To be self-aware, the three interrelated aspects of cogni-
tion (thinking), affect (feeling) and behaviour (acting) must
be considered (Rungapadiachy, 1999). For instance, feelings
can affect the actions of a clinician who has unresolved
issues related to death and dying. These issues may make it
difficult for the clinician to engage in a therapeutic relation-
ship with a dying person or the person’s family.
Self-awareness includes the personal attributes of moti-
vation and moral agency that are essential for reflective
practice and being aware of the influence our emotions have
on our thoughts and behaviour. Clinicians need to develop
this deeper level of self-awareness, understanding motiva-
tion and moral agency in order to engage in therapeutic
relationships.
M
otivation
is the desire to do the best you can, which
determines how you, as a healthcare professional, contribute
to the relationships that develop between you and others in
the workplace (Toode, Routasalo & Suominen, 2011). It is
through becoming aware of the self that the individual
becomes more adept at creating the relationships needed for
person-centred care.
In using the self to create a therapeutic relationship, the
nurse or midwife is enacting a sense of agency, and when
this agency has an ethical dimension, it becomes
moral
agency
. In Chapter 9, the concept of agency is discussed.
Stein-Parbury (2009) points out that, in any intervention,
nurses and midwives need to make sure that the tool they are
using is in good order. This is as true for the nurse or
midwife using the self as the tool as it is for any physical
piece of equipment. In addition, becoming self-aware is an
important precursor to the self-growth that occurs through
professional development.
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Chapter 13 Thoughtful practice: Self-awareness and reflection
Motivation and moral agency depend on being aware of
our own beliefs and values, and understanding the impact
these have on our actions. This understanding is an impor-
tant aspect of how we develop as healthcare professionals.
It is concerned with who we are as individuals and with
what we bring of ourselves to the context of practice. If
we are to develop and grow through our experiences, it is
important for each of us to become more self-aware.
Chapter 6 discusses this ability to know self, in terms of
cultural beliefs and prejudices, and how this affects the way
we see and treat others in a culturally safe way. By becom-
ing more self-aware of how your preconceptions can
sometimes influence your judgements, you can grow as a
professional carer. For example, a student may hold the
belief that all older adults are incapacitated by illness, and
so may treat all older people in the same way. Through
experience, after meeting many older adults who are not
incapacitated by illness, the student realises that this pre-
conception was wrong, and then starts to question whether
this is the only preconception held that is influencing how
they perceive and treat patients. This student is becoming
more self-aware, and when this is carried through into prac-
tice, professional growth occurs.
As discussed above, self-awareness is an essential attrib-
ute for clinicians who are required to work effectively with
other people. Through self-awareness, you can also develop
the final two attributes in Box 1-5—leadership and bravery
—through your ability to respond appropriately to your own
needs, recognise the needs of others, and lead and motivate
others in the team. This ability was termed ‘emotional intel-
ligence’ by the psychologist and author Daniel Goleman
(Akerjordet & Severinsson, 2007).
Self-awareness
Critical thinking
Reflective
practice
Context of thoughtful
nursing and
midwifery practice
Reflection
Figure 13-1
The components of reflective practice
