Reflective practice, putting it into perspective

During the course of every day, we reflect on our acts and omissions, conversations, and interactions, yet when it comes to submitting our reflective practice as part of revalidation, we are often unsure as to where to start, what to reflect on, and how to get our thoughts down on paper.

In this article, I’ll explore what the Nursing and Midwifery Council (NMC) is asking us to do and offer some top tips on the ‘why’, ‘what’, and ‘how’ for turning a chore into a cinch.

Introducing the reflective conditions

In terms of the ‘why’ of the requirement, the NMC has two reflective conditions as part of revalidation. This consists of five written reflective accounts and an additional reflective discussion.^[1] This discussion should be with another nurse, midwife, or nursing associate, also on the register, from the preceding three-year period since joining the register or renewing registration.^[2] This is a must-do, not a could-do.

These reflections then need to link to the four key themes of our Code of Conduct:^[3]

1. To prioritise people
2. Practise effectively
3. Preserve safety
4. Promote professionalism and trust

Fortunately, the NMC template helps with the structure. You can find resources, further guidance and templates on the NMC website.

Where to start

When it comes to the ‘what’ of reflective practice, this isn’t set in stone. You can reflect on anything, which can often seem overwhelming in knowing where to begin, but I’ve found patients are often the easiest place to start.

We all can remember encounters when our consultations or experiences have gone really well or conversely when they haven’t. We think about these and that’s basically what reflective practice is – getting pen to paper and reflecting on those consultations through the lens of one of the four themes. It may be that the consultation meant we prioritised our patient, we may have interacted with them in a way that led to safer care, management or treatment and we should always act in a way that promotes professionalism and trust.

We also have daily interactions with our colleagues and peers. These encounters again can be a rich source of reflection and link easily to the theme of professionalism and trust. Hopefully, most of these interactions are positive. But even if there is something not as positive, if it makes us think and leads to change, turn the negative into a positive. Reflect on what you have learnt from it, even if it is that you decide it was non-professional and you would never act like that in your role.

Using feedback in your reflective practice

Another ‘what’ is you can use feedback. This may be formal, from our appraisals, or informal, for example, a brief thank you note or email for something we have done. It’s important if this has led to us reflecting on our practice, reinforcing something we do or changing something we do.

We may also have learnt something that has led to a change in our practice or the way we interact with others. You can reflect on this learning and link to the theme of practicing effectively. Those light bulb moments we have are also a ‘what’, and worthy of reflection.

Positives and negatives matter

Reflection is about thinking about what happens in our practice and our daily encounters. We can use the negatives as well as the positives but don’t dwell on the negative unless it was constructive. If it helped us think, change, or re-evaluate then it’s been useful. Remember it’s personal, not for publication. It’s like writing a diary, so don’t overthink it. Write from the heart and write as though no- one’s reading it, which actually they rarely are.

The last step is to have a discussion with another person on the register about your reflections. This is similar to us sitting down with a colleague and discussing something. This should be a positive experience and again can be a learning experience.

Start reflecting

As for the ‘how’ – use the template supplied by the NMC and get it down in writing.

On reflection, reflective practice is a necessity, but it shouldn’t be too binding. Use the NMC website for guidance and structure. Don’t overthink it, be honest and use your everyday experience as the basis for honest reflection.

Finally, remember you can reflect on what you’ve read on Together in Respiratory by using the free profile functionality. Look for the reflections log at the end of each article. The reflections log is structured to mirror the NMC reflections criteria so is a quick and easy way to start reflecting.

Any advice given and opinions expressed in this article are those of the author and do not reflect the view of Chiesi Limited (Chiesi).  All content in this article is for informational and educational purposes only.  Although Chiesi strives to always provide accurate information, it is not responsible for and does not verify for accuracy any of the information contained within.

[1] NMC. What is revalidation? Available at: https://www.nmc.org.uk/revalidation/overview/what-is-revalidation/

[2] NMC. Reflective discussion. Available at: https://www.nmc.org.uk/revalidation/requirements/reflective-discussion/

[3] NMC. Reflective Practice Guidance Sheet. Available at: https://www.nmc.org.uk/globalassets/sitedocuments/revalidation/reflective-practice-guidance.pdf