Reflection Within Professional Development

In this essay I intend to reflect upon a clinical skill, which I have learned and become competent in
practicing. I will apply the Gibbs model to the chosen skill throughout the essay to allow for critical
thought. Gibbs model includes the areas of description, feelings, evaluation, analysis, conclusion and
action plan. (Gibbs, 1988)

The term “reflection” directly refers to one’s own ability for serious thought or consideration
regarding events, which have occurred in the past. Professional bodies and organisations utilise
reflective practice within continuous professional development as an effective tool to evoke critical
thoughts regarding their own actions. This analysis of one’s own actions facilitates insight into areas
of improvement and areas of development for future skills. Furthermore, as a result of reflection,
new skills and practices can be developed and strategies can be adapted to the demands of the ever-
changing needs of society.

Reflection in practice is a highly regarded skill which healthcare professionals should all become
familiar with. Any concerns or complications encountered on previous occasions can be reflected
upon and necessary amendments can be made. This alteration to one’s practice can empower
healthcare workers to deliver first class person centred care, whilst remaining observant, competent
and mindful of previous endeavours, which can instil a level of confidence within the workplace.

Regular use of reflection within continuous professional development allows for the development of
new skills, knowledge and techniques, which in turn will benefit the service users who are directly
receiving the care. With this information, the skill I have chosen to reflect upon is wound care. I have
chosen this as prior to commencing work at placement, I had no practical experience of would
dressing aside from applying sticking bandages to myself in the event of a small injury.

For the purpose of this essay, I will refer to the aforementioned placement as “Brampton Lodge” in
order to maintain anonymity. During the first few weeks of my placement as I was finding my feet
and settling in, I found myself at a loss as to what to do as there were only female service users
present. Due to policies in place at Brampton Lodge, female service users could only receive personal
care from female support workers. This was not much of a concern to me as it was necessary for me
to remain mindful of the individual at question’s privacy, dignity and personal preferences. However,
in the forthcoming weeks as male residents began to arrive, I found myself becoming more directly
involved within their personal care.

With these newfound skills I had developed, I felt empowered within placement – like I was
beginning to fit in and not just a loose end. As the shifts passed, I began to evaluate my own practice
to identify areas for improvement and make amendments in order to compensate for the diverse
needs of the client base at Brampton Lodge.

Description
During the fifth week of placement, a service user who I will refer to as “Adam”, again to maintain
anonymity arrived at the lodge. Adam was an intriguing individual who presented a host of
distinctive, complex needs. As an infant, Adam had endured a number of arduous medical
procedures, which were required as a result of the physical deformities he had been born with.
Unfortunately, Adam has a medical condition known as “Osteogenesis Imperfecta,” which put simply,
means he has extremely brittle bones. In addition to this, Adam was born with Down’s syndrome and
a number of physical deformities – the most discernable of which being his entire thoracic area,
which is displaced, leaving it perpendicular to his abdomen and pelvis.

Adam was born with a large, elongated cavity -resembling an armpit only deeper- spanning the
breadth of his back, which was prone to bacterial infections and sores caused by the inflammation
and pressure subjected to this area due to the inherent moisture and displacement of his ribs.
Unfortunately, on the occasion he had been booked in for his respite stay at Brampton Lodge he had
developed a pressure sore, which was deep inside the aforementioned cavity. Adam’s carer had
informed us of this prior to checking him into his room and explained that he has been restless and
at a great deal of discomfort due to the injury. In turn, the restlessness had caused him to fracture
one of his vertebrae, resulting in even more pain within the central area of his back.

I was delegated the task of dressing Adam’s wound whilst under the supervision of the senior care
worker. Being careful not to aggravate the already painful area I used a number of different dressings
and an antiseptic cream to help heal the wound. Although I successfully managed to complete the
task, I found it difficult to manoeuvre around the infected area due to having large hands. I asked to
speak to the care worker who supervised and informed her that I didn’t feel comfortable or
appropriate repeating the task later in the day, I would, however be willing to observe in order to
adapt my approach.

Feelings

Whilst meeting Adam and reviewing his condition, I felt a degree of pity regarding how he was
feeling. I was also upset and embarrassed by my own inability to maintain dethatched whilst he was
crying due to the discomfort. Unfortunately as a result of this I became somewhat irritable with
other members of staff within the complex as I felt I shouldn’t have been delegated such a task. After
I had completed the task of dressing Adam’s wound and spoken to my placement supervisor, I
developed a feeling of regret that I had decided not to participate in Adam’s wound care. Reflecting
back on those feelings, I realise now that the irritability I displayed towards the staff was in fact
emotional displacement (Cherry, 2011)

Evaluation
Although I was given praise after completing the task, I did not feel that I had attained any valuable
experience as in my personal and professional opinion, the implementation was unacceptable.
However, after speaking to the senior care worker regarding the situation, I felt it was beneficial for
me to observe the task being performed by a more experienced care worker. I realised everybody
feels nervous on the first day of doing something new, as documented by (Aubrey, 2011)

Analysis

The situation I found myself in was itself worsened by my own inability to control my emotions and
the care worker who initially delegated me the task. I feel like I should have voiced my concerns
towards her and simply said “No, thank you” in response instead of taking on the task. However, I
feel I made the correct decision in speaking to the senior care worker after the situation as it allowed
me to calm my nerves and eliminate any irrational thoughts I was having at the time. As stated by
(Quirk, M. E. 1994) within teacher-learner situations, it is more appropriate to address and prevent a
problem before it arises. I feel that in future I should express my concerns prior to undertaking a
task, which I believe to be outwith my professional capacity.

Conclusion

In retrospect, I will carry out a number of things differently. I should have voiced my concerns to the
care worker prior to taking the lead on dressing Adam’s wound. I also should have taken a moment
to calm down and regain my professionalism instead of becoming irritable towards other members
of staff. The situation, however, has made me realise the importance of knowing one’s own
professional limitations - a skill, which is fundamental in sustaining a successful placement. I feel that
had I had the opportunity to develop my skills in the weeks prior to the situation, this would have
provided me with the necessary tools to reflect upon and adapt my approach and perhaps avoid the
complication completely.

Action Plan

In future I will ensure that I am confident in my own abilities prior to undertaking a specific task. This
will in turn instil a sense of confidence in myself and ensure I don’t work outwith my professional
limitations. I intend to arrange regular meetings with my placement supervisor with regards to
continuously developing my knowledge and skills for practice. I plan to observe all clinical procedures
before undertaking them myself, allowing me to ask relevant questions and gain insight into the
reasoning behind the procedure. With regards to training, I intend to ensure I retain all knowledge
taught within my essential skills for nursing class. Finally, whilst at Brampton Lodge, I will strive to
participate in any tasks which I feel I would require additional experience within.