Introduction
The Gibbs reflective framework provides a structured approach to reflect on an experience and identify areas for improvement. It comprises six stages: description, feelings, evaluation, analysis, conclusion and action plan. I will use the framework to reflect on the feedback I received from my mentor regarding nursing care for patients with chronic obstructive pulmonary disease (COPD). I will further evaluate the impact of feedback in enhancing my professional development as a nurse and improving the nursing practice in acute care. In nursing practice, feedback is crucial in promoting professional development and improving the quality of care provided to patients.
Description
I am a registered nurse working in acute care, and as part of my practice, I was deployed in the acute ward. I worked under the supervision of my practice assessor who guided my practice in handling COPD patients. The patients need careful handling since their breathing is affected by the inflammation and narrowing of the airways that cause damage to the lungs. My practice assessor assigned me to do a handover to my team from one shift to the next. Upon completion of the handover, I asked for feedback from my mentor, and the request was pre-arranged and took place in a structured environment devoid of noise and interruption. The need for feedback was informed by the Nursing and Midwifery Council (NMC) standards. According to Walker (2020), the NMC emphasizes the need for nurses to provide and seek constructive feedback from colleagues that aims to support improvements in practice. I believe feedback is an essential tool for continuous improvement in nursing for COPD patients. The NMC mandates nurses to act responsibly by seeking and acting on feedback to ensure high-quality care for their patients.
The feedback was largely positive and constructive and highlighted areas where I excelled. In particular, I was appreciated for being supportive and adopting a transformational approach as a leader. The feedback further covered different aspects of work, including leadership, communication skills, time management, clinical judgment, and patient-centered care (Bjerkvik and Hilli, 2019). The feedback also covered areas I needed to improve on, particularly in being more confident in my presentation during the handover. I was advised to mainly act as a valued member of the team as opposed to just being the student on placement. The requested feedback was provided formally through structured evaluation processes involving performance appraisals and clinical assessments. Peer feedback was provided by colleagues that entailed their different perspectives and experiences. I have utilized this feedback to reflect on my practice and identify ways to enhance my nursing skills and knowledge.
Feelings
Sometimes, receiving feedback can be challenging, making a person feel exposed and vulnerable. Initially, I felt defensive and embarrassed about receiving feedback from my colleagues and supervisor. However, I have come to appreciate the value of feedback and the opportunity it provides for personal and professional growth, especially in specifying areas for improvement and development. The feedback helped me to uncover my areas of strength and weakness. Cheng et al. (2022) state that such an understanding is necessary to encourage improvement by employing a personalized professional development plan to expand knowledge, skills, and overall performance. COPD is mainly caused by smoking and long-term exposure to irritants, hence, the feedback obtained is essential in understanding ways of providing better care to patients, improving on the outcomes, and enhancing job satisfaction.
I was proud to pride myself on my leadership skills, even though I felt criticized. However, I recognized that the feedback was given to me to help me improve, and I appreciated the opportunity to learn and grow as a nurse. It has helped me to become a better nurse to provide more effective acute care to patients. According to Davey et al. (2021), receiving constructive feedback helps nurses make necessary changes in the practice, resulting in improved patient outcomes. For example, feedback on leadership helped me to consider improving the skills needed to lead a team for increased patient satisfaction and better clinical outcomes. Similarly, feedback on clinical skills can trigger the need to seek additional training or support that can result in better patient care and outcomes.
Evaluation
The feedback I received was instrumental in shaping my nursing practice and enhancing my professional development. I noted that there exist different facilitators for obtaining feedback, such as communication, as outlined in the 6 Câs. Walker (2020) states that having open communication helps nurses feel comfortable expressing their opinions and ideas without fear of retaliation. Gautun et al. (2020) argue that a positive work environment enables nurses to provide feedback if they feel valued and respected. Leadership also plays a significant role in facilitating the provision of feedback by providing the necessary support, such as implementing the appropriate technology.
On the contrary, several barriers hamper the delivery of feedback. The key barrier is the fear of supervisor retaliation, which makes nurses feel apprehensive about expressing their opinions (Moriya et al., 2019). Time is another major constraint, considering nurses work in a hectic environment attending to COPD patients, and that the damage caused to the lungs cannot be undone. Tugba and Deniz (2019) state that nurses consider providing feedback more of a low priority compared to attending to patients. There are also language and cultural barriers, considering that nurses in the United Kingdom come from diverse cultural and language backgrounds. Pangh et al. (2019) state that such diversity makes it hard for people to provide appropriate feedback. Culture defines personal values and can influence engagement and interaction with team members. Given the different cultural backgrounds, even with the mentor, I noted that the varying beliefs and values affected feedback delivery.
Furthermore, I understood the importance of feedback, given that leadership is a critical component of nursing practice. According to George, DeCristofaro, and Murphy (2020), feedback helps a team leader lead effectively to ensure patients receive the best possible care. The feedback helped me to understand my boundaries and limitations within the team. This will help me participate effectively in future engagements to provide safe and effective patient care. I appreciate the role of feedback in stimulating the urge for teamwork and collaboration through learning from each other, sharing best practices, and identifying areas for improvement to provide better patient care.
A nursing team could best deliver on its mandate through a leader who promotes and models civility in the workplace. Ister (2020) states that as a role model the nurse leader should be a model to the team by treating all members respectfully and professionally, even under challenging situations. A team-oriented environment is needed to foster positive relationships among team members through team-building or regular meetings (Sidebotham and Fenwick, 2019). I recognize that conflicts can arise in the workplace, requiring proper nursing leadership to be resolved positively and respectfully. Positive feedback boosted my confidence and validated my strengths, while constructive feedback challenged me to improve my weaknesses. Jones et al. (2019) state that feedback is an essential tool for quality improvement in nursing practice. It helped to increase my strive for excellence by focusing on developing skills in the areas where I need improvement for better clinical outcomes.
