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 and the community are spending much more of their time dealing with acutely ill patients who require specialised care (Annstrong et al 2007). In order to function in these complex environments, practitioners are required to constantly 'refresh and update their knowledge and skills, and frame and solve complex patient and healthcare problems' (Mann et al 2009:595-596). This can cause feelings of concern or confusion, but it also 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 2010). It is a given that society expects nurses to practise safely and to undertake what is necessary to keep up to date. Reflection helps us to self-correct where the notion of continuous improvement becomes habitual to our practice (Usher et al 2012). As a consequence of the constantly 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 2013, Mann et al 2009). 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 2014, Thompson & Pascal 2012). 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'.