Learning from practice – Reflections on a critical incident

Centre for Nurse Education, Mater Misercordiae University Hospital, Nelson Street, Dublin 7, Ireland.
Accident and Emergency Nursing 08/2007; 15(3):128-33. DOI: 10.1016/j.aaen.2007.03.004
Source: PubMed


Reflective practice is considered not only as a valuable tool for providing appropriate levels of care but also as an important prerequisite for the provision of professional nursing. Indeed, there appears to be consensus in the literature that reflections have the potential to assist practitioners to tap into knowledge gained from experience and connect theory to practice. However, evidence suggests that nurses, including emergency nurses, neglect reflective techniques. This paper outlines how the processes of reflection led to one emergency nurse developing new insights and understandings on nursing practice.

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    • "The discussions served as a verification of that the assessments were correct and optimal actions were performed. New knowledge and experience was created by reflecting on the events, which are corroborated by previous research [22,23] as well as included in the SAN’s competence description [7]. From this, arises an awareness that further research is needed on how structured discussions between colleagues may enhance the practical acquiring of knowledge and experience in the profession. "
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    ABSTRACT: Background A common feature of prehospital emergency care is the short and fragmentary patient encounters with increased demands for efficient and rapid treatment. Crucial decisions are often made and the premise is the specialist ambulance nurse’s ability to capture the situation instantaneously. The assessment is therefore a pre-requisite for decisions about appropriate actions. However, the low exposure to severe trauma cases in Sweden leads to vulnerability for the specialist ambulance nurse, which makes the assessment more difficult. Our objective was to describe specialist ambulance nurses’ perceptions of assessing patients exposed to severe trauma. Methods This study had a phenomenographic approach and was performed in 2011 as an interview study. 15 specialist ambulance nurses with a minimum of 2.5 years of experience from praxis were included. The analysis of data was performed using phenomenography according to Marton. Results The perceptions of assessing patients exposed to severe trauma were divided into: To be prepared for emergency situations, Confidence in one’s own leadership and Developing professional knowledge. Conclusions This study reveals that the specialist ambulance nurse, on the scene of accident, finds the task of assessment of severe trauma patients difficult and complicated. In some cases, even exceeding what they feel competent to accomplish. The specialist ambulance nurses feel that no trauma scenarios are alike and that more practical skills, more training, exercise and feedback are needed.
    Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 09/2012; 20(1):67. DOI:10.1186/1757-7241-20-67 · 2.03 Impact Factor
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    • "Art is well - suited as a means of provocation , and nude drawing and the experience of being exposed to nudity are events that leave few students indifferent . As such , nude drawing might be understood as a kind of " critical incident " , a concept described by several health care scholars ( Boud , Keogh & Walker , 1985 ; Martin & Mitchell , 2001 ; McBrian , 2007 ) . As a concept , " critical incident " is used to describe situations that make a deep impression , and thus create a kind of emotional and professional imbalance . "
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    ABSTRACT: Background: The Mensendieck physiotherapy programme at Oslo University College includes nude drawing as part of the curriculum. Aim: To explore how nude drawing can be used as a tool for encouraging the students to reflect on observation from different perspectives. Method: The data are based on a thematic analysis of 50 reflection papers. Findings: The students' reflections indicate that nude drawing contributes to an awareness of perceiving the body as object and subject. Their reflections also illuminate a growing consciousness of preconceptions and ethical aspects of observation as a method. Conclusion: Nude drawing seems to be an effective teaching tool. However, the relevance of the knowledge needs to be made explicit in terms of its application for the students' clinical training.
    Arts & Health 02/2012; 4(1-1):16-25. DOI:10.1080/17533015.2011.561358
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    ABSTRACT: This review summarizes the knowledge of error and of critical incident reporting systems in general and especially in emergency medicine. Medicine is a high-risk area and emergency medicine in particular needs consequent use of critical incident reporting systems. We need a safety culture to learn from our mistakes and we need to discuss all mistakes regardless of hierarchical structures in medicine. The first step in avoiding fatalities in emergency medicine is to accept that errors do occur. The next question is how to prevent errors in medicine and not to search for personal mistakes. We need a culture of error and not a culture of blame. Critical incidents occur in all ranges of medical hierarchical structures. We have to accept the presence of mistakes and we need to recognize them every day to protect our patients.
    Current Opinion in Anaesthesiology 05/2008; 21(2):240-4. DOI:10.1097/ACO.0b013e3282f60d82 · 1.98 Impact Factor
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