Professional and Management Development
Within this assignment I will utilise the Nursing and Midwifery Council Standards of Proficiency (NMC 2004a) for entry to the register to critically reflect upon my portfolio of evidence in order to demonstrate that I am fit to practice. In doing this I will discuss the terms ‘proficiency’ and ‘reflection’. I will identify the model of reflection I am going to use within this assignment and will give a rationale for this choice. For each domain I will provide a critically analysed reflection, using evidence taken from my portfolio. For each domain I will demonstrate what learning has taken place, identifying a learning outcome and action plan from each reflection.
Nursing is a practice based profession and as such requires an agreed standard of proficiency to ensure patient safety (Howard and Eaton 2003) The Nursing and Midwifery Council has developed Standards of Proficiency (NMC 2004a) and these standards must be achieved in order to for the student nurse to become registered as a qualified nurse (Gallagher and Holland 2004).
The NMC Standards of Proficiency are contained within the four domains, which are professional and ethical practice, care delivery, care management and personal and professional development (NMC 2004a). The NMC (2004a) define ‘proficiency’ as standards which define the fundamental principles of being able to practice as a first level nurse. Benner (1984), in her 5 levels of proficiency, describes the proficient nurse as a nurse who, as a student, has become competent through acquiring experience in her role, and is now able to demonstrate that she can draw deeply upon previous experiences and adapt them appropriately to the current situation. Applicants for entry onto the register must have achieved the standards of proficiency in the practice of their chosen branch of nursing in order to become registered on the first level of the nurse’s part of the register (NMC 2004a). Evidence of achievement of the standards of proficiency is provided through reflections contained in the individual’s portfolio of evidence (Gallagher and Holland 2004).
Reflection has been described as an essential tool where students can bring together their theoretical knowledge and their actual practice, enabling the student to develop the knowledge and skills needed to become a professional nurse (Jasper 2003). It involves using a questioning approach towards our experiences and also the ‘self’, enabling the reflector to confront, understand and take action as a result (Johns 2000). The use of reflective practice is intended to guide the way towards best practice, both for the student nurse and continuing professional development (O’Regan and Fawcett 2006). Driscoll and Teh (2001) echo this, describing reflection as a process which contributes to professional development by revealing the knowledge and skills used in everyday practice and identifying areas that require development.
Reflection is used in many professions and is seen as a way that enables professionals to learn from experience in order to understand and develop their practice (Jasper 2003). Two types of reflection are reflection-in-action and reflection-on action, as identified by Schon (1983). Reflection-in-action is seen as an automatic activity which occurs subconsciously everyday. It is often seen as the way experienced practitioners practice, using their skills and knowledge to make decisions, for example deciding which pressure relieving device to use for a particular patient (Jasper 2003). Reflection-on-action involves the reflector thinking about an experience after it has occurred, transforming the experience into knowledge through analysis and reconstruction (Taylor 2000).
There are several different frameworks of reflections, each of which provide structures and strategies for reflection which can be used as a guide, providing cues and ways of breaking down experiences...