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Reflection: Professional Growth and Development in Nursing

Name

Institution
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1. Introduction

Nursing is among the most demanding careers because of its traumatizing working

environment. It is not an ordinary career for the faint-hearted. Instead, it is a profession that

requires people to have a strong personality and emotional stability. Without a strong character,

one can hardly succeed in a nursing profession. While pursuing a nursing career, it is one of the

educational and professional requirements to reflect on the career development and practice to

improve professional outcomes and nursing experience (Dubé & Ducharme, 2015). Personal

reflection is among the effective ways to improve professionalism. In this reflective paper, I

discuss my professional journey in the last six months and recognize improvement areas.

Reflection is a critical aspect of professional and personal growth to allow nurses to keep pace

with up-to-date healthcare practice.

2. Appropriate Reflection Framework

           While there are many reflective models to use, I decided to use the Gibbs model because

it is easy to apply and systematically allows one to appraise strengths and recognize professional

gaps to address. In addition, Gibbs's reflective model emphasizes the connection between action

and reflection (Okamoto, Koide, Maura, & Tanaka, 2017). As a result, this helps me to set

professional development goals. Gibbs's model is also effective in deeper self-reflection and

considers professional development and personal development (Adeani, Febriani, & Syafryadin,

2020). Therefore, this reflects the importance of applying this model in professional

development. 
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           Gibbs model is also an effective model in reflecting on life or professional experiences. In

this reflection, I provide a compelling story illustrating my negative experience in my career

practice. While reflecting, I analyze the scenario to drive critical insights on the lessons I learned

and effective ways to improve my career practice. Using Gibbs’ model will also allow me to

explore the context in which I practice and ask critical questions to develop my learning from

experiences.

           Another reason for using Gibbs's reflective model is its easiness to remember. In this

reflection, part of the goal was to ensure that one can easily follow a reflective process (Okamoto

et al., 2017). Gibbs's model also perfected my self-awareness, a critical aspect of emotional

intelligence (Li, Chen, Liu, & Deng, 2020). It was also an effective model in helping me to avoid

over-repeating the stories. Gibb’s model is a procedural approach with six reflective stages,

including the event description, feelings identification, experience evaluation, experience

analysis, concluding, and developing an action plan.

3. Connecting Learning Outcomes With Own Journey

Case Study in My Professional Journey (My Sad Experience With an Asthmatic Patient)

Stage One: Facts Description 

           One night at an emergency department (ED), I had a weird experience that nearly

prompted me to end my nursing career. On one fateful night, senior nursing staff left my

colleague and me with a nursing assistant to handle 46 critical patients in an ED. Our project was

to care for these patients requiring emergency attention on a night shift. It was not the first time

we were working in the emergency department to nurture our skills in nursing. I had worked the

night shift in this project for close to two months. However, this fateful night nearly turned the

gains, including the experience I had gained, into hogwash. Throughout my professional journey,
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I had never worked in a critical care room before. I was excited to learn new aspects of critical

care nursing, yet I was confused and anxious because it was my first time working in an

emergency care setting. Working in the ED could expose me to a more challenging role in

nursing. After our supervisor left, a junior nurse with merely two years’ experience led during

the 9-hour night shift.

           On that fateful night, I was up to a task to administer a dose of 25 mg of captopril to a 40-

year-old hypertensive patient in critical care. A stranger physician that I had never met before

directed me to administer this drug to this patient. Captopril is a medication used in treating

various cardiovascular diseases, including hypertension and heart failure (Mitra, Arifin, & Rivai,

2021). In addition, it is a drug used to prevent the patient from developing stroke and kidney

problems. Captopril treats high blood pressure by blocking ACE (angiotensin-converting

enzyme), causing blood vessels to tighten and relax, improving the blood supply to the heart and

other internal organs (Mitra et al., 2021). My colleagues and I had never seen or used such a drug

in any patient. We looked at each other, not knowing what to do. 

           I gathered courage and checked with the physician on the script written 50 mg of

captopril. Before doing anything, I asked the physician whether I was to administer 50 mg of

captopril to the patient, but he nodded in agreement and signaled me to go ahead. I doubted

whether this medication was of the right quality and even thought of subdividing it to meet the

recommended requirements. However, since I knew it was unprofessional and wrong to try

chances in a medical profession, I decided to confirm with the physician whether the dose was

right. Once again, the physician agreed that the dose was indeed right. 

           I used my stethoscope to check for the patient's pulse rate before administering the drug.

