Reflections

The start of this new year marks a turbulent time in health care and brings particular uncertainty and challenges . The end of one year and the beginning of the next is a time when we often find ourselves looking back at what has happened and looking forward to what is to come. 

Round ups of the year fill our television and our socials - photos, montages, lists and clips of what was best, most surprising or most shocking. These are reflections on the year and summarise the ups and downs that we all experience - twelve months is a long time.

Silver balls (Anish Kapoor, Guggenheim Bilbao) 

Reflecting back on something that has happened is a way of looking at what can be learned, of celebrating things that went well so they can hopefully be repeated and finding out if things could be done better. Many professions, such as nursing, rely on this type of exploration or introspection of events in order to continually develop and improve the care provided. 

As part of revalidation five pieces of reflection are required but really a continual stream of reflections whenever it feels appropriate can be more beneficial. It doesn't matter if they are initially written in a scraggy notebook, kept in a neat folder or held on the cloud, it is the act of reflection that is important. At revalidation five which are most representative or useful can then be selected for submission and discussion.

Reflections of trees in water

There are many frameworks available to guide reflection from Benners Novice to Expert (1984), through Gibbs' reflective cycle (1988), Jarvis' 1995 model to the 2009 DEBRIEF model by Allan. There is no right answer to what model should be used for reflection as it depends on the individual and the situation. If it works and helps to give some support and structure and enables conclusions to be drawn for development then it is the right one. My personal favourite because of its simplicity is the three stage: What? So what? Now what? by Driscoll (2007).

Whilst reflecting in action becomes a natural part of nursing care, reflecting on action (Schon, 1991) requires an additional commitment of time and motivation. The reward of this extra effort though is greater awareness and knowledge. Frequently jotting down reflections makes them easier to do and more personal as they become a tool rather than 'homework'. They start to work for you rather than being work.  

Beaumaris Castle, Anglesey reflected in the moat

Looking back and reflecting on what has happened gives us a different view and, hopefully a better understanding. Remember though to be gentle with yourself as you reflect, it is a tool for development, not punishment. I love this quote from Neil Gaiman - "I hope that in this year to come, you make mistakes. Because if you are making mistakes, then... you're doing things you've never done before and more importantly, you're Doing Something."