Introduction
Reflection is a cornerstone of professional development in nursing, enabling practitioners to critically evaluate their experiences, enhance clinical skills, and improve patient care. This essay employs Kolb’s Experiential Learning Theory (ELT) as a framework to reflect on my placement experience on a vascular surgery ward. Kolb’s model, which comprises four stages—Concrete Experience, Reflective Observation, Abstract Conceptualisation, and Active Experimentation—provides a structured approach to learning from real-world practice (Kolb, 1984). The purpose of this essay is to explore a specific incident involving patient care during my placement, critically analyse my actions and emotions using Kolb’s cycle, and consider how this reflection informs my future practice. The discussion will focus on communication challenges with a post-operative patient, the emotional impact of the experience, and the broader implications for my development as a nurse. By engaging with academic literature and professional guidelines, this essay aims to demonstrate a sound understanding of reflective practice within the context of vascular nursing.
Concrete Experience: The Incident on the Vascular Surgery Ward
During my placement on a vascular surgery ward, I encountered a challenging situation with a 68-year-old male patient, Mr. Smith (a pseudonym to maintain confidentiality as per the Nursing and Midwifery Council (NMC) Code (NMC, 2018)), who had undergone a below-knee amputation due to peripheral arterial disease. On the second day post-operation, I was tasked with assisting in his wound care and monitoring for signs of infection. While performing these duties, I noticed that Mr. Smith seemed withdrawn and unresponsive to my attempts at conversation. Despite explaining the procedure and offering reassurance, he avoided eye contact and provided minimal responses. Initially, I felt frustrated and assumed he was uninterested in engaging. However, I soon realised that my communication approach may have been inadequate for his emotional state, prompting a deeper reflection on the incident. This experience became the foundation for applying Kolb’s cycle, as it highlighted a practical challenge in patient interaction that required further analysis.
Reflective Observation: Analysing My Response and Emotions
Reflecting on this incident, I observed that my initial frustration stemmed from a lack of immediate success in building rapport with Mr. Smith. I questioned whether my tone or body language may have appeared rushed or impersonal, potentially exacerbating his withdrawal. Furthermore, I considered external factors, such as the psychological impact of his surgery. Losing a limb can evoke profound grief and a sense of identity loss, which may manifest as disengagement (Murray, 2013). I also noted that the busy ward environment limited the time I could dedicate to individual patient interaction, a common challenge in nursing practice. Emotionally, I experienced self-doubt about my communication skills, wondering if I had failed to provide the empathetic support Mr. Smith needed. This stage of Kolb’s cycle encouraged me to step back and view the situation from multiple perspectives, including the patient’s, which proved invaluable in understanding the complexity of the interaction.
Abstract Conceptualisation: Linking Experience to Theory and Evidence
To make sense of this experience, I turned to relevant literature and professional frameworks. Effective communication is widely recognised as a fundamental component of nursing care, particularly in post-operative settings where patients are vulnerable (Bramhall, 2014). The NMC Code (2018) emphasises the importance of listening to patients and responding to their concerns with compassion. In retrospect, I could have employed therapeutic communication techniques, such as active listening and open-ended questions, to better understand Mr. Smith’s feelings (Stickley, 2011). Additionally, research highlights that patients undergoing amputation often experience psychological distress, including depression and anxiety, necessitating tailored emotional support (Horgan and MacLachlan, 2004). Drawing on these insights, I conceptualised that my initial approach lacked depth in addressing Mr. Smith’s potential emotional needs. Kolb’s stage of abstract conceptualisation allowed me to connect my experience to broader theories, reinforcing the notion that communication in nursing extends beyond verbal exchange to include empathy and emotional intelligence.
Active Experimentation: Planning for Future Practice
The final stage of Kolb’s cycle involves considering how I can apply these reflections to improve future interactions. Firstly, I intend to prioritise building rapport with patients by allocating time, however limited, to understand their emotional state before initiating clinical tasks. For instance, with a patient like Mr. Smith, I might begin by asking how they are feeling about their recovery, thereby creating a space for dialogue. Secondly, I plan to enhance my knowledge of psychological support strategies by engaging with training resources provided by the NHS and reviewing guidelines on post-operative care for amputees. Additionally, I will seek feedback from mentors during placements to refine my communication skills. By actively experimenting with these strategies, I aim to address the limitations identified in my initial response and develop a more patient-centered approach. This stage of Kolb’s model underscores the importance of translating reflection into actionable improvements, a critical aspect of professional growth in nursing.
Broader Implications for Nursing Practice
This reflective exercise has illuminated several broader implications for my development as a nurse. Firstly, it highlights the necessity of emotional resilience when faced with challenging patient interactions. Indeed, nursing often involves navigating complex emotions, both the patient’s and one’s own, and developing strategies to manage these is essential (Smith, 2015). Secondly, the experience underscores the value of continuous learning; while I demonstrated competence in clinical tasks, my communication skills require further refinement. Engaging with Kolb’s cycle has also reinforced the relevance of reflective practice in identifying gaps in knowledge and addressing them proactively. Arguably, such reflection not only benefits individual nurses but also enhances patient outcomes by fostering a deeper understanding of holistic care. Therefore, I view this incident as a formative step in my journey towards becoming a competent and compassionate practitioner.
Conclusion
In conclusion, this essay has employed Kolb’s Experiential Learning Theory to reflect on a significant incident during my placement on a vascular surgery ward. By progressing through the stages of Concrete Experience, Reflective Observation, Abstract Conceptualisation, and Active Experimentation, I have critically analysed a communication challenge with a post-operative patient, identified areas for improvement, and planned actionable steps for future practice. The reflection revealed the importance of empathetic communication and the psychological impact of surgical interventions like amputation, supported by evidence from nursing literature and professional guidelines such as the NMC Code. The process has highlighted limitations in my initial approach but also demonstrated my ability to draw on appropriate resources to address complex problems. Moving forward, the insights gained from this reflection will inform my development as a nurse, ensuring that I prioritise patient-centered care and continuous learning. Ultimately, this experience underscores the transformative potential of reflection in bridging the gap between theory and practice in nursing.
References
- Bramhall, E. (2014) Effective communication skills in nursing practice. Nursing Standard, 29(14), 53-59.
- Horgan, O. and MacLachlan, M. (2004) Psychosocial adjustment to lower-limb amputation: A review. Disability and Rehabilitation, 26(14-15), 837-850.
- Kolb, D. A. (1984) Experiential Learning: Experience as the Source of Learning and Development. Englewood Cliffs, NJ: Prentice-Hall.
- Murray, C. D. (2013) Psychological and social dimensions of limb loss. Journal of Rehabilitation Research & Development, 50(6), 789-802.
- Nursing and Midwifery Council (NMC) (2018) The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. Nursing and Midwifery Council.
- Smith, P. (2015) Emotional resilience in nursing: Challenges and strategies. British Journal of Nursing, 24(16), 853-857.
- Stickley, T. (2011) From SOLER to SURETY for effective non-verbal communication. Nurse Education in Practice, 11(6), 395-398.
