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DEC 01/2015

How to write a reflective account

Definition of ‘Reflect’: To think, meditate, or ponder. 
As part of your revalidation application, you will be required to provide five reflective accounts and complete one reflective discussion.
Why do I need to evidence reflective accounts?
The reflective requirement of the process encourages you as a nurse (or midwife) to reflect on your practice so that it is easier to identify changes or improvements on your practice or on what you have learnt. You will also need to evidence that you have thought about how this relates to the Code and document this as part of your reflective account.
What can I produce a reflective account on?
As long as it relates to your practice as a nurse, you can reflect on it.
Here are some examples of what you can use: Training (CPD), an event or experience in practice and feedback that you have collected about yourself or the team you are part of (verbal, written, formal or informal).
One thing to remember is to not provide any details that may easily identify an individual, service user or patient especially if the event is out of the norm. I would also recommend that you don’t use exact dates, again for the same reasons. Instead, as an example I would simply use MONTH/YEAR.
How to complete a reflective account:
The good news is that there are many ways to create a reflective account and it could be online or hand written. As an example, Medacs Healthcare nursing agency has issued agency nurses with a free RCNi Portfolio. The account allows nurses to type up reflective accounts into an NMC approved format.
Here are the recommended steps to take when writing a reflective account:
  • ‘Title’ – make it easily recognisable and descriptive;
  • ‘Date’ – as previously stated, if it could identify a patient, just use MONTH/DATE;
  • ‘What was the nature of the CPD activity/ practice-related feedback?’ – This is where you set the scene – what happened or what did you attend;
  • ‘What did you learn from the CPD activity and/or feedback?’ – After you attended the CPD or the event took place, what do you feel that you learnt from the experience;
  • ‘How did you change or improve your work as a result?’ Try to keep emotions out of your response. State what could be done to avoid or improve similar situations in the future. Remember, It does not have to be a criticism, it could be positive. 
  • How is this relevant to the Code? - The final part is to explain how you believe this relates to the Code - Prioritise people, Practice effectively, Preserve Safety and Promote professionalism and trust. This doesn’t need to be an essay and your reflective account could relate to all four, or just the one, but it’s important to explain how. 
Here are some examples of statements that could be used depending on the situation:
Recognising that you could improve: 
“To avoid similar situations, I will ensure that I always double check the drug administration documentation before I issue the prescription to the patient.”
Observing a positive action of your own: 
“I believe that in this situation I followed the nursing Code and correctly administrated the right prescription drug. I will continue to practice at this standard.”
When an event occurred from no wrongdoing of your own: 
“I recognise that I could not have known of the outcome of this situation. All documentation and practice was correctly administered to the patient, however, the situation had a huge impact on me emotionally, therefore I will look to find another NMC registered nurse who I can talk to about my feelings should events like this ever occur again.” 
That’s it! Much of the feedback I’ve received as part of the reflective accounts is that ‘it’s something that we already do on a daily basis, it’s just writing it down’. 
The next step:
Before you submit your revalidation application you will need to have a reflective discussion, about your accounts, with another NMC registered nurse. Once they are happy that you have correctly recorded and reflected your five pieces, they will sign a copy of the mandatory Reflective Discussion NMC form.
It’s important to note that you will not need to submit your reflective accounts as part of your revalidation application, however you do need to keep a record of them for future reference but also, should you be part of the NMC random sample asked to show their evidence.
I hope this help’s with writing your reflective accounts. For the next step please take a look at my article written on reflective discussions, appraisals and confirmation which you can find here. Good luck!
Written by Hayley Boulton
The Agency Nurse Revalidation Champion at Medacs Healthcare
Add me on LinkedIn for my latest blogs and articles
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