unaware of her confusion and distress about an uncertain future. I now consider that I was poorly informed and that my actions at the time did not improve the situation, with hindsight it would perhaps had been better if I had contacted the GP before the visit or just after to discuss alternative options.
I have spoken to my line manager about the need for better communication within our team and have requested that I shadow one of our occupational therapists when they next carry out a patient assessment for equipment. In agreement with my line manager I have booked to attend a trust sponsored communication and listening course, along an extra e-learning module on Person-Centred Approaches (PCT) which is available via the E-learning for Health portal, as supported by Health Education England (HEE). I have also done some reading around trust guidelines on record-keeping and the importance of dignity and compassion in a patient/healthcare professional interchange. Now armed with useful websites such as https://www.nhs.uk/conditions/social-care-and-support-guide/care-services-equipment-and-care-homes/household-gadgets-and-equipment-to-make-life-easier/ I now know that information is available from organisations such as the Disabled Living Foundation. Also, that Mrs X and her husband could have applied to their local council for a home assessment, and help with possible alterations such as an extra stair rail and suitable adjustments in the bathroom to help maintain the patient’s independence. My intention is to prepare a leaflet listing this information and local details, to give to patients and families or carers when having this type of discussion in the future.
Updated 11/03/2025.
There are many definitions of reflective practice, but a useful definition of critical reflection could be said to be the following, as outlined by Roberts (2015, p. 21) – it is defined as:
“…that activity in which experiences are considered in order to identify the assumptions influencing the thoughts, feelings and actions in a given situation. These assumptions are then rigorously questioned and challenged with a view to developing alternative ways of thinking, feeling and acting in future situations.”
What follows is a critically reflective piece with the intention of meeting the requirements of this definition. The author will use the singular personal pronoun throughout, which is the convention for a piece of reflective writing (University of Adelaide, no date) and has already analysed the events that are described below with the use of the Gibbs Cycle (Gibbs, 1988) – a well-established standardised model of reflection which represents the process as cyclical.
Reflection
Last week I had an appointment to see Mrs X, whose name and personal details have been anonymised for reasons of confidentiality and data protection, as outlined by Baez (2002, cited in Kaiser, 2009, p. 1638). I understood that the visit was organised in advance by her General Practitioner (GP) and assumed that the date and time had been communicated to her and her husband by our admin team, which turned out not to be the case. I now understand that this should have been checked before I arrived.
I was told to do a quick assessment about getting a bed and a commode in downstairs for Mrs X. Her husband was not present and I did not ask where he was, but I did ask her about how he was managing. It would have been better if I had spoken to him directly, either when the patient was present or in some other way, possibly by telephone just before or after the visit.
The importance of good communication as part of compassionate care is emphasised by Gault et al. (2017, p. 4); in this respect I now comprehend that my actions fell short of what was required.
There were some basic details on the computer and I needed to read as I went along; I now realise that I should have read more about the case before I arrived. What happened subsequently has made me think very hard about my communication and listening skills, at the time I felt annoyance because it seemed that the patient was not listening to me, in fact it should have been me that was giving a willing ear to the patient. The value of listening and questioning in demonstrating that a professional is interested in the patient and focused on them is outlined by Schmidt Bunkers (2010, as quoted by Gault et al., 2017, p. 17) and further underlined through the findings of Myers et al. (2020) in their recent study of empathetic listening behaviours from the point of view of the patient. This is a key part of the concept of person-centred care, as discussed in the nursing literature through the pivotal book written by McCormack and McCance (2010).
I did not question the suggestion that a downstairs bed and commode would be the best arrangement for the patient and I was unaware of her confusion and distress about an uncertain future. I now consider that I was poorly informed and that my actions at the time did not improve the situation, with hindsight it would perhaps had been better if I had contacted the GP before the visit or just after to discuss alternative options. The Office for Health Improvement and Disparities (2022) have issued guidance offering information on falls and their prevention with links for healthcare professionals and the general public.
