This reflective essay aimed to present the key learning and gaps in knowledge and practice of a student nurse. The Gibbs model of reflection was used to evaluate and analyse the learning needs of the author. An action plan is presented at the end of the essay to demonstrate the learning aims and activities needed to achieve these aims. These are needed to prepare the author in her future work as a registered nurse.
Reflection allows student nurses and healthcare practitioners improve current and future nursing practice by learning from one’s experiences (Bulman and Schutz, 2013). This essay aims to present a reflective account on my role as a student in health education and as a future healthcare practitioner. Gibbs (1988) model of reflection will be used to reflect on my experiences as a student nurse.
My work as a Health Care Assistant in the past six years helped me decide to pursue a nursing education. I was able to work in a busy environment and experience working with patients with different ethnic background and a multicultural healthcare team. Seeing patients improve as a result of the care they receive from healthcare professionals was one of the significant events that helped me decide to become a nurse. My life as a student nurse is challenging since I have to balance family life with work and my studies. I have to demonstrate key nursing skills, become a self-directed and independent learner, take responsibilities, manage my time and follow rules and regulations of the university. I also have to prepare myself to become a future healthcare practitioner. For instance, I have to acquire skills to meet the physical, psychological, spiritual and social needs of my patients. I also have to ensure that care received by my patients is evidence-based. In addition, I have to achieve the competencies required by the Nursing and Midwifery Council’s (NMC, 2008) code of conduct.
I am excited in my new role as a student nurse. My training in the past has been in accounting and business and my career shift brings some challenges. However, I am happy pursuing what I love to do. While I am passionate with my new role, I am also aware that becoming a nurse requires extensive training and study. Hence, I want to develop skills such as becoming an independent and self-directed learner in order to succeed as a student nurse. I also need to demonstrate key skills in order to prepare myself to become a registered nurse. At times, I am worried if I would be able to acquire all the skills needed to become an effective nurse. For instance, I feel that communicating with patients with different ethnic backgrounds could be a challenge. While I was able to witness how nurses communicate with patients of different ethnic backgrounds, I am aware that this would not be easy in actual practice. I also feel that I need to develop skills on how to deliver patient-centred care this is holistic.
Analysis and Evaluation
Developing the self-directed and independent learning style is crucial during the undergraduate nursing years. Kaufman and Mann (2010) suggest that problem based learning is common in medical education and helps students to become independent learners. Learning styles differ amongst adult learners. Biggs and Tang (2007) emphasise that an individual’s learning style is a result of affective, physical and cognitive factors. An individual’s learning preference is influenced by motivation, cognitive style, attitude, personality and a student’s stage of development (Cassidy, 2004; Biggs and Tang, 2007). On reflection, I have to consider my own motivation and cognitive style in order to become a successful independent learner. I also have to determine my own stage of development as a student.
Learners are identified into at least four types of learners. These are the visual, aural, read, write and kinaesthetic learners (Cassidy, 2004). During independent learning, students should be able to identify their learning style in order to optimise the learning process. On reflection, I learn best through observation (visual), reading and writing (R) and practicing what I learned (K). I can use all forms during self-directed learning. For instance, I can participate in simulation training to visualise the skills that I need to learn. Next, I can read on the topic and write a reflection or notes on what I learned. Finally, I can report my learning to my supervisors or mentors through presenting clinical skills. While self-directed learning is only one method employed in my nursing curriculum as a means to acquire knowledge and skills, this learning method is very important in my future role as a nurse.
It should be noted that the Nursing and Midwifery Council’s (NMC, 2008) code of conduct stresses the importance of providing quality evidence-based care to my patients. To meet the competencies contained in the NMC’s code of conduct, it is necessary that I inform my current nursing practice with current evidence from published literature. This is also emphasised in the NMC (2010) standards for nursing students in the UK. Evidence-based care (Greenhalgh, 2010) is described as the type of care supported by findings from published literature, personal experiences, expert opinion and patient experiences. Becoming an independent learner will help me in future role as a nurse since this will help me search for literature and evidence on the current and best form of intervention for specific healthcare conditions.
Apart from becoming an independent learner, I also realised the importance of developing my communication skills. The NMC’s code of conduct states the importance of developing empathy to patients and providing them with quality care. This is only possible with effective communication (Purden, 2005). Barclay et al. (2007) suggest that effective communication is possible if patients have learned to trust their healthcare practitioners and are allowed to participate in healthcare decision-making. Communication involves listening to both verbal and non-verbal messages of the patients and identifying their healthcare needs (Barclay et al., 2007). It is noteworthy that language barriers may become a deterrent to effective communication (Leonard et al., 2004). This is especially evident when patients and nurses have different ethnic background (Leonard et al., 2004). These differences may contribute to misunderstanding especially if patient education is not culturally sensitive or nurses fail to consider the patient’s preferences, cultural background, tradition and beliefs before introducing an intervention.
