Introduction
This essay presents a reflective account of my experiences during an episode of mental health care, specifically focusing on the role of teaching and supervision within the context of my Return to Practice in Mental Health Nursing programme. Reflective practice is a cornerstone of nursing education and professional development, enabling practitioners to critically assess their actions, learn from experiences, and improve future care delivery (Bulman and Schutz, 2013). The purpose of this essay is to explore a specific clinical episode, evaluate my performance in teaching and supervising within that context, and apply evidence-based insights to enhance my skills. The discussion will centre on an encounter with a patient experiencing acute anxiety, where I was tasked with guiding a junior colleague through the intervention process. Key points of analysis include the effectiveness of my communication, the challenges encountered during supervision, and the implications for my ongoing professional development. Throughout, I will draw on established reflective models and relevant literature to ensure a structured and evidence-informed approach.
Context of the Reflective Episode
The episode under reflection occurred during a clinical placement in a community mental health setting. I was assigned to support a patient, pseudonymously referred to as Sarah, a 34-year-old woman presenting with acute anxiety symptoms. My role extended beyond direct care as I was also tasked with supervising a student nurse, Emma, who had limited prior experience in managing mental health crises. The dual responsibility of providing patient care and teaching required me to balance clinical priorities with educational objectives. This context aligns with the Nursing and Midwifery Council (NMC) standards, which emphasise the importance of mentorship and leadership in nursing practice (NMC, 2018). Reflecting on this episode offers an opportunity to assess how well I adhered to these standards and to identify areas for improvement.
To structure my reflection, I have adopted Gibbs’ Reflective Cycle (Gibbs, 1988), a widely recognised framework that encourages a systematic exploration of experiences through six stages: description, feelings, evaluation, analysis, conclusion, and action plan. This model is particularly useful in nursing as it facilitates a comprehensive review of both practical and emotional aspects of care delivery (Bulman and Schutz, 2013). In the following sections, I will apply this framework to dissect the episode and draw meaningful insights.
Description and Feelings During the Episode
During the episode, Sarah was visibly distressed, displaying symptoms such as rapid breathing, trembling, and repetitive negative thoughts. My initial focus was to de-escalate her anxiety using grounding techniques, while simultaneously explaining the rationale behind my actions to Emma. I felt a sense of responsibility to model best practices, yet I was acutely aware of the time constraints and the need to prioritise Sarah’s immediate needs. Internally, I experienced mild anxiety myself, concerned that my dual role might compromise the quality of care or the learning experience for Emma. This aligns with literature suggesting that nurses often feel torn between clinical and supervisory duties, particularly under pressure (Cleary et al., 2012). Despite these feelings, I endeavoured to maintain a calm demeanour to reassure both Sarah and Emma.
Evaluation and Analysis of the Experience
Evaluating the episode, several aspects went well. Firstly, Sarah’s anxiety levels reduced after approximately 20 minutes of intervention, indicating that the grounding techniques were effective. Secondly, Emma was able to observe and later discuss the rationale behind each step, which appeared to enhance her understanding of anxiety management. However, there were notable challenges. My verbal explanations to Emma during the intervention occasionally felt rushed, potentially limiting the depth of her learning. Furthermore, I noticed that my attention was divided, which might have delayed certain responses to Sarah’s cues. This issue of divided focus is not uncommon; research highlights that simultaneous teaching and care delivery can strain cognitive resources, sometimes impacting patient safety (Cleary et al., 2012).
Analysing this further, my communication style during supervision warrants scrutiny. While I provided clear instructions to Emma, I arguably failed to encourage her active participation, such as asking her to suggest alternative approaches. According to literature on adult learning theories, active engagement is critical for effective knowledge retention (Knowles et al., 2015). Reflecting on this, I recognise that adopting a more collaborative teaching approach could have enriched Emma’s experience. Additionally, the time constraints of the clinical environment posed a barrier, a common limitation noted in mental health settings where patient needs often take precedence over educational goals (Cleary et al., 2012).
Implications for Professional Development
This reflection has illuminated key areas for my professional growth as both a practitioner and a supervisor. One significant lesson is the need to integrate teaching into clinical practice more seamlessly. Strategies such as debriefing sessions after patient interactions could provide a dedicated space for teaching without compromising care, a practice supported by educational research in nursing (Bulman and Schutz, 2013). Moreover, I aim to develop my skills in fostering a participatory learning environment, perhaps by incorporating questioning techniques to stimulate critical thinking in mentees like Emma.
Another implication relates to managing the emotional demands of dual roles. The mild anxiety I experienced suggests a need for better self-regulation strategies. Mindfulness techniques, widely endorsed in nursing literature for reducing stress, could be beneficial in maintaining composure during high-pressure situations (Smith et al., 2011). Indeed, addressing my emotional responses will likely enhance my ability to model resilience and professionalism, thereby benefiting both patients and students under my supervision.
Conclusion
In summary, this reflective account has explored a specific episode of mental health care, focusing on the intertwined roles of teaching and supervision. By employing Gibbs’ Reflective Cycle, I have critically examined my actions, emotions, and the outcomes of the intervention with Sarah, alongside the learning experience provided to Emma. Key challenges included balancing clinical and educational priorities and ensuring active engagement during supervision. The analysis, supported by relevant literature, underscores the importance of strategic communication and emotional self-management in fulfilling dual responsibilities. Moving forward, I intend to implement structured debriefing sessions and mindfulness practices to address these challenges, ultimately enhancing my competence as a mental health nurse and mentor. This reflection not only contributes to my personal development but also aligns with broader professional standards set by the NMC, ensuring that my practice continues to evolve in an evidence-informed manner.
References
- Bulman, C. and Schutz, S. (2013) Reflective Practice in Nursing. 5th ed. Wiley-Blackwell.
- Cleary, M., Horsfall, J. and Hunt, G.E. (2012) Mentoring in mental health nursing: Challenges and benefits. International Journal of Mental Health Nursing, 21(5), pp. 403-410.
- Gibbs, G. (1988) Learning by Doing: A Guide to Teaching and Learning Methods. Further Education Unit.
- Knowles, M.S., Holton, E.F. and Swanson, R.A. (2015) The Adult Learner: The Definitive Classic in Adult Education and Human Resource Development. 8th ed. Routledge.
- Nursing and Midwifery Council (NMC) (2018) The Code: Professional Standards of Practice and Behaviour for Nurses, Midwives and Nursing Associates. NMC.
- Smith, A.P., Duggan, M., Tattum, D. and Francis, K. (2011) Mindfulness-based stress reduction for nurses: A pilot study. Journal of Holistic Nursing, 29(1), pp. 78-85.
