Reflection in Action Paper

Reflection in Action Paper

Reflective practice in nursing is a profound aspect that enables nurses to learn from past experiences to improve care quality. According to Patel & Metersky (2021), reflective practice also entails individual awareness of values, beliefs, and practices that allow nurses to utilize insights from experiences to improve patient health outcomes. Therefore, reflecting on experiences and demonstrating awareness of beliefs, values, and practices are central to professional growth and development. This reflection in-action paper elaborates on experiences, thoughts, feelings, and learning moments from the course. It focuses on various topics, including thoughts on evidence-based practice, evidence supporting Jean Watson’s Theory of Human Caring, ethics in research, protecting human subjects, and lessons learned while conducting an evidence-based literature review.

Thoughts on Evidence-Based Practice

Learning moments and activities from this course emphasized the need to utilize internal and external evidence to answer clinical questions and inform care decisions. The competency of utilizing internal and external evidence to improve care practices and decisions underpins evidence-based practice. According to Li, Cao & Zhu (2019), evidence-based practice (EBP) entails applying the best available evidence to improve care efficiency and effectiveness, alongside improving the decision-making process. Amidst the need to provide safe, patient-centered, and quality care, evidence-based practice emerges as a profound strategy for preventing errors and making decisions based on available evidence. Also, it allows nurses to establish the relationships between available evidence, knowledge and skills, and patient’s health needs and priorities. These aspects are central to enhanced patient safety, satisfaction, and health outcomes.

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Evidence Supporting Jean Watson’s Theory of Human Caring

In this course, learners evaluated the evidence that supports Jean Watson’s Theory of Human Caring and explored its application in different clinical contexts. Although healthcare professionals should comply with systematic protocols and standards of practice, Watson’s Human Caring theory emphasizes the need to shift from conventional nursing approaches to humanistic dimensions that will allow healthcare professionals to establish meaningful relationships with patients and cultivate an ideal healing environment. Wei & Watson (2018) contend that Watson’s theory emphasizes “The Ten Caritas Processes,” which include practicing love and kindness to others, enabling faith and hope, cultivating trusting Interpersonal caring relationships, showing empathy to others, and fostering one’s spiritual practices. Also, the theory establishes the need to engage in genuine teaching-learning experiences, valuing humanity, and cultivating a caring-healing environment (Wei & Watson, 2018). These “Caritas Processes” are consistent with the need to provide dignified social and spiritual support to patients grappling with different healthcare issues.

Various studies recommend the application of Watson’s Theory of Human Caring in caring for patients with life-threatening conditions. Castello (2018) argues that Watson’s “Caritas Processes” can apply in oncology nursing since they allow healthcare professionals to understand self-spirituality, engage patients in care modalities, initiate spiritual assessment, and pay attention to patients’ perceptions of comfort. Yangoz & Özer (2019) argue that Watson’s theory can improve adherence to treatment among hemodialysis patients. In this case, healthcare professionals can instill faith and hope, allow patients to express feelings and thoughts regarding treatment options, create a physically, emotionally, and spiritually comfortable and healing environment, and align care interventions with patients’ needs and preferences (Yangoz & Özer, 2019). These aspects are central to eliminating fear, uncertainty, and misconceptions that affect treatment adherence.

Ethics in Research

Another profound learning activity from this course was exploring the ethical underpinnings that guide nursing research endeavors. While research endeavors seek to answer clinical questions and inform decisions, it is evident that researchers need to strictly comply with various ethical standards to safeguard participants’ safety, avoid manipulating subjects, and improve the credibility, relevance, and generalizability of the findings. According to Resnik (2020), ethical standards in research that cut across disciplines like nursing, psychology, and sociology include honesty, objectivity, carefulness, integrity, transparency, accountability, and confidentiality. In this case, researchers are responsible for ensuring honest and open scientific communication, avoiding falsifying or fabricating data, minimizing bias or self-deception, keeping their promises and agreements, and avoiding errors or incidences of professional negligence.

Other ethical obligations for researchers include openness to criticism, transparent disclosure of information by obtaining informed consent, taking responsibility for their roles in research activities, protecting participants’ data, and ensuring responsible information dissemination (Resnik, 2020). Finally, researchers should strive to protect human subjects by minimizing risks and harms, adopting precautionary measures when dealing with vulnerable populations like children, and respecting human dignity. These aspects are consistent with the need to uphold the four bioethical principles: autonomy, beneficence, non-maleficence, and justice.

