Why Reflective Practice Shall Increase in Importance in the Future - Essay Example

Why Reflective Practice Shall Increase in Importance in the Future Introduction Nursing as an applied discipline entails different applications, considering the social, political and cultural climate of its practice setting. In Australia, nursing education is in the verge of marked developments. Accordingly, nursing in Australia has been largely influenced by British System; however, with recent developments; the traditional apprentice nursing has been replaced with higher education sector. In which case, the image of nurses from simply being a physician’s assistant has now been enhanced, transforming nursing into a more significant role (Parbury, 2000). Moreover, universal access to health care is particularly important in Australia and in this manner, Medicare levy was established to provide varying benefits for individuals as regards hospital reimbursements, physician’s fees, medications and many more. Another worth noting fact is that health care system in Australia is largely government–run. Privatization of health care is said to be an issue gaining much commotion from all sectors of the society especially that private care offers freedom to choose doctors and that it also creates threat to equity and access in delivery of health care (Parbury, 2000). In connection, other issues compounding nursing practice in Australia include the ageing populace which is also evident in other countries. In lieu of this, great fiscal demands are gauged to impact health care system. Moreover, the shortage of potential nurses in rural and remote areas of the country is apparent. If not properly addressed, this may result to further problems for the healthcare sector of the country. Moreover, the surging concern for poor health of the indigenous people in Australia, such as Aboriginal and Torres Strait islanders, increases the pressure for reconciliation between the indigenous people and white settlers of the country. As stressed by Parbury (2000), nursing in Australia is indeed exciting due to the massive opportunities for nurse practitioners. These are an outcome of the recent developments in nursing education and professional practice. Nonetheless, what is deemed to be of utmost concern is related to high attrition rate among nursing work force and the challenge affronted the health care system as regards poor health and increased mortality rate amongst indigenous Australians. From this perspective, the study shall seek understanding and clarification of why reflective and critical thinking shall grow increasingly important in the future. According to past researches, critical thinking or reflection can help substantially in providing nurse practitioners with freedom to introspect oneself as to his or her thoughts and actions (Simpson and Courtney, N.d.). Analyzing the events within which the nurse found difficulties to deal with can be essential to obtain peace and understanding, therefore, alleviating pressure and stress at work. It is indeed a purposeful task according to John (2004). Critical Issues in Nursing a. Nursing Shortage The nursing shortage in Australia and the rest of the countries around the globe is deemed a huge problem which needs to be addressed substantively the soonest possible (Miller-Rosser, 2006). High attrition rate is obtained because of the increased demands and complex changes happened in the nursing profession. Apart from the effect of burgeoning number of old age people or that of baby boomers, growth of potential nurses cannot adequately compensate this number due to continuous increase in attrition rate and decline in nurse enrollees (Lambert, 2008). With the problem of attrition comes the pragmatic problem of drain in competent nurses. This makes critical thinking and reflective practice all the more important among those who choose to stay within the profession. b. Increased Mortality of Indigenous Australians Australia is home to both indigenous inhabitants and white settlers. The conflicts between white settlers and the original inhabitants or those indigenous Australians have dated back to history. With the reports of the worsening health condition of the indigenous inhabitants, such entails a more pressing problem for Australian Health Care System. As such, it is also deemed to be not only an issue of health care but also of political and cultural disparity. In this case, it reflects a major issue which affronts the nation about the feasibility of reconciliation between the two (AIHM, 1996). This issue on mortality may be alleviated partly through reflective practice and critical thinking among nurse practitioners, with the ultimate goal of providing better care for this sector. Reflective Practice Reflective practice is practically an emerging concept in the field of nursing since it has penetrated the field of teacher education (Shoffner, 2009). Recent developments entailed the creation of “Reflective Nurse Practitioners” across different regions or countries (Teekman, 2000). What is reflective thinking? This idea was first conceptualized by Dewey (1933, cited in Teekman, 2000, p. 1126), as he explored the process and product of reflective thinking. However, the most important study among contemporary writing about reflective thinking is that of Schons work ( The Reflective Practitioner,1987). . His work was based on Dewey’s concept of reflective thinking though distinctly characterized because of the focus of entailed outcomes for Schon whilst Dewey focused on process. In this case, Schon developed two key concepts of reflective thinking. First, reflective –in-action, which relates to one’s own reflection while on the course of doing the action; and secondly, reflection-on-action, which entails the person to reflect the action after the experience took place (Teekman, 2000). Accordingly, the value of reflective thinking allows the person to engage on self-evaluation and thus improve one’s clinical competency (Saylor, 1990, cited in Teekman, 2000; Kim, 1999). Especially that nurses nowadays are deeply engrossed with increasing challenge in lieu of the complexity of their roles and functions in providing health care, employment of reflective thinking may help nurse practitioners to learn from the result of the situation and thus promote continuous learning, growth and development for professional practice. In lieu of the growing issues on health care of indigenous Australians, the role and functions of nurse practitioners as provider of health care regardless of ethnicity or color, entails to be of importance in this specific situation. On the other hand, political and cultural factors do affect the situation, which embeds a part of moral and ethical dilemma for many nurses. Reflective thinking in this case may contribute to ease the complexity of the situation and therefore derive more clear and