This essay will discuss a clinical experience in which I feel more competent in practicing. I will use a reflective model to discuss how I have achieved the necessary level of competence in my nurse training programme.The reflective model I have chosen to use is Gibbs model (Gibbs 1988). Gibbs model of reflection incorporates the following: description, feelings, evaluation, analysis, conclusion and an action plan (Gibbs 1988). The model will help facilitate critical thought process as it relates theory to practice. Discussion will include the knowledge underpinning practice and the evidence base for the clinical skill. A conclusion to the essay will then be given which will discuss my reflection skills, acknowledge my competence and show my personal and professional development. Trigger Event
The clinical skill I have chosen to reflect on within this essay is my first IV start. I have chosen this as my first clinical placement is on a surgical unit, where Intravenous therapy is a widely used to administer medication. I was very happy to finally be able to start developing this skill as I have seen it done several time and was ever able to acquire the process in which is needed to start an intravenous. Appraisal
The first stage of Gibbs (1988) model of reflection requires a description of events. As a transitioning Registered Practical Nurse to a Registered Nurse the expectation are that I will have develop this scope in my practice. I had observed this clinical skill on a variety of occasions and had previously administered IV medication and antibiotics under supervision. On this occasion I was being observed by my clinical educator. I had gathered all the necessary things I needed which included a bag of normal saline. My clinical educator was talk me through the procedure step by step and informed me that I should never place the tape on any surface as tit leads to cross contamination, and I should always clean blood from around the IV site. The facility also uses chlorhexadine instead of alcohol as eliminates stinging sensation.
The second stage of Gibbs (1988) model of reflection, which is a discussion about my thoughts and feelings. I was aware of being under the supervision of my educator and other classmates this made me feel very nervous and self- conscious. Once my professor said I am in do not advance I realize how truly nervous and under pressure I was feeling. I held my breath as I did not want this vain to blow and have to stink the patient again. This patient was an elderly gentlemen and I did not want the patient to feel that I did not know what I was doing. I thought that as I had been observed this clinical procedure on many other occasions it would be easy for me to do but it was very challenging, finding an appropriate vain, the right size of needle and wanting to get success on my first try made this a very trying experience. Exploration
Evaluation is the third stage of Gibbs (1988) model of reflection and requires the reflector to with state what was good and bad about the event. This experience was filled with emotion because for many years I have been an rpn and I always wanted to be able to start an IV and I finally got to do just that. I think the best thing about this experience is I got it the first time and my instructor made it seem so effortless. So many times I had place tape on the hand rail of a bed in preparation of taping a dressing, I never thought of the fact that I was taking all the germs from that rail onto the patient. This one little thing has caused me to change my present practice. Integration
Stage four of Gibbs (1988) is an analysis of the event, where Gibbs encourages the reflector to make sense of the situation. I will do this by exploring the skill and look for other opportunities to get more starts that I will feel more confident in my practice. In conclusion the use of this model of reflection has helped me to structure my thoughts and feelings appropriately. My level of awareness concerning evidence based practice, and its importance, has been enhanced with the use of critical reflection. My competence, within this clinical skill, has been further developed and I now feel that my personal and professional development is progressing. Using this reflective model has helped me to realise that my learning is something which I must be proactive in. Furthermore as a student nurse I have recognised that reflection is an important learning tool in practice.