REFLECTIVE JOURNAL 1

REFLECTIVE JOURNAL

Student Name:  Neha Kaushal

Name of Unit Coordinator:  Renju Joseph

Appendix

Title Page No.

Introduction 3

Incident 1 3,4

Incident 2 5,6,7

Conclusion 7

References 8
REFLECTIVE JOURNAL 3

REFLECTIVE JOURNAL
Introduction

One of the inevitable constituents of nursing curriculum is reflective practice because it is

crucial for the development of advanced and critical nursing skills. It is the continuous cycle

in which nurses reflect on their daily experiences to enhance their professional skills and to

deliver quality care through better understanding of their actions (Jones, 2016). Various types

of errors can be seen in the hospital settings because of various factors such as staff being

forgetful, tired, doing multiple tasks simultaneously. Some of these errors can be in terms of

documentation, medication administration, communication etcetera. Nurses tend to overcome

or minimise these errors by using reflective practice (Jones, 2016). In this paper, I will be

reflecting on few incidents which happened during my clinical placement at Bellbird private

hospital. Moreover, I will be relaying my feelings and thoughts using the Gibbs cycle to

reflect on these incidents and will be explaining that how these will benefit me during my

nursing practice.

Incident 1

During my placement, I was posted in medical- surgical ward. I was working under the

supervision of my preceptor. I was assigned with one patient by my mentor. She was 92 years

old women admitted to hospital with the reason of infected wound at right big toe. Moreover,

patient had history of minor debridement and skin grafting at right big toe which did not heal

because of her unstable diabetes. My preceptor asked me to change the dressing so that

doctor and wound nurse can assess the condition of wound. I had been observing my

preceptor and other nurses doing the dressing of the patient during the first few days of

placement Initially, I read the doctor’s order for wound dressing. I explained the patient about

the procedure and asked for her cooperation to have student nurse. I performed thorough
REFLECTIVE JOURNAL 4

hand hygiene and wore personal protective equipment’s to prevent cross infection and then

removed the old soiled dressing by using non-touch technique. While doctor and wound

nurse were examining the wound for any exudates, colour and signs of infection, they also

taught me about the same. I cleaned the wound with prescribed solutions and secured the

wound with new sterile dressing with date on it. After the procedure I disposed of all the

equipment’s which I had been using throughout the wound dressing and washed my hands. I

documented the condition of wound on the wound chart. My mentor appreciated me for

following sterile techniques throughout the dressing.

Prior to the procedure, I was feeling uncomfortable of being observed by qualified personnel.

Although, I had done many surgical dressings or aseptic dressings during my nursing practice

in India, but still I was feeling anxious. Meanwhile, my mentor asked me to assess the

patient’s wound which I found difficult to explain, but my mentor was very reassuring and

was instructions as well. My mentor referred me some good websites that explains various

stages of wound healing and care.

I found the procedure challenging for me, but it gave lot of positive outcomes for me. I am

having better understanding of topics such as stages of wound healing and assessment of

wound (Abdelrahman & Newton, 2011). Moreover, I was After completion of procedure, I

felt really relieved knowing that I am enhancing my skills by practicing it.

Various researches have suggested patients with diabetes are more likely to develop wound

on their foot (Dutton et al., 2014). Wound management is a complex area and the it is the

nurse’s responsibility to ensure that they give the correct care to the patient and they use the

dressings that are selected on their knowledge and understanding of what the dressing will

achieve they need to be constantly aware of new products available to treat the wounds

(Abdelrahman & Newton, 2011). By regular assessment of the wound they will be able to see
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if the dressing selected is helping to promote wound healing. To get more knowledge about

the topic I searched various journal articles and literatures (Collier, 2004). I also searched for

my scope of practice related to wound management.

From this experience and after reading all the resources I think my knowledge and confidence

in this area of assessment has developed tremendously. I am aware that if I wish to work in

the community. I would need a good knowledge of dressing that is used in wound

management. I know that I am likely to meet patients who try to make me doubt my ability

however this is something that I know I will overcome as my confidence builds and I become

more used to working in the community.

