Reflective Journal: The Benefits of The Reflective Learning

Introduction

The Reflective journal is a way of recording ideas, own perceptions, and experiences, as well as persuasions and understandings one have in their process of learning over a period of time. The benefits of the reflective learning process are usually accrued over a period of time, in which there will be sequences of progressive changes, personal growth, and changes in the outlook during the process of learning. Reflective Journal helps in vigorous learning and it also improves critical thinking and creativity. It helps to freely express one’s own perception and judge oneself. John Dewy stated that 'we do not learn from experience…we learn from reflecting our experiences. This assignment consists of about three clinical issues that helped me to upgrade my knowledge and skills in the clinical area. For elaborating on my clinical issues, I am using Gibbs's reflective cycle. I choose it because it encouraged me to think systematically about the phases of my experience and the evaluation phase made me think about the positive side of my improvement. Professor Graham Gibbs published his Reflective cycle in 1988, it is known as Gibbs Reflective Cycle. Gibbs stated that “the process of a reflective cycle is a 5 phase cycle”. The first phase is the ‘description phase’, where we analyze the situation, when and where does that happen, and what had happened to me? What did I do and who else was there and what did other people do? The second phase is ‘feelings'. In this phase, we talk about what we thought and felt during the experience. At this stage avoid commenting on the emotions. We should recollect the incident, how do I feel during that situation and what did I feel after the situation, and what’s my perception towards the situation now? Consider what other people feel about the same situation now. The third is the phase of ‘Evaluation’, here we are looking at what was the positive and negative sides of the incident. What went well and didn’t? What did me and other people do to contribute to the situation either positively or negatively? In the phase of ‘conclusion', we have to think about the incident again with the same information in the mind. How could this have been a positive experience for everyone involved? The last step is the ‘Action phase’’. Here, we come up with a plan so that we can overcome the problems in the next time. This tool is designed as a cycle, replicating an ongoing process. The clinical objectives are, it helps in critical thinking and also keeps a track of the skills we are learning and the knowledge we acquire. It also helps to find connections between the topics and the theories. It mainly helps to make sense of our own thoughts and feelings.

There are quite bitter as well as sweet experiences in the field of nursing. I had come across certain bitter experiences and later I realized the mistake what I have done. In 2016, I worked as a registered nurse in the cardiovascular department, in a fast-paced environment. Daily there will be cases posted for CAG, PTCA or CABG. There are lots of transfers in/ out in the wards as we shift the patient to the Cath- Lab or the operation theatre. One busy day, an admission has come to our ward in the morning for CAG as a same-day procedure. It's quite hard to manage as the procedure is overloaded with pre-procedural workups. Somehow I managed to finish the workups. There is a protocol in our hospital that we have to contact the Cath-Lab staff and inform them about the scheduled procedure. I failed to inform it to the staff that the case is posted for the same day and I even kept the patient NIL PER ORAL. Then towards the end of the procedures in the Cath-lab around 5 pm, I received a phone call from the respective Doctor why I didn't inform about the procedure to the Cath- Lab. Then I realized that I hadn't been informed about it. And that case was canceled because of my mistake and with the request and condonation the Doctor posted the case for the next day. Here I realized my mistake and I was downhearted. Doctors, Cath- Lab staff, and nursing supervisor scolded me badly for the incident. I was not disappointed for the scolding, but for the cancellation of the procedure just because of my remissness. I took the incident in a positive way. What I learned through this incident is to prioritize the needs of the patient. I had lacked communication with Doctors as well as the other nursing staff. When the same incident has come, I overcome it by prioritizing the needs and by keeping that incident as an example. Here I learned through practice. Communication plays a major role in health care sectors, it enhances the patient care outcomes with the better communication between the nurses and physicians. There are many challenges that persist for effective communication among caregivers. Health care community members have to examine these challenges and have to rule out solutions which matches particular situations. Communication is a vital component in which all the caregivers have the responsibility to improve it in professional practice.

When I was a student nurse, during my internship period I was posted in a medical-surgical ward. There were lots of patients and only a few staff for the morning shift. Morning medicines were given and signed by the senior nursing staff and they have asked me to give the nebulization which comes in between. I gave nebulizations for the required patients and that is also eye-witnessed by one of the senior staff. All of a sudden Drug Nurse came for the rounds and checked the drug chart and found that signatures are missing in the areas of nebulization. The Drug Nurse came to conclude that I haven’t given nebulization and she went to enquire it to the patient. The patient said that, I have given the nebulization at the right time. Here what had happened is the documentation error. Even though I gave the right medication at the right time, I failed to put my signature in the drug chart. The Drug Nurse scolded me in front of the patient and has reported it to our clinical instructor and made me write the incident report. I was heartbroken and thought of quitting my studies by this incident. I recollected the incident and evaluated who made this mistake? Is it mine or my senior staff who asked me to give the nebulization? I came to the conclusion that it was my mistake. After giving the nebulization I could have signed it or else I could have informed it to the senior nurse. I failed to do both. This painful incident has taught me about the proper documentation then and there. Later, during my working period, I was very keen on my documentation and I developed error-free situations.

I was a fresher when I joined The Madras Medical Mission Hospital in 2015. Initially, I was not assigned to patient care. I was assigned to a few things like bio-medical waste management, crash cart checking, and oxygen cylinder checking. Even though I was assigned to bio-medical waste management I failed to do the proper waste management. I wrongly discarded the syringe with the needle. Actually, the needle should go to the puncture-proof container and the plastic syringes to the red bin. The infection control nurse came for the rounds and caught me red-handed. Due to the improper waste management, they made me to write an incident report. I was embarrassed for the lack of knowledge. That was a humiliating situation in my life. It has happened because of the knowledge deficit. Later on, I carefully discarded the waste in the appropriate bins. It was something like learning through experiences. Bitter experiences will never make us repeat the incidences again.

Conclusion

In conclusion, this reflective journal writing has helped me deepen my quality of learning, in the form of critical thinking, understanding my own learning process, creativity, improved professional development, active involvement in learning, and personal ownership of learning. This intensive method of learning which I have learned from this module is necessary for my career development.

References

1. Dewey, J. (1993). How we think: A restatement of the relation of reflective thinking to the education process.
2. Flicek, C. L. (2012). Communication: A Dynamic between nurses and physicians. professional issue, 385-387. G, G. (1988). Learning by doing: A guide to teaching and learning methods. Oxford Brookes University, 97- 99.
3. Schaick, M. (2017). Association of low caregiver health literacy with reported use of nonstandardized dosing instruments and lack of knowledge of weight-based dosing. The official journal of the Ambulatory Pediatric Association, 292-298.
4. Tobias Hodgson, E. C. (2016). Risks and benefits of speech recognition for clinical documentation: a systematic review. Journal of the American Medical Informatics Association, 169-179.
5. Wang, Q.-Q. W. (2018). interventions to improve communication between nurses and physicians in the intensive care unit: An integrative literature review. International Journal of Nursing Science, 81-88.