New student? What's that? You're worried about your finals!

For a new student nurse, mention of your finals, as in, exams - seems a world-away. After a paroxysmal attack of fear (and motivation!), time resolves. "It's fine. I can relax. We're good!"

Especially so in the pre-Project 2000 days (Swaby, 2021), when nurse education was conducted in more local schools of nursing. You could be forgiven for feeling reassured that there's plenty of time; if your first step was to work as a nursing assistant (or cadet) prior to starting as a student.

Then all of a sudden, you can point to many wornout shoes. You've been busy; helped run a ward, a caseload, a team, and raised a family. And, while the NHS, nursing, society, and much else besides have continued their relentless pace of change, change and more change.

You blink,* look again and you're starting what will be your final 3-year period of nurse registration. What this will bring: who knows?

Kelly Swaby (2021) Did Project 2000 fulfil the intention set out by nursing’s leadership to create
a profession of highly educated practitioners. Thesis.
https://pure.hud.ac.uk/ws/portalfiles/portal/70492399/Swaby_THESIS.pdf

*'Blink' https://www.youtube.com/watch?v=4f0p5KqdU9U

The Nursing and Midwifery Council: Independent culture review - Reflection, accountability and action

Individual

|

      INTERPERSONAL    :     SCIENCES                   

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :    POLITICAL 

|

Group

Title: 'Registered Nurse' ... Professionalism Reflection	Theory - Practice - Governance [gap*] PROCESSES ACTION
Community of Practice Role models Models of  Care - Across all care contexts

c/o Twi/X

*always trying to bridge ...

Reflection, Revalidation, RCN Congress and Research

Thinking Out Loud: Journal 'Regulars'

Like many people I looked forward to experiencing RCN Congress again in June. Now of course Congress itself is a casualty of COVID-19.

Last May as already posted, I picked up several nursing journals too. Having time(!) I've read about reflection, I submitted the required reflective accounts to complete my revalidation last month (so good through to March 31 2023) and I've time to reflect now.

Reading some of the papers and browsing through the journals I notice one has "CPD reflective questions" which are specified for full-length article submissions. Here are some examples from one journal issue:

"If a patient presents with red flag signs of impeding airway obstruction, consider the aspects of the 6Cs in nursing and reflect on the care, compassion, and communication required to the patient and family.
Consider the different dimensions of a person-centred climate of a long-term care setting.
Reflect on the nurse's role in the provision of person-centred care in an older adult residential setting.
How could you make the care of patients in your setting more person-centred?
Reflecting on the case study, what do you consider may help nurses in recognising the condition early and minimise the need for investigations?
Reflect on how the time perspective [can] be an indicator of health and quality of life in people with HIV or another patient group.
Consider how the time perspective can be incorporated into the health care of people with HIV.
Think about how nurses can assess the time perspective in people with HIV."

If you understand Hodges' model then you will appreciate how the model can facilitate reflection on all of the above.

The contents page of many publications usually differentiate between 'features', or 'special focus' and pages listed as 'regulars'.

For quite a while I've not only worked on papers (two advanced drafts at present) but (quietly) wondered about those 'regular' pages and what would it take for journals to adopt Hodges' model as a common resource?

Of course, this begs questions of legitimacy, evidence-base, standards ... and as I have acknowledged Hodges' model is no panacea for a practitioner's or a health system's limitations. Hodges' model itself may constrain the adopted perspectives of readers; as opposed to as I believe, liberating them? If all the posts here were analysed, what is the holistic bandwidth of the content?* If Hodges' model was adopted what trends, if any, would be revealed? If students used Hodges' model to reflect on their own well-being in year 1 - year 3 what would they learn? Are there wells of reflection about which reader's reflections would congregate? Would this in turn be influenced by other recognised biases in publishing and the way the above questions are selected?

It would still be amazing to see Hodges' model as a regular and universal prompt. Even as a research project - the aide-mémoire it is intended to be. The journal would then actively engage with its readership and provide invaluable CPD.

My new folder is already open for the next three years ...

Be Well :: Be Safe All

*I admit that there are topics I have avoided posting, as they are potentially fraught 'politically' or in other respects.

British J. of Nursing, 28,9. 2019 (9 May, Congress Bumper Issue!).

"Nurses' ability to reflect on their practice is vital to the profession" Is it?

I beg to differ with the title of this editorial, as I wonder how vital reflection really is; and not just to nursing, but to the profession. I wonder from the rather detached perspectives of:

• Wigan Pier - and the parochial view this engenders (#globalhealth - where on Earth do I think I am?);
• As a 'local' nurse practising in Bolton;
• As a mental health nurse practising in the community within the NHS
• As a champion of a pivotal* resource for reflection and critical thinking (where is everyone?);
• and several others ...

Nursing Management

Quinn notes how "Nursing continues to develop to meet the needs of the society in which it operates." Plus: "A core part of revalidation is the ability to reflect on, and learn from, our interactions with others." My reading of Kinchin (and others over the years) suggests that reflection needs to be more a practice and revalidation based. I understand this is not what Quinn is saying in this issue on "Reflection as part of revalidation". Reflection using Hodges' model can be preemptive and anticipatory. We need to get beyond introspection and the retrospective important as this is.

As to where people are, it seems they are elsewhere, maybe reflecting in the sciences domain seeking theories and evidence. Perhaps, current teaching and exposure to models and theories of nursing and healthcare has them reaching for 'pure' models of reflection - Boud, Gibbs et al. when necessary. As we talk about the legacy issue that is integrated care, in Hodges' model here is a tool - a 'freebie', a 'takeaway' yes an Ubercare, that can grow with students, newly qualified nurses and experienced staff as lifelong learners.

Now that is vital to me. When reflection is hard-wired**, a part of a practitioner's cognitive apparatus and their educational toolkit to share with the public explicitly or implicitly as the context and engagement demands.

*Pivotal? Yes, and of course in light of the above, I'd be pleased to explain and even argue the case. The irony here is the current (ongoing!) focus upon recruitment and retention. Hodges' model is 'just' a tool, I recognise this; but could the application of Hodges' model energise, inoculate and so prime students for their course of education and practice placements?

**soft-wired too - humanistic

Quinn, B. Nurses' ability to reflect on their practice is vital to the profession, Nursing Management, April 2019. 26:2, p.5.