This means that once initial training is completed it is necessary for nurses to participate in regular training and develop competence and performance. As a nurse
there is the responsibility of practicing and delivering care based on current evidence and what is thought to be best practice according to current guidelines.
As a student it is good practice to set some goals including long term that extend beyond time at university. This should give some motivation to carry on developing skills and knowledge enabling the best possible care to be given to the patients being treated.
In order to achieve goals an action plan needs to be made specifying what needs to be achieved and how it would best be achieved. There are three types of goals to be decided: short term, medium term, and long term. They should act as stepping stones until the individual reaches there ultimate goal.
Honey and Mumford (1992) identified four main learning styles: the activist, the theorist, the pragmatist, and the reflector. The Activist enjoys new experiences and challenges, an environment of changing activities and appreciates the chance to develop ideas through discussion and interaction with others. The Reflector appreciates the opportunity to reflect before making a decision, prefers to listen and observe others debating and discussing issues, and prefers to work alone. The Pragmatist likes linking theory with practice, enjoys problem – solving, and appreciates the opportunity to develop practical skills. The Theorist enjoys theories and models, and thrives on problem – solving when it involves understanding and making sense of complex issues.
Honey and Mumford’s theory on the four main learning styles is very successful but, may not the best way for nurses to achieve their goals effectively. Learning as a nurse would involve integrating and mixing these learning styles as they do not really cater for a nurses needs.
In terms of long term goals The Pragmatist is the most ideal learning style for a nurse as it involves learning practically with some element of theory. This is necessary as when dealing with patients, nurses need to know the correct method of doing something and needs to understand why they do it, but practice means that a nurse feels confident to put the theory into practice, therefore feeling confident about their abilities and more able to reassure the patient.
Nursing is a practical job but it is still important to spend time reflecting. Abstract conceptualisation follows on from reflection. The concept is the idea; abstract conceptualisation is the understanding of the idea. As a nurse the ability to reflect is crucial to develop in-depth knowledge and skills and achieve life long goals effectively. Reflective practice is like any other skill, it can be learned, and become second nature once learnt.
Goodman (1984) said that there are three different levels of reflection.
1st - To reach given objectives: Descriptive
2nd - Relationships between principles and practice
3rd - Incorporates ethical and political concerns
These different levels are can only be obtained through practice.
There are many theories relating to reflection and it depends on the individual which one is followed.
Some are very simple such as Maslin – Prothero (2001);
WHAT?
SO WHAT?
NOW WHAT?
Kolb’s (1984) Learning Cycle and Gibbs Reflective Cycle (see appendix 2) are both very similar but go into more detail than Maslin – Prothero.
The benefits of reflection are high in nursing. It helps the development of nurses’ autonomous practice, and it develops knowledge. Reflection however is only valuable when it is reflective practice and not just thoughtful practice. There is a difference between just thinking about an experience and in – depth exploration of it. To successfully reflect the individual should be open minded, responsible, objective, willing to explore emotions and, adaptable to change.
Although nurses constantly learn through practice it is a good idea to develop good study methods as a back up to the practice. Achieving this means gaining firm knowledge, and ability to learn new and specialist skills.
Information can be sought by reading relevant materials. Journals are a good way of receiving information on new and revised policies. There are an abundance of journals available. The information may come from a general nursing magazine or from a journal that focus’ on a specific branch of such as paediatric nursing. It is also good practice to start reading newspapers and listening to news reports.
As well as reading and researching into the techniques that are required, it is also important to practice. As a nurse it is important to become familiar with the routine and ensure that the task will be carried out with confidence. It is important that a nurse feels confident carrying out the different tasks that may be asked. It makes the patient feel more relaxed in a very stressful situation.
‘Confidence comes with practice.’ () Practice may not always be thought of as a learning method. It is however one of the most valuable learning experience to anybody. An individual can be taught things and be the most skilled and competent person but, could that person put it into practice in a real situation.
Communication is a good learning method as well as helping the nurse look more confident and competent. Life long learning involves being able to communicate effectively. By talking to colleagues and having a good comprehension of them new skills can be learnt. Quite often nurses will learn from each other and good communication skills are imperative.
Does a nurse know everything there is to know about nursing? No
Does a nurse know when they know everything about nursing? No
So how can a nurse possibly know when learning ends?