Upon giving medication, I monitored the patient for nearly two hours without anything
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happening. Suddenly, I found a script written the correct dose that different hypertensive patients

should receive. Terrified, I realized that the patient should indeed have received 25 mg of

captopril. I called the physician and informed him that I had administered an overdose twice the

correct dosage that the patient should have received. Quickly, I filled an incident form,

addressing the hospital on the occurrence. In the morning, I decided to visit the nursing manager

and inform her about the incident. Fortunately, the patient's condition did not deteriorate after an

overdose.

Stage 2: Feelings Description

           From my experience, the emergency department was understaffed and had to rely mainly

on the junior staff to do most of the duties that experienced or senior nurses needed to do. As a

result, we had to work for long hours. Although it was not new to me to work for long hours, this

fateful night was exceedingly busy for three staff members to care for 46 patients in critical care.

During the incident, I was reluctant and nervous to administer the drug because of my

unfamiliarity. In addition, I believe that the work had overwhelmed the physicians, straining him

to provide proper directions on how to administer the drug. From my experience, he was in a

rush to attend to another patient with a heart condition that needed immediate attention. Perhaps,

the physician was also suffering from professional burnout affecting his performance.

Stage 3: Evaluation

           Undeniably, I was nervous and even felt guilt for administering the wrong dose to a

patient. Although it was not my mistake, I acknowledged my failure to use my judgment to

prevent an unfortunate outcome from occurring from this incident. Regardless, the nursing

manager was kind to me did not blame me for this incident. In addition, I had impressed the
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nursing manager for being responsible for reporting the incident upon realizing that I had

administered the wrong treatment. 

Step 4: Analysis

           This ordeal horrified and saddened me because I thought I had followed all physician

directions on administering the drug. Before this incident, I had no idea that physicians could

mislead nurses in drug administration. Although I was doubtful, I never thought that the

physician. From this incident, I realized how physicians could mislead nurses in their medical

practice. In addition, I realized the importance of trusting your instincts when administering

drugs. 

Step Five: Conclusions 

           Notably, this experience taught me that staffing shortages, occupational stress,

professional burnouts, and misunderstandings affect care service delivery. I felt sorry for the

patient and appreciated their loved ones and the nursing manager for understanding. In my

opinion, the patient’s relatives and the nursing manager were empathetic. However, I believe the

situation would have been different if unexpected eventuality, including death or irreversible

damage, occurred. If an unfortunate eventuality happened, I am unsure whether I could find it

possible to become a nurse.

Step 6: Lessons Learned and Areas of Improvement 

           My experience with an overdose taught me many lessons that I would never forget in my

professional and personal life. In my view, only fools never learn from their experiences in life.

Although this incident was unexpected and unfortunate, it was among the greatest learning

opportunities I have encountered in life.

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           One of the major lessons I learned from this experience is the importance of trusting your

instincts before administering drugs or executing nursing services. Today, medical errors are

among the leading causes of fatalities in the country. Medical errors refer to preventable

mistakes that may lead to adverse effects, including fatalities and injuries. For example,

inaccurate diagnosis, incomplete treatment, and overdoses are some of the leading causes of

medical errors. According to Bari, Khan, and Rathore (2016), medical errors are highly

disastrous and have adverse implications on the patient, medical community, and healthcare

institutions. Besides the effects on the patients mentioned above, medical errors elicit ethical

controversies (Yates, 2020). For example, people question the competency and professionalism

of the medical providers and practitioners. In addition, the integrity of the medical profession and

institutions suffer (Feizi Nazarloo et al., 2017). Lawsuits may also arise from medical errors and

attract hefty legal penalties. 

           Various aspects lead to medical errors. From my learning experience, emotional distress

in an occupation is among the leading causes of medical distress. In most healthcare institutions,

lack of emotional preparedness and overworking the healthcare team increase emotional distress

and increase the likelihood of medical errors affecting learning institutions (Berlin, 2017).

