Australian Student Nurse Reflection Example

Nursing is a subject that drives its accuracy from the minutest technicalities. Gibb’s reflective cycle is an effective model for reflecting on handling patients in an emergency. It is an important part of the nursing curriculum.

Gibb’s reflective cycle consists of 6 stages which are the following:

Description of a particular patient handling situation, the feelings developed during the whole episode of that particular emergency situation, evaluation of the work done by a nurse in the emergency situation, analysis of the situation to come to the fifth stage, the conclusion about the whole episode and finally the action plan, in alignment with the evaluation and analysis of the same situation.

For a greater understanding of Gibb’s reflective cycle, an example has been shared below.

The reflection is written about an emergency situation encountered by a nurse in the ICU of the rehab department of a hospital. 

Stages Of The GIBB’S Reflection Cycle

The first stage of Gibb’s reflection cycle is describing the concerned emergency situation. It has to be written concisely with all the valid information about the patient’s condition at the time of admission to the healthcare department.

  I was doing my assigned duty when my senior arrived in the same room and asked me to attend to a patient who was just admitted to the hospital’s rehab ICU.

I was informed that the patient’s situation was critical at that moment and I need to provide him with the primary aid for stabilising the patient’s condition. 

 I reached the rehab’s ICU as soon as possible. The symptoms and the previous reports of the patient indicated that he was suffering from the withdrawal symptoms of alcohol, liver cirrhosis, swollen abdomen and ascites.

The condition of the patient seemed critical, therefore I started to conduct the required level checking of the following: fluid balance, level of the fluid, peripheral edema, sodium level, serum level and blood levels.

The weight of the patient was also recorded. The respiration rhythm was also checked to identify any difficulty in the breathing pattern.

Sodium level was required to be stabilised for preventing fluid accumulation in the body. This was important to maintain the proper level of dilutional hyponatremia.

All the abnormalities were registered and the updated information was forwarded by me to my senior. After all the preliminary examinations, I could conclude that patient is a sufferer of chronic liver cirrhosis.

I could see that the levels of all other observed parameters have deviated from the normal. The patient needed a prompt and intensive care plan.

Feelings

 The second step of Gibb’s reflection cycle is concerned with the explanation of feelings generated when the medical practitioner was attending to the patient in an emergency situation. 

 As for the situation described in the description, I can say that when I was assigned to this patient, I was a bit hesitant as it was my first time attending to a patient alone and in an emergency.

I was feeling a bit confident and thus, I talked with my senior about the same. She guided me in the right direction and showed me the first step which was required to be taken.

After doing one or two preliminary tests, I started gaining confidence about the situation. It was an achievement for me that I could conduct all the tests properly and note everything in detail for further use and understanding of the other staff or my senior attending the patient.

I can proudly say that I was able to not only manage the situation effectively but also the patient.

Sometimes, the behaviour of the patient also poses problems which becomes resistance for the assisting healthcare staff. Such patients are entitled to have a mental breakdown or get anxious and start behaving violently.

But, I can say that this patient was also very cooperative. I was also a bit tensed with the fact that if anything goes with the conduction of tests then I would pose a major problem for the patient.

Whenever I felt that I am getting confused or stuck, I used to ask for guidance from my senior. All the information obtained about the health condition of the patient was relayed simultaneously to my mentor which is one of the very important aspects of nursing.

This was an addition to my experience list and I was content at the end that nothing on my part went wrong. It gave me a boost of confidence and I feel I am ready that I can manage the such pressured situation.

Evaluation

This stage of Gibb’s reflection cycle revolves around the evaluation of the experience gained by being in a particular situation. 

           I would like to evaluate my job with progressive as well as regressive aspects of my doing for the patient in rehab’s ICU. The progressive part of this experience was that it helped me get confident in handling patients in ICU.

As mentioned before, it was my first experience in an emergency situation, being confident was very important to manage the patient and the situation, simultaneously. This task was assigned to me by my mentor and I could not let her down.

It was my duty to take the decisions on my own as the seniors were busy with other patients. At this moment, I realised that the phrase, “ every nurse is a leader”, is hundred per cent true.

The emergency situation requires one to apply all the theoretical knowledge aptly in a practical scenario. All the theoretical evaluations concerning liver conditions, read in the theoretical classes were applied and recalled at that moment instantly.

I checked the medical history of the patient which is very important to identify the gaps in the treatment which was going on previously. All the associated complications were also identified.