In conclusion many nurses will share the same goal, to become the best nurse that they can possibly be. This means that learning within nursing will never end. As previously stated it is one of the few ever changing professions and so to become a competent nurse it is necessary to stay up to date and continue learning throughout life.
Personal Reflection
I was working at Safeway’s and I was the only first aid trained person in on this particular shift, which was a mistake on behalf of the store as there should be one person trained and insured to carry first aid out at all time. I was asked if I would deal with a minor accident which had happened in store.
The duty manager explained to me what had happened:
“A young boy was walking on a small wall situated just outside one of the exits to the store, and has slipped of and bashed his face and head, his mother has bought him in and I would like you to have a look at him and let me know what you think”
At first I thought that this was a bit much for me but I felt confident that I could remember what I had learnt and the practical experiences I have had in the seminars. I went to the coffee shop where the young lad was and met the mother. I started talking to them both about who I was and what I was going to do. After the experience I realised that I was just following my training for always talking to the patient and making sure that they were kept informed, it seemed almost natural.
As I knew I was not legally covered I was very careful with what I did to make sure that there could be no come back on myself or the store. From my first impressions the young lad was quite distressed and I needed to calm him down. I looked at his face and noticed quite a lot of cuts and bruises which had quite a bit of blood and also, he had lost a tooth and had a severe nose bleed.
The wounds on his face had bits of gravel in and he looked a bit dazed. My first reaction was to try and stop his nose bleed and talk to the child about how he felt. From my observations and what the young boy was telling me, I recommended that he was taken him to casualty to make sure that there was nothing further wrong; I suspected that he may have had concussion. The mother agreed and I asked a colleague to call an ambulance. While waiting for the ambulance I kept the boy happy and tried to keep him calm and started to clean up the blood which was obviously not near any major cuts.
The ambulance came and took the mother and child and they thanked me before leaving. I had to assist the duty manager fill out the accident book and make sure all actions were recorded.
After the event I went for a drink and thought to myself what I have done seemed to be very natural and I was very surprised that I did it all so calmly and as though I had done it many times before.
I think that my practical training has been imperative but also that my theory has helped me to understand why signs and symptoms occur, and look forward to improving my skills and approach. It made me determined to stay up to date with my first aid training and decide that I wanted a job that was rewarding. It made me set out some goals; to go to university and study nursing, to learn more about what to do in such situations and to further my learning at every opportunity.
References
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Goodman (1984) cited in, Cottrell S (2003) The Study Skills Handbook, 2nd Edition. Houndmills, Palgrave Macmillan.
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Maslin – Prothero, Sian (2001) Balliere’s study skills for nurses, 2nd edition, Balliere Tindall.
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Reflective Practice in Nursing. The Growth of the Professional Practitioner. Oxford, Blackwell Scientific Publications
- The Code of Professional Conduct, (CPC)
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Walsh, Ian with Maslin – Prothero, Sian (2001) Balliere’s study skills for nurses Chapter 2: learning and learning skills, 2nd Edition, Balliere Tindall.
Appendices
Appendix 1
(Walsh et al)
Knowledge - This represents the progression starting from being able to remember straightforward facts, such as being able to label a diagram of the heart (simple recall or knowing what the various parts are). This is a useful starting point but it constitutes only a part of learning.
Comprehension - Being able to explain the function of the heart valves, or the reason why the muscle layer of the left ventricle is thicker than the right represents a higher level of learning – the ability to comprehend the concepts.
Application - Increasing to another level is being able to put your knowledge to use. For example, if you have a patient who has suffered damage to the left ventricle following a coronary thrombosis you will be able to plan nursing care that takes the patient’s impaired circulation into account.
Evaluation - By observing the effect of exercise on the patient, such as the degree of breathlessness after walking a prescribed distance, you will be able to evaluate the effect your plan has had on the patient’s heart. So learning is more than the mere acquisition of facts, it involves a range of intellectual activities.
Appendix 2
Gibbs’ Reflective Cycle
Kolb’s Learning Cycle
()
Appendix 3
- Word Processing Practice - Microsoft Word
Appendix 4
Search Strategy
I have used several search engines to look for relevant information to this question. Below is a list of my results.
There are too many results to search through them all so I need to try to make my search more specified. This time I shall search for learning methods related to nursing.
I already know some theories from previous courses. I shall also type in Gibbs learning cycle, Kolb’s reflective cycle, and Honey and Mumford, which will scale down the number of results I get.
In addition to this I shall use books and journals to back up my research and vary the source of my information.