In future, my aim is to be more proactive and will try to grab all the opportunities to enhance

my learning. Moreover, I will continue to learn more about wound healing process, wound

management and will keep myself updated with this topic.

Incident 2

The incident here I want to discuss is about medication administration. During my placement

I was working under the supervision of registered nurse. My mentor encouraged me to give

medications to patients under her supervision. I was excited to do that. I had been

administering the medications to the patients many times during my nursing practice in India.

I was very confident while doing so. I checked the medication chart thoroughly. Patient was

due for I/v Ceftriaxone which is an antibiotic. I went to the drug room to prepare the

injection. I collected all the needed equipment’s and then we asked one of the other registered

nurses to cross check the injection. After the preparation of I/V Ceftriaxone, we went to
REFLECTIVE JOURNAL 6

patient’s room. I performed hand hygiene before entering to patient’s room. I explained the

patient about the procedure and took her verbal consent. I followed the seven rights of

medication administration. After successful completion of the procedure we came back to

medication room to discard the waste according to hospital policy. My mentor appreciated

me for this and to check my knowledge she asked me about the action and side effects of I/V

Ceftriaxone. I confidently explained the action and general side- effects of the drug but

couldn’t explain the specific side-effects as I was not aware of them. So, my preceptor

advised me to study more about it by reading drug books and various websites and articles.

Although, I was being observed by my preceptor, but still I was confident throughout the

procedure. I ensured that I was doing everything correctly and not making any error. I gained

confidence of patient by maintain good rapport and relationship. I was enlightened when

patient appreciated me. I felt little anxious when my preceptor questioned my practice by

asking me the action and side- effects of the drug, but I realised that she is just trying to push

my boundaries to enhance my knowledge and to make me competent.

Medication administration is one of the key elements of nursing care. Although doctors

prescribe the medication and pharmacist dispense the medications, but the nurses play a vital

role in the correct administration of medication as any error while doing so can impose a risk

to patient’s health (Elliot & Liu, 2010). To enhance my knowledge about this topic I searched

various articles as well as journals. Further, I read about the correct storage and dispense of

drugs. Nurses need to follow and check all the eight rights to practice the drug administration

safely and to prevent medication errors (Elliot & Liu, 2010). Prior to giving medication to

patient, it is also essential for nurses to identify drug classification, its action, dose, side-

effects. Nurses should be able to use their clinical judgement skills to know if the patient

really need the medication and patient got any allergy to any medication (Hayes et al., 2015).
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Looking back into the incident and after reading all those sources I feel bit relieved. I am

really keen to apply this knowledge into my nursing practice. I am now aware that if I am not

competent about the administration or dispense of certain medications, I need to inform the

supervisor to shadow them and have opportunity to learn help me in future practice. I also

believe that I need to be more prepared and organised while giving medications to the

patients. I also need to mindful of researching more about patient’s diagnosis and

medications.

Conclusion

This reflective essay provided me with the opportunity to figure out my strengths and

weaknesses. Moreover, I was able to express my feelings by using Gibbs cycle. I strongly

believe that I am competent enough to practice my nursing career safely. I will actively

participate in all the education sessions to keep myself updated.

REFRENCES
 Abdelrahman, T., & Newton, H. (2011). Wound dressings: principles and
practice. Surgery (oxford), 29(10), 491-495.
 Collier, M. (2004). Recognition and management of wound infections. World wide
wounds, 7, 8-14.
 Dutton, M., Chiarella, M., & Curtis, K. (2014). The role of the wound care nurse: an
integrative review. British journal of community nursing, 19(Sup3), S39-S47.
 Elliott, M., & Liu, Y. (2010). The nine rights of medication administration: an
overview. British Journal of Nursing, 19(5), 300-305.
 Hayes, C., Jackson, D., Davidson, P. M., & Power, T. (2015). Medication errors in
hospitals: a literature review of disruptions to nursing practice during medication
administration. Journal of clinical nursing, 24(21-22), 3063-3076.
 Howatson-Jones, L. (2016). Reflective practice in nursing. Learning Matters.