As a student nurse, I am aware of the importance of communication and why it is necessary for me to develop communication skills that are sensitive to my patients’ culture, traditions and beliefs. Developing these skills during my student years will help me become more sensitive to the needs of my patients. It has been shown (Barclay et al., 2007) that effective communication is a prerequisite to quality care. Many patients (Majumdar et al., 2004) express that the time nurses spent with them allowed them to communicate their feelings and needs better since they were able to communicate in an unhurried environment. On reflection, it is essential that as a student nurse, I will learn how to listen to my patients and determine their needs. It is also essential that I receive training on how to develop cultural sensitivity when dealing with patients with different ethnicity. Majumdar et al. (2004) stress the importance of assigning patients with different ethnicity to healthcare workers who share similar ethnic background. However, this might not be achieved in all instances in actual healthcare settings. Hence, it is essential that nurses should be trained on how to develop cultural sensitivity.
On reflection, I also learned the importance of developing skills on how to promote psychological, social, emotional, physical and spiritual care of patients. As a student nurse, I am still beginning to develop these skills and understand that it will take time to develop all these skills. I realised that these skills are best learned when working with other healthcare professionals. Hence, it is crucial that I learn how to collaborate effectively with other healthcare workers. Apart from developing effective communication skills, I also need to learn how to work with others and manage conflicts during meetings. It is suggested that conflicts (Leonard et al., 2004) do not lead to poor team working but provides an opportunity for team members to choose the best form of intervention for a specific healthcare condition. Conflicts also allow team members to view an issue from different perspectives.
In conclusion, there are many skills that I still need to develop as a nursing student preparing to become a registered nurse in the future. To date, I need to hone my skills in independent or self-directed learning. I also need to develop communication skills, cultural sensitivity and learn how to collaborate effectively with other team members. All these skills are necessary to help me observe the NMC’s code of conduct and gain competencies for registered nurses in the UK.
The following are the objectives of my action plan:
Improve skills on how to carry out independent or self-directed learning.
Develop communication skills.
Develop cultural sensitivity.
Learn how to collaborate effectively with team members
Table 1. Action Plan
Improve skills on how to carry out independent or self-directed learningEngage in self-directed learning on specific topics in nursing.1-4
Develop communication skillsAttend simulations on how to communicate effectively with patients suffering from chronic or acute conditions; Observe/shadow senior nurses on how they communicate with patients suffering from different conditions5-8
Develop cultural sensitivityAttend simulations on how to develop cultural sensitivity; watch videos showing nurses demonstrate cultural sensitivity when caring for patients with different ethnic background; shadow senior nurses and observe how they show cultural sensitivity to patients with different ethnicity9-12
Learn how to collaborate effectively with team membersBecome part of healthcare teams/ shadow healthcare teams and observe how they collaborate with each other13-16
Barclay, J., Blackhall, L. & Tulsky, J. (2007) Communication strategies and cultural issues in the delivery of bad news. Journal of Palliative Medicine. 10(4). p. 958-977.
Biggs, J. & Tang, C. (2007) Teaching for quality learning at university. 3rd ed. England and New York: Society for Research into Higher Education & Open University Press.
Bulman, C. & Schutz, S. (2013) Reflective Practice in Nursing. 5th ed. London: John Wiley & Sons.
Cassidy, S. (2004) Learning styles: An overview of theories, models and measures. Educational Psychology. 24(4). p. 419-444.
Gibbs, G. (1988) Learning by doing: A guide to teaching and learning methods. Oxford: Further Educational Unit, Oxford Polytechnic.
Greenhalgh, T. (2010) How to read a paper: the basics of evidence-based medicine. 4th ed. Chichester: Wiley-Blackwell.
Jarvis, P. (2010) Adult education and lifelong learning: Theory and Practice. London: Routledge.
Kaufman, D. & Mann, K. (2010) Teaching and learning in medical education. In: Swanwich, T. (ed.). Understanding medical education. ASME: Blackwell Publishing.
Leonard, M., Graham, S. & Bonacum, D. (2004) The human factor: the critical importance of effective teamwork and communication in providing safe care. BMJ Quality & Safety. 13. p. i85-i90.
Majumdar, B., Browne, G., Roberts, J. & Carpio, B. (2004) Effects of cultural sensitivity training on health care provider attitudes and patient outcomes. Journal of Nursing Scholarship. 6(2). p. 161-166.
Nursing and Midwifery Council (NMC) (2010) Standards for pre-registration nursing education. London: Department of Health.
Nursing and Midwifery Council (NMC) (2008) The Code: Standards of conduct, performance and ethics for nurses and midwives. London: Nursing and Midwifery Council.
Purden, M. (2005) Cultural considerations in interprofessional education and practice. Journal of Interprofessional Care. 19(1). p. 224-234.
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