Reflective practice: what, why and how

Abstract

The context in which nursing occurs has changed markedly in the last two decades. As a result of advances in nursing and medical knowledge, and reduced government spending (which has led to a reduction in hospital beds, shorter hospital stays, and more rapid patient turnovers), workers in healthcare institutions are spending much more of their time dealing with acutely ill patients who require specialised care (Usher et al 2001). This can cause feelings of concern or confusion, but we must also recognise that it offers us an opportunity to reconceptualise our profession by making it more responsive and reflective of the needs of society (Lauder et al 2004). The role of the nurse is also influenced by cultural, social, economic, historical and political constraints that all affect the ways in which nurses approach and react to certain situations (Taylor 2000). It is a given that society expects nurses to practise safely and to undertake what is necessary to remain current. Reflection helps us to self-correct where the notion of continuous improvement becomes habitual to our practice (Usher et al 2008). As a consequence of the changing healthcare arena, today's nursing graduates must not only be clinically competent practitioners, but also need to be adept at critical thinking in order to understand the complexities of the world and the rapidly changing practice arena, even though this can itself be challenging (Johns 2004, Usher et al 1999). Critical thinking, or the practice of questioning, is necessary so that practitioners integrate relevant information from various sources, examine assumptions, and identify relationships and patterns (Parker & Clare 2000). Reflective practice and critical thinking are often used interchangeably, but, while not identical, there is a reflexive relationship. After all, as Lumby (2000:338) explains: 'to adopt a critical approach to the world, it is necessary to reflect on the world and one's experiences in it'.