Introduction
This essay applies Rolfe’s reflective model to a nursing scenario involving the care of a patient with gynaecological cancer who is undergoing surgery that may result in colostomy formation. The reflection concentrates on the psychological and mental health dimensions of the patient’s experience. Rolfe’s framework, which prompts practitioners to consider “What?”, “So what?” and “Now what?”, provides a straightforward structure for examining clinical encounters. The discussion draws on established principles in nursing to explore how reflective practice can support psychological wellbeing, while acknowledging the limitations of any single model when addressing complex emotional needs.
Rolfe’s Reflective Model in Nursing Practice
Rolfe’s model is designed for quick, structured reflection in health-care settings. It asks the practitioner first to describe the situation (“What?”), then to analyse its significance (“So what?”), and finally to identify future actions (“Now what?”). In contrast to more elaborate frameworks, the model offers accessibility for undergraduate nurses who are developing reflective skills. Its simplicity, however, can limit depth, particularly when the emotional aspects of care require more sustained exploration of underlying values or power relations.
Application of the “What?” Stage
In the scenario under consideration, the nurse encounters a woman diagnosed with gynaecological cancer who faces major surgery and the potential creation of a permanent or temporary colostomy. The patient expresses visible anxiety about body image, sexual function and future independence. At this descriptive stage, the nurse records the observable facts: the patient’s verbalised fears, changes in appetite, sleep disturbance and withdrawal from family discussions. Accurate documentation of these indicators is essential, because untreated psychological distress can impair recovery and adherence to treatment plans.
Analysis in the “So What?” Stage
The second stage requires consideration of why these observations matter. Research consistently shows that women with gynaecological cancer report elevated rates of anxiety and depression both before and after surgery, especially when stoma formation is possible. The prospect of altered bowel function and visible changes to the abdomen can intensify feelings of loss and shame. These emotional responses are not merely secondary to physical illness; they directly affect the patient’s capacity to consent to treatment, engage in rehabilitation and maintain social relationships. Therefore, failure to address mental health needs at this point risks poorer clinical outcomes and diminished quality of life.
Action Planning in the “Now What?” Stage
The final stage turns attention to future practice. The nurse might decide to arrange a referral to a clinical psychologist or cancer support specialist before the operation, ensuring the patient receives timely counselling. In addition, the nurse could incorporate brief, structured conversations using validated screening tools such as the Hospital Anxiety and Depression Scale during routine observations. Collaboration with the multidisciplinary team, including the stoma nurse and palliative care colleagues, becomes important to coordinate consistent messages about realistic recovery trajectories. Such steps demonstrate how reflection can translate into concrete improvements in psychological support.
Conclusion
Rolfe’s model supplies a clear, repeatable process that helps nurses examine the psychological challenges faced by patients with gynaecological cancer who may require a colostomy. By moving systematically from description through analysis to action, practitioners can identify mental health needs earlier and respond more effectively. Nevertheless, the model’s brevity means it should be supplemented by deeper reflective approaches and specialist mental health expertise when distress is severe. Ultimately, integrating psychological care into surgical pathways supports both patient wellbeing and professional development.
References
- NICE (2022) Improving supportive and palliative care for adults with cancer. National Institute for Health and Care Excellence.
- Rolfe, G., Freshwater, D. and Jasper, M. (2001) Critical reflection for nursing and the helping professions: a user’s guide. Palgrave.