accurate realization of what is deemed important and not in the situation (Cirocco, 2007; Birch, 2005). As stressed in the study of Simpson and Courtney (N.d)., greater accountability concomitant to increase demands and complex changes in the field of nursing, connotes more emphasis for critical thinking and reflective thinking. Nurses ought to be prepared not only physically but also emotionally and mentally as regards dealing with the daily challenges that the task entails. Problem solving skills are importantly attuned with manifestation of critical thinking so that responsibilities aligned with the job could be addressed properly and effectively (Simpson and Courtney, n.d). Such problems are expected to be increasingly complex in the future, thus entailing an increase in critical thinking and reflective practice. Using the model of Reid Gibbs (1994) of Reflective Cycle, the diagram illustrates five (5) processes of reflection: (1) What were you thinking/feeling? - feeling (2) What was good about the experience? - evaluation (3) How can you make sense of what happened? - analysis (4) What alternatives did you have? - conclusion (5) What would you do if it happened again? - action plan In summary, the five questions are key points that will help guide in guiding nurse practitioners as they about to face the complexities of daily duties in clinical settings. According to Schon, reflective thinking is important as it helps nurse practitioners to not only rely upon acquired technical skills but also to help uplift one’s self-knowledge and critical assessment of situations (McBrien, 2007). Meaning, the importance of reflective practice is observed in the outcome that it provides as result of effective assessment of the situation which provides learning points and formulation of action plan. Barriers to Implementation of Reflective Practice In spite the positive regard of many researchers and experts in reflective thinking, there are still some problems and issues which serve as barriers for the successful implementation of this concept. According to London Pharmacy Education and Training (LPET, 2005), these barriers include time, preconceptions of task as difficult, organizational culture, gender, honesty with self, fear and “a science background”. From this perspective, nurses are also in difficult situation to think critically and reflectively because of the pressure entailed by inadequate time to manifest or perform an action. It is also difficult for the reflective practice to take place if the organization embraces a culture that is not open to such contemporary thinking. Likewise, difficulty as regards accepting the truth or being honest to oneself can also influence the likelihood that critical thinking be manifested. In as much as a nurse want to reflect and gain deeper understanding about the situation, if fear and anxiousness initially affronts the individual, it may likely not happen. As nurses are deemed part of a field of study which focuses on science, accepting reflective thinking in nursing practice can be difficult to attain (LPET, 2005). Summary The study perpetuates that reflective practice and critical thinking shall grow increasingly more important in the future for nurse practitioners in Australia, as they begin accepting reflective thinking as dutiful process in the provision of patient care. It is indeed essential as the profession takes more accountability for quality nursing care (Birch, 2005). The many challenges parallel to complexities of nursing profession entails the need to value critical thinking and reflective processes of situations on any clinical setting, be it in mental health (Wilshaw and Bohanon, 2003), ambulatory, oncology, and other facets of healthcare provision. Application of critical reflection is believed to be of positive influence as it allows self-discovery for nurse practitioners according to Ashby (2006; Morgan, 2009), aside from its influence on improving patient care (Mitchell, 2007). By being a reflective practitioner, the nurse may able to determine their strengths and weaknesses, and obtain better insights as to how they may better deal with the health problem or issue they are confronting (O’Connor, 2007). References Ashby, C. (2006). The benefits of reflective practice. Practice Nurse. 32(9), 35-37. Australian Institute of Health and Welfare [AIHW] (1996). ATSIC [Aboriginal and Torres Strait Islander Community] Annual Report, 1994-1995-Evaluation of National Aboriginal Health Strategy. Canberra: Australian Government Press. Birch, DMF. (2005). Critical thinking and patient outcomes: A Review . Nursing Outlook. 53, pp. 59-65 Cirocco, M. (2007). How reflective practice improves nurse’s critical thinking ability. Gastroenterology Nursing, 405-413. Gustafsson, C. and Fagerberg, I. (2004). Reflection, the way to professional development? Journal of Clinical Nursing. 13, 271-280. Heath, H. (1998). Reflection and Patterns of knowing in nursing. Journal of Advanced Nursing. 27, 1054-1059. Kim, HS. (1999). Critical reflective inquiry for knowledge development in nursing practice. Journal of Advanced Nursing. 29(5), 1205-1212. Lambert, MJ. (2003). Recruiting and retaining employees: critical issues for organizational leaders. The Physician Executive, pp. 1-19 McBrien, B. (2007). Learning from practice – Reflections on a critical incident. Accident and Emergency Nursing. 15, 128-133. Miller-Rosser, K. and Francis, K. (2006). Historical, cultural, and contemporary influences on the status of women in nursing in Saudi Arabia. Online Journal of Issues in Nursing. 11(3), 1-15. Mitchell, J. (2007). Reflective Practice. Nursing Standards. 21(46), 59-60. Morgan, G. (2009). Reflective practice and self-awareness. Perpsectives in Public Health, 129 (4), 161-162. O’Connor, E. (2007). Foundations in nursing and health care: Beginning reflective practice by Melanie Jasper (2006): Book Review. 85(2), 1-2. Parbury, JS. (2000). Nursing around the world: Australia. ANA Periodical. Online Journal of Issues in Nursing, 5(2). Retrieved on October 17, 2009 from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume52000/No2May00/NursinginAustralia.aspx Reflection and reflective practice. (2005). London Pharmacy Education and Training. 2, 1-3. Reid Gibbs (1994). Reflective Practice Model. Mcgraw-Hill. Schön, D. A. (1987) The Reflective Practitioner. Jossey-Bass Publishers, San Francisco. Shoffner, M. (2009). Personal attitudes and technology: Implications for preservice teacher reflective practice. Teacher Education Quarterly, 143-161. Simpson, E. and Courtney, M. (n.d). Critical thinking in nursing education: A literature review, 1-25 Teekman, B. (2000). Exploring reflective thinking in nursing practice. Journal of Advanced Nursing. 31(5), 1125-1135. Wilshaw, G. and Bohanon, N. (2003). Reflective practice and team teaching in mental health care. Nursing Standards. 17(50), 33-55. Read More