Why Do We Reflect?

Meizrow(1990) argues, "that a professional practice comprised largely of routine and habitual action is non-reflective. Routine practice is guided by impulse, tradition or authority. The routine practitioner accepts the realities of daily practice and concentrates on discovering the most effective and efficient way of solving problems, often missing opportunities for reflection� (cited in Williams, 2001, p 34)

When Do We Use Reflective Practice?

• Nursing Education
  
  There has been a trend in nursing towards creating reflective practitioners. Since Schon's work on reflection in 1983, this idea has been evolving in all aspects of nursing. This concept mirrors the notion of nurses educated as critical thinkers. The shift to creation of a profession with higher education standards has prompted the profession to reflect on what it is we do. The pursuit for evidence based practice in nursing has raised an awareness that we must ask questions in order to explore all the possible answers and resolutions. This process ultimately provides the framework for anlaysing a wealth of nursing knowledge and its applied theories.
  
  
• Practice Environment
  
  

  Nurses are continually reflecting on their practice. During the assessment phase a nurse is collecting patient information both subjective and objective. She draws on previous clinical situations to help evaluate and create a plan of care. As well she has practice standards she must follow to ensure standards of care are being met.
  The challenge for nurses in the present health care system is to perform this critical reflective process when there is limited time. With the high patient acuity and nurse patient ratios, nurses need to be able to think on their feet.
  

  Schon (1983) refers to the following key concepts:
  Reflection in Action-refers to the reflective thinking one is doing while one is doing the action. Reflection on Action-occurs, in contrast to reflection-in-action, after the experience has taken place.
  (Cited in Teekman 2000,p. 1126)
  

  Opportunities To Reflect

• Nursing Rounds: If the individual feels collegial support within his/her unit this is an excellent forum for group reflection on a patient situations. This would provide an educational opportunity for all staff to reflect and further develop plan of care.

• Group discussions: A forum for group discussion provides an environment for different phenomenological perspectives on clinical situations based on the individuals work experience of the participants. This environment must be a respectful non confrontational behaviours towards each other.

• Journals: Writing in reflective diaries and personal narratives about caring situations are helpful in identifying practice issues. Confidentiality must always be considered when journaling patient accounts.