09. Reflection / Critical incident reports and analysis

Reflection on own actions and skill is very important in the nursing profession for continuous development and improvement. I always keep my reflective journal with me. I also carry a personal diary where I write my reflection on special events. Apart from that, I have done different reflective essays during my Master's degree. After reflection, I always analyze my action and decisions made during that action and try to find out what could have been done better. I believe reflection is the best approach to build confidence and improve my skills and knowledge.

I came across a critical and uneventful scenario when I was in placement. I was helping the physiotherapist to take my patient for a walk. We tried to access his vital signs but the machine could not find his blood pressure. I tried to check his pulse manually but could not find it. I called the RN working with me as I was not confident enough and said we have to do manual blood pressure. But she said it is all good to take him for a walk as the blood pressure machine sometimes plays up. As decided by the physiotherapist and RN, we stood him to walk. But, as soon as we reached the door, we started to be sluggish and said he was tired. We brought him back to his bed and he started leaning on his right. Then I pressed the emergency buzzer and everyone was there. We came to find out that he had a stroke and was transferred to ICU. He was already in palliative care, so after he was admitted to ICU and could not recover, he was transferred to end-of-life care with palliative services. Thus, he was back in the ward after three days with an indication of NFR and lost his life on the last day of my placement. I also did care of his body after death. While reflecting on this whole scenario, I still get goosebumps. I got to know how it is like to lose a patient. I think I will never forget that person. On reflection, I came to realize that I should have spoken up and said that we need to do manual blood pressure or contact doctors. This could have avoided the whole event. But I think I was quick enough to press the emergency buzzer that all of the emergency team were there to save him. So, whenever I reflect on that critical event, I always feel emotional but at the same time confident about the way I should act if something like that happens.