Because of overwhelming work, many nurses, clinicians, or doctors become fatigued,

undermining their efficiency in attending to patients and offering quality and safe medical

services. A variety of emotions, including guilt, sorrow, and inadequacy, predict mental distress

in a healthcare institution. Lack of interprofessional coordination and collaboration in a medical

community is also a leading issue affecting the healthcare profession (Berlin, 2017). For

example, lack of coordinated care practice and accurate information sharing leads to medical

errors.
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           I have learned the importance of obtaining adequate and accurate information before

performing any action when handling patients. From my experience, healthcare institutions

should prioritize medical errors elimination by ensuring that there is proper coordination and

collaboration among healthcare workers (Reeves, Xyrichis, & Zwarenstein, 2018). Effective

coordination within the medical team is necessary to address quality healthcare services (Yates,

2020). In addition, avoiding overworking the staff by hiring the right medical professionals is

necessary (Berlin, 2017). Apart from solving medical errors, sufficient medical professionals will

reduce professional burnouts and occupational distress common in the healthcare practice

(Reeves et al., 2018). Therefore, healthcare institutions will improve job satisfaction within the

medical community.

           Another aspect I learned in this project caring for 46 patients on a night shift is

communication training within the health profession. Improper communication is among the

major challenges affecting most healthcare institutions. Lack of proper communication

undermines interprofessional collaboration and team spirit within the medical profession

(Anderson & Abrahamson, 2017, January). From my learning experience, healthcare institutions

must recognize the importance of interprofessional collaboration. One advantage of this

collaboration is that it reduces medical errors by allowing accurate and smooth information. For

example, the coordinated spread of information across modern informatics, including EMR

(electronic medical records), is necessary to reduce medical errors because the health experts

have the information required. 

           However, medical professionals require training on how to use different information to

administer their service effectively. Service quality also improves by focusing on error reduction.

Another advantage of interprofessional teams and collaboration is reducing healthcare costs

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(Anderson & Abrahamson, 2017, January). Teams can share vital resources through

collaboration, including ideas, technologies, and materials while delivering care practices.

Therefore, this reflects the critical role interprofessional teams and effective communication

plays in providing appropriate healthcare services.

           Another improvement area is to hire adequate medical staff. Although healthcare staff

shortages are not new, the COVID-19 intensified it (Gohar, Larivière, & Nowrouzi-Kia, 2020).

Furthermore, the COVID-19 aggravated the issue by disrupting the care practice (Marks,

Edwards, & Jerge, 2021). For example, the overwhelming number of patients that require

medical attention is on the rise as the pandemic continues to wreak havoc in healthcare systems

(Gohar et al., 2020). In addition, the pandemic led healthcare providers to redirect efforts,

including staff, medical supplies, and equipment, towards the fight against the pandemic.

Therefore, this intensified the staff shortages crisis.  

           Today, staff members left to attend to the growing number of patients leads to

overworking, lengthy working hours, and attending to many patients. As a result, this induces

mental exhaustion and increases the risk for mental health disorders. Therefore, this reflects the

need for healthcare providers to address this challenge.

           Healthcare providers can use a combination of methods to address this shortage. For

example, hiring sufficient medical professionals, including pharmacists, clinicians, nurses, and

physicians, to meet the growing patient number across the hospitals is an effective way to

address the occupational shortage facing healthcare workers (Kim, 2018; Wan, Gu, & Ni, 2020)).

In addition, healthcare providers should install new technologies, including robotics, to offer

assistive care and surgical services, preventing healthcare workers from being overwhelmed
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(Kim, 2018). Medical technologies, including robotics and telemedicine, can also reduce medical

errors facing countries today. 

           I would want to become a great nursing leader in my professional journey to address the

healthcare practice's current challenges. For instance, I would lead campaigns against medical

errors facing health institutions. Advocacy against medical errors is an effective way to improve

healthcare services (Schot, Tummers, & Noordegraaf, 2020). Another strategy I would use in my

professional growth is to lead training and development on interprofessional collaboration to

reduce healthcare costs, maximize efficiency, and allow resource sharing. Professional growth

through training and development is an effective way to promote staff satisfaction and maximize

healthcare goals, including affordability and quality services (Schot et al., 2020). Therefore, this

explains why career growth should be a top priority.

Conclusion

           Professional reflection is essential to allow a healthcare practitioner to understand how

career progression affects you. In conclusion, my reflection on the nursing practice will help me

identify learning and development areas to keep pace with up-to-date, evidence-based care.

Through this reflection, I learned how to achieve development objectives and support learning

from other healthcare professionals. From my professional experience, I learned the importance

of encouraging interprofessional collaboration and accurate information sharing. If the physician

were cooperative and listened carefully to me, the overdose incident would not have occurred.

Being a great listener and communicator is necessary for medical practice because it reduces

preventable medical errors in a health institution. The overdose experience also helped me to

learn the need to avoid doubtful aspects. If any fatality happened, the story would have been

different.
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