It was found that the patient was suffering from an aldosterone effect. It was the need of the moment to control the aldosterone effect, therefore, frusemide as well as spironolactone was given to the patient keeping in mind the restricting medical conditions of ascites and edema.

Due to the medical condition of the liver, potassium was getting eradicated from the body in urine. An external supply of potassium was needed and provided. The patient was also a cardiac-conditioned one, therefore, arterial vasodilators were also given to the patient.

As the condition of the patient started resolving, I can say that there are no regressive aspects of this case on my part as well.

I was not able to stay with the patient afterwards but the whole time I took care of him properly and noted every deviation or betterment of the patient, for which I got a round of applause also from my seniors. I could understand my capacity and the number of ways in which such a situation can be managed. 

Analysis

The fourth stage revolves around the analysis of the situation and performance of the medical assistant with respect to the concerned situation. 
           
From the above evaluation, now I am confident to admit that a major quality that a nurse requires when handling a patient in an intensive care unit is to be competent enough to take decisions of our own.

The quality of care provided to the patient is one of the major criteria in nursing. This can be achieved by being alert and implying all the correct interventions for the recovery of the patient.

The preliminary tests done by me were the deciding factors according to which the treatment was started. It was very exclusive to make the right decision by doing several tests properly and coming to a proper conclusion.

The complications associated with the medical condition of the patient are also to be noted very carefully so that no intertwined reactions take place. The practices and interventions work only when the conclusion about the medical condition of the patient is correct.

Proper evidence procurement as well as analysis of the tests being done helps in reaching a proper conclusion. The critical appraisal of the situation and the tests done with respect to the emergency medical condition of the presented patient is important for applying the correct intervention.

The symptoms being displayed by the patient are also to be analysed carefully because the same medical condition can show differently in different patients. The interference with the other medical condition of the patient should not take place of hinder the treatment process.

The theoretical knowledge is to be remembered always about all the situations, which is practically impossible but by practical experiences, it can get fresh again.

When I was with the patient in the rehabilitation ICU, I noted every step taken by me with the responses from the patient and subsequent conclusion of the same. This proved to be very useful for the other nurses and my mentor applauded me for this.

The noted observation helped me in thinking clearly from the start and when the patient showed signs of recovery and getting stable then I started to have confidence in the steps taken me. I can say from my analysis that every nurse being an independent leader should take steps or initiatives which work for them for example, making notes, which aided me in having a clear mind and confidence. 

Conclusion

 The conclusion in Gibb’s reflective cycle is reflecting on the findings about the capability of the nurse while attending to a patient and the situation. 

There are many things which I would like to conclude about my experience. Firstly, when I was told to attend to the patient in ICU, I was a bit sceptical about the capabilities I possess to handle such a situation. But, after having a conversation about my doubts with my mentor, I started to feel better and thought of taking on the situation thrown at me.

So, it can be said that the standard procedures which are required to be followed for patients in different situations are apt and to be followed to the letter. The guideline helped me get through my preliminary tests’ conduction and conclusion about the situation of the patient. It was a huge help for me. 
 
As the patient was suffering from liver disease and withdrawal symptoms of alcohol, an immediate ban on alcohol intake was recommended for the patient. Clear and crisp conversation was done with the patient’s family so that there remains no loopholes for any mishap or unclear guidance.

The patient was advised to get into rehab for mental recovery and if not, then it would be highly appreciated if the patient receives positive support socially. The patient should be encouraged and enrolled in some light activity that can help him cheer up as such patients tend to suffer from anxiety and depression.

The situation added a lot to my experience and as it was the first one so it will be remembered properly. I could not continue with the patient for long as I had other commitments to complete but the opportunity left me pumped up and ready for facing emergencies again. 

Action Plan

The last stage is concerned with the derivation of an action plan according to the evaluation and analysis. 
           
According to the above evaluation of my performance and the patient’s situation, it can be said that cooperation and a properly synchronized pattern of work are encouraged.

The intervention provided to the patient should always have one goal, betterment of the patient’s condition. This is my action plan for the future also.

According to my thinking and capabilities, the mentioned action plan will help in having a clear mind, and confidence and be a competent nurse. The experience on which I reflected in this piece, was a positive one and thus, it would count on my good experiences.

I would not think that it would go like this but be prepared for a sideway situation too. It would be better to rely on practices that will make me perfect. My priority will be to handle my patients confidently and take help from my mentor when feeling any doubt. 

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