In this essay, I will discuss several issues that seem to bind nursing practice with questions of ethics, sociology and management. Reflective practice is an important aspect of nursing management and in this essay we discuss implications of discrimination in nursing care and examine the importance of anti-discriminatory perspectives in nursing. In this paper, the case study I will elaborate is of an elderly woman who was of a non-British ethnic origin and spoke little English. A junior nurse visited her home to provide care but her attitude towards the patient has been discriminatory and abrupt, a situation that calls for serious reflection on the issues of racial discrimination at the clinical setting. The patient was apparently treated with leg ulcer. The questions that have to be considered here are:
Where in the observation did discrimination occur and how this could have affected the delivery of care given? And how has discrimination influenced the lady’s care?
The concept of anti-discriminatory practice as a contemporary issue within adult nursing is discussed here considering observational evidence and similar case studies.
Reflection in Nursing:
Reflective practice in nursing is guided by models of reflection. Reflective practice model serves as a framework within which nursing or other management professions can work. Reflective practice model is also a structural framework or learning model that serves the purposes of a profession and is particularly applicable to health related professions. Any portfolio of practice includes a model of reflection as reflection helps in determining what was positive or negative or a learning experience within the profession. Reflective practice highlights the importance of learning from experiences after thinking about it and relates the practical experiences to the theoretical learning approaches. The four important reflective models that form part of the clinical and nursing portfolio are:
Gibbs Model of Reflection – 1988
Kolb’s Learning Cycle – 1984
John’s Model of Reflection – 1994
Atkin and Murphy’s Model of Reflection – 1994
Gibbs Model of reflection is shown in a cyclical manner and is represented a follows:
Gibbs’ model of reflection (1988)
Given by Gibbs, 1988.
Source: CPSU, 2005
Unlike Gibbs’ model that has five stages, Kolb’s Learning cycle with four stages is shown as follows:
Source; CPSU, 2005
In the Gibbs’ model, the event is reflected upon and includes a description of what happened followed by feelings about the situation, and reflection on what the thoughts and feelings were at that time upon being into the situation. The nursing professional then personally evaluates whether the experience has been good or bad for her and analyses whether she can make any sense to the situation. The conclusions are drawn depending on alternative and what else could have been done with the situation and what were the other options available to tackle the situation better or more appropriately. Proposed and future action plan is thought of and how the situation will be acted upon in the future is also determined. Kolb’s model however stresses on the importance of generalizations of concrete experiences testing the implications in similar situations.