Protecting Human Subjects in Quality Improvement or Evidence-Based Projects

One of the profound learning activities for this course was to explore various concepts of human subjects’ protection, including the historical background, steps to minimize risks to human subjects, characteristics of vulnerable populations, and appropriate ways of recruiting subjects. Also, learners identified elements of valid consent and the committees responsible for monitoring the protection of human subjects. Throughout the learning activity, it was evident that children (minors), pregnant women, people with diminished mental capacity, and incarcerated people are vulnerable since they are often incapable of making informed decisions or providing consent. Further, they may not understand the components of informed consent. Therefore, researchers should protect these susceptible populations to prevent manipulative behaviors and acts.

Some evidence-based interventions for protecting human subjects include obtaining informed consent, practicing appropriate data collection and storage to prevent data privacy violations, appropriately recruiting them in research activities, planning for unexpected events during research, and avoiding coercive or deceptive acts like tricking or forcing them to participate in research (Buchanan, 2023). The failure to protect human subjects may lead to disapproval of biomedical research by International Review Boards (IRBs) and lawsuits.

Lessons Learned While Conducting Evidence-based Literature Review

This course gave learners an ideal opportunity to understand the intricacies and thresholds for conducting an evidence-based literature review. While reviewing literature underpins evidence-based practice, researchers should understand the steps for comprehensive literature review processes. For instance, the learned lessons from literature review practices include the need to determine the research question (through the PICO(T) format), the requirement to determine inclusion or exclusion criteria for ideal evidence sources, correctly identifying databases that publish potential evidence sources, and awareness of various literature search strategy, including leveraging keywords and subtitles (Snyder, 2019). Further, researchers should know strategies for reviewing results, synthesizing information, analyzing information from the reviewed evidence, and writing a comprehensive literature review. In this case, the compiled literature review should be consistent with the clinical question or topic of exploration, precise, relevant, original (free from plagiarism), and objective to avoid ambiguity.

Conclusion

This reflective paper focuses on various topics that formed the basis of this course. These topics include evidence-based practice, Jean Watson’s Theory of Human Caring, ethics in research, protecting human subjects in evidence-based projects, and conducting evidence-based literature reviews. Learners can extract meaning and lessons from different topics by reflecting on this course’s learning activities and moments. Subsequently, they can apply the learned lessons from the course to improve care quality and patient outcomes in their current and future practices.

References

Buchanan, D. (2023). How can a researcher minimize causing harm when conducting interviews with particularly vulnerable children in longitudinal research? Children & Society. https://doi.org/10.1111/chso.12704

Costello, M. (2018). Watson’s Caritas Processes® as a framework for spiritual end-of-life care for oncology patients. International Journal of Caring Sciences, 11(2), 2. http://www.internationaljournalofcaringsciences.org/docs/1_costello_special_10_2.pdf

Patel, K. M., & Metersky, K. (2021). Reflective practice in nursing: A concept analysis. International Journal of Nursing Knowledge, 33(3), 180–187. https://doi.org/10.1111/2047-3095.12350

Resnik, D. (2020, December 23). What is ethics in research & why is it important? National Institute of Environmental Health Sciences. https://www.niehs.nih.gov/research/resources/bioethics/whatis/index.cfm

Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of Business Research, 104(1), 333–339. https://doi.org/10.1016/j.jbusres.2019.07.039

Wei, H., & Watson, J. (2019). Healthcare interprofessional team members’ perspectives on human caring: A directed content analysis study. International Journal of Nursing Sciences, 6(1), 17–23. https://doi.org/10.1016/j.ijnss.2018.12.001

YANGOZ, Ş. T., & ÖZER, Z. (2020). Nursing approach based on Watson’s theory of human caring in treatment adherence in hemodialysis patients. Bezmialem Science, 8(2), 189–195. https://doi.org/10.14235/bas.galenos.2019.3546

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The purpose of Reflection-in-Action is to reflect upon what one has learned or how one has performed as compared with one’s expectations or goals. This assignment will provide an opportunity for students to share their experiences, thoughts, feelings and learning moments from this course.

Self understanding through reflection on life experiences, feelings, etc., is a core concept in Dr. Jean Watson’s Theory of Human Caring.

The Reflection for this course must address at least three (3) of the following topics:

• Learning moments or activities from this course
• Thoughts on evidence-based practice
• Evidence supporting Jean Watson’s Theory of Human Caring
• Ethics in research
• Protecting human subjects in quality improvement or evidence-based practice projects
• Understanding or comfort level with statistics in nursing research and other research reports
• Perception of MSN graduates’ role in nursing research
• Creating and sustaining an Evidence-Based nursing environment
• Asking compelling, clinical questions
• Lessons learned while conducting evidence-based literature review