(e.g. undertake more intensive assessment of the person,
which reveals that they are in pain, which may explain the
increasing blood pressure). If we are not thoughtful and
we are just doing without thinking and are therefore non-
251
Chapter 13 Thoughtful practice: Self-awareness and reflection
Source: Johns, 2000.
BOX 13-6 Reflective cues
•
Who is the person?
•
How is the person feeling?
•
What meaning does the person hold regarding his
or her health issue?
•
How has the person’s day-to-day life been affected
by the health issue?
•
How do I feel about this person?
•
How can I help this person?
•
How can I work with this person?
•
What is important in order to make the person’s stay
in hospital optimal?
•
What supports does the person have?
•
How does the person view his or her future?
reflective (noticing only that the person’s blood pressure is
slightly above normal), then we are likely to be in danger of
missing cues that should alert us that we need to take action
(and so the person’s condition is not assessed further and
their pain continues to increase, as does their blood pressure),
resulting in suboptimal care (inadequate pain relief and
increased blood pressure). Throughout this text the
reflective
cue icon
will remind you to take time to stop and think about
a given situation. By helping you to keep in mind the impor-
tance of the person, these reflective cues can help you to
think beyond the technical aspects of the situation, and serve
as a reminder of the importance of person-centred care.
Nurses and midwives who are sincerely committed to
quality care learn early to make reflection an integral part of
their clinical practice. Reflective skills promote professional
development, enhance self-esteem and help develop self-
awareness. The critical thinking questions and reflective
practice points throughout this text will enable you to
develop these skills within everyday practice. Each of these
activities provides a particular challenge to your understand-
ing and knowledge development, and can be documented
within your learning portfolio.
Developing knowledge skills
This chapter has introduced reflective practice, which is the
first component of thoughtful practice. As you worked through
this chapter you will have become aware that each of these
components is essential in delivering person-centred care
within an ever-changing healthcare context. Each of the com-
ponents is required for you to be able to effectively learn in
and from practice.
What have you learnt?
•
Basic knowledge of the importance of developing self-
awareness
•
Methods for developing self-awareness
•
Knowledge of the various models of reflection
•
Ability to undertake an individual reflection using
critical incident analysis
•
Recognition of the barriers to and criticisms of reflection.
To enhance your learning and facilitate further
understanding of this chapter, refer to thePoint
and LNPS online resources.
Developing critical thinking skills
1.
Work with another student using the reflective cues in
Box 13-6 to help you work with two patients during your
next clinical placement. Choose a patient each and inter-
view them separately. Try to capture what you know of
your patient before you use the cues. Then, after using
the cues, capture what you now know about them:
(a) What have you learnt about yourself in relation to
the information you have uncovered?
(b) Will the information you now have assist you in
working with the patient in a more person-centred
manner?
(c) Compare lists with the other student, and explore
any differences between the two.
2.
Swap patients and repeat the process. Has your previous
reflection altered the experience of interviewing the patient?
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