Analysis
Through analysis, I reflected on the feedback that I received and identified patterns in the areas where I need improvement. For example, I struggle with time management during busy shifts, which is not permissible in providing nursing care for COPD patients. The understanding helped me to identify and develop strategies to manage time more effectively, such as prioritizing tasks and delegating responsibilities. I recognized the importance of open and effective communication in nursing practice, which, according to Jakobsen et al. (2023) can be boosted by holding regular meetings or forums where nurses can express their feedback and concerns. The management can promote a positive work environment by creating a culture of recognition and appreciation and implementing peer-to-peer recognition programs or recognition boards.
In addition, regular leadership rounds in units help create a positive relationship between management and nurses and encourage feedback. Kim et al. (2018) argue that user-friendly technologies can allow nurses to provide feedback conveniently, anonymously, efficiently, and without fear of retaliation. Providing feedback can further be supported through incentives to encourage nurses to use breaks or shift changes despite having a busy schedule (Matshaka, 2021). Establishing a feedback loop and regular updates on actions taken based on feedback can help build trust with nurses. Training nurses on language and cultural differences can promote effective communication and facilitate communication between nurses and management.
Conclusion
Using the Gibbs reflective framework allowed me to reflect on the feedback I have received from nursing practice in acute care. It has been instrumental in pointing to areas where I need to enhance my nursing practice and professional development when attending to COPD patients. This experience taught me the importance of receiving feedback, especially while leading a team. I identified areas for improvement and implemented strategies to enhance my nursing skills and knowledge to ensure that COPD patients receive better nursing care. I have recognized the importance of seeking and utilizing feedback to continuously improve my practice as set out by the nursing standards in the NMC and NHS guidelines.
There are several facilitators and barriers to obtaining feedback. Their impact can be contained by developing strategies for mitigation. The nurse leader plays a crucial role in defeating challenges by positively affecting a team for improved patient care. The leader should make the team members feel respected and supported. A show of civility is needed for effective collaboration and open communication leading to better engagement in improving patient outcomes. A positive work environment helps to create a more stable and experienced nursing team. I identified my strengths and weaknesses and evaluated my feelings by taking a structured reflection approach.
Action Plan
The NMC requires nurses to take action to address any issues identified through feedback. Nurses can satisfy this requirement by seeking additional training or support, adjusting their approach to care, or addressing any concerns or complaints raised by patients or colleagues. Moving forward, I plan to seek feedback from my colleagues and supervisors and utilize this feedback to enhance my nursing practice and professional development. I will work towards developing my leadership, communication, teamwork, and clinical practice skills and be open in expressing my opinions. I plan to reflect regularly on my practice in acute care and identify areas where I can constantly improve on for better attention to COPD cases. I will seek opportunities for continuing professional development to enhance my skills and knowledge. The action will ensure that I am well-versed with the latest advancements in COPD nursing practice, including new trends in technology, clinical training, and communication.
Reference List
Bjerkvik, L.K. and Hilli, Y. (2019), âReflective writing in undergraduate clinical nursing education: a literature reviewâ, Nurse Education in Practice, 35(35), pp.32â41.
Cheng, Y.-C., et al. (2020) âExperiential learning program to strengthen self-reflection and critical thinking in freshmen nursing students during COVID-19: a quasi-experimental study,â International Journal of Environmental Research and Public Health, 17(15), p.5442.
Davey, B.R., et al. (2021) âEvaluating the impact of reflective practice groups for nurses in an acute hospital settingâ, Australian Journal of Advanced Nursing, 38(1).
Gautun, H., Hartford K.L.A. and Bratt, C. (2022) âAfter hospital: should older care-needing patients be transferred to their homes or to an intermediate care institution?â Healthcare, 10(3), p.475.
George, T.P., DeCristofaro, C. and Murphy, P.F. (2020) âSelf-efficacy and concerns of nursing students regarding clinical experiencesâ, Nurse Education Today, 90, p.104401.
Ister, E.D. (2020) âInvestigation of relationship between levels of self-care agency and self-efficacy in nursing studentsâ, Asian Pacific Journal of Health Sciences, 7(1), pp.1â6.
Jakobsen, L., et al. (2023) âDeveloping and testing digital ethical reflection in long-term care: nursesâ experiences,â SAGE Open Nursing, 9.
Jones, J., et al. (2019) âReflection in practice: how can patient experience feedback trigger staff reflection in hospital acute care settings?â Health Expectations, 23(2).
Kim, Y.H., et al. (2018) âEffects of a work-based critical reflection program for novice nursesâ, BMC Medical Education, 18(1).
Matshaka, L. (2021) âSelf-reflection: a tool to enhance student nursesâ authenticity in caring in a clinical setting in South Africaâ, International Journal of Africa Nursing Sciences, 15(15).
Moriya, E., et al. (2019) âThe relationship between perceived difficulty and reflection in the practice of discharge planning nurses in acute care hospitals: a nationwide observational studyâ, Journal of Clinical Nursing, 29(3-4), pp.511â524.
Pangh, B., et al. (2019)â The effect of reflection on nurse-patient communication skills in emergency medical centresâ, Journal of Caring Sciences, 8(2), pp.75â81.
Sidebotham, M. and Fenwick, J. (2019) âMidwifery studentsâ experiences of working within a midwifery caseload modelâ, Midwifery, 74(74), pp.21â28.
Tugba, G.K. and Deniz T. (2019) âInvestigation of nursing studentsâ perception of caring behaviours’, Journal of Caring Sciences, 8(4), pp.191â197.
Walker, P. (2020) âCracking the code: the genesis, use and future of the Code of Conductâ, Disasters, 29(4), pp.323â336.