Gibbs Reflective Model Of Reflection In Nursing

The clinical skill I have chosen to reflect on is the administration of Intramuscular (IM) injections. I will use a reflective model to guide me in my reflection. The Gibbs reflection cycle features, description, feelings, evaluation, description, conclusion and an action plan (Gibbs 1988).

The first stage of Gibbs (1988) is description of events. On my clinical placement I had the opportunity to administer a drug to a patient via IM injection under the supervision of my mentor. I had already observed this skill on various occasions and previously had the opportunity to administer IM injections in previous placements. My mentor was talking me through the process as this was the first time I have performed the skill with her supervision. When the mentor got to the step of using an alcohol wipe to cleanse the area of the injection site the patient said he did not usually get that done. He continued to say that an alcohol wipe had been used once before and had caused him an unpleasant stinging sensation and he would rather it was not used. The previous times I had administered IM injections, I had cleansed the site with alcohol wipe, and therefore I asked my mentor for some guidance in this situation. My mentor confirmed that it was acceptable
The Royal Marsden manual of clinical nursing procedures (Dougherty & Lister 2004) advocate the use of skin cleansing wipes, it is however stated within their guidelines that they adopt this for patients who are immunosuppressed, and also give evidence of previous studies which indicate that skin cleansing is not normally necessary. Research by Workman (1999) suggests that the use of skin cleansing wipes is inconsistent and not necessary in IM injections if the patient appears to be physically clean and the nurse has adopted an aseptic technique as well as stringent hand