I have spoken to my line manager about the need for better communication within our team and have requested that I shadow one of our occupational therapists when they next carry out a patient assessment for equipment. In agreement with my line manager I have booked to attend a trust sponsored communication and listening course that uses the SAGE & THYME communication model as developed by Connolly et al. (2010); along an extra e-learning module on Person-Centred Approaches (PCT) available via the E-learning for Healthcare portal, as supported by Health Education England (HEE) in partnership with the National Health Service (NHS) and professional bodies (HEE, 2021). I have also done some reading around guidance on record-keeping (Andrews, 2020) and the importance of dignity and compassion in a patient/healthcare professional interchange (Gault et al. 2017).
Now armed with useful and easily accessible websites such as the patient facing NHS.uk page Household gadgets and equipment to make life easier (NHS, 2018), I now know that information is available from organisations such as the Disabled Living Foundation (DLF) who provide a comprehensive online resource (DLF Shaw Trust, 2021). Also, that Mrs X and her husband could have applied to their local council for a home assessment, obtaining contact details via the Gov.uk portal (Apply for equipment for your home if you’re disabled, no date), and help with possible alterations such as an extra stair rail and suitable adjustments in the bathroom to help maintain the patient’s independence. My intention is to prepare a leaflet listing this information and local details, to give to patients and families or carers when having this type of discussion in the future.
In conclusion, the writing of this critical reflection has led to the identification of weaknesses in practice: both for the individual and the wider team and to the generation of a suitable action plan to address these issues, therefore improving teamwork and patient care.
References
Andrews, A. (2020) Record keeping for nurses and midwives: an essential guide. Keswick: M&K Publishing.
Apply for equipment for your home if you’re disabled. (no date) Available at: https://www.gov.uk/apply-home-equipment-for-disabled (Accessed: 11 March 2025).
Connolly, M. et al. (2010) ‘SAGE & THYME: a model for training health and social care professionals in patient-focussed support’, Patient Education and Counseling, 79(1), pp. 87-93. doi: 10.1016/j.pec.2009.06.004.
Disabled Living Foundation Shaw Trust [DLF Shaw Trust] (2021) Living made easy. Available at: https://livingmadeeasy.org.uk/ (Accessed: 11 March 2025).
Gault, I. et al. (2017) Communication in nursing and healthcare: a guide for compassionate practice. London: Sage.
Gibbs, G. (1988) Learning by doing: a guide to teaching and learning methods. Available at: https://thoughtsmostlyaboutlearning.wordpress.com/wp-content/uploads/2015/12/learning-by-doing-graham-gibbs.pdf (Accessed: 11 March 2025).
Health Education England (2021) e-L-H. e-Learning for healthcare. Available: https://www.e-lfh.org.uk/ (Accessed: 11 March 2025).
Kaiser, K. (2009) ‘Protecting respondent confidentiality in qualitative research’, Qualitative Health Research, 19(11), pp. 1632-1641. doi: 10.1177/1049732309350879.
McCormack, B. and McCance, T. (2010) Person centred nursing: theory and practice. Chichester: Wiley Blackwell.
Myers, K.K. et al. (2020) ‘Nurses’ active empathetic listening behaviors from the voice of the patient’, Nursing Outlook, 38(5), pp. 266-275.
National Health Service (2018) Household gadgets and equipment to make life easier. Available at: https://www.nhs.uk/conditions/social-care-and-support-guide/care-services-equipment-and-care-homes/household-gadgets-and-equipment-to-make-life-easier/ (Accessed: 11 March 2025).
Office for Health Improvement and Disparities (2022) Falls: applying all our health: guidance. Available at: https://www.gov.uk/government/publications/falls-applying-all-our-health/falls-applying-all-our-health (Accessed: 11 March 2025).
Roberts, M. Critical thinking and reflection for mental health nursing students. London: Learning Matters/Sage.
University of Adelaide (no date) Writing in the first person. Available at: https://www.adelaide.edu.au/writingcentre/sites/default/files/docs/learningguide-firstpersonwritinganthropology.pdf (Accessed: 11 March 2025).
Updated 11/03/2025.
The below books can be found on the library catalogue.
