STUDENT & NEWGRADUATE FOCUS 31
Protecting reflective time INMO student and new graduate officer, Neal Donohue , discusses the critical role of reflected practice in nurse and midwife education
test hypotheses in future situations and ultimately enhance practice. This process of learning is widely accepted as the basis for development of any profession and is a vehicle for innovation and change. Effective use of protected reflective time Many students say that protected reflective time (PRT) provides a great opportunity to enhance their knowledge on clinical skills and on medication man- agement and pharmacology. For example, where they are supporting or shadowing a registered nurse/midwife on the medica- tions round the task must be completed within prescribed times, and the registered nurse/midwife may, therefore, not have sufficient time to teach students. PRT provides the student with the perfect opportunity to reflect on the experience of medications management, reflect on the knowledge they have gained, and do some background research into the desired effects, side effects, and considera- tions before and after the prescription and administering of medications. This enhances the student’s understanding of the patient/ service users’ experience of an illness/con- dition and its treatment. It also helps them to conceptualise the plan of care for an individual. Developing skilled reflection will enhance the student’s experiential learning and lead to enhanced care practices. Students must maintain a personal portfolio of learning to support and record the development of their reflective practice and development of competence. Management of PRT Under the NMBI Nursing/Midwifery Registration Programmes Standards and Requirements time equivalent to a min- imum of four hours per week should be allocated to supernumerary students during placement. A minimum of four hours should also be allocated to intern- ship students in order to enhance the
Clinical practice experience is an integral component of the undergraduate nurs- ing and midwifery programmes. Students should be afforded varied quality learn- ing opportunities at all levels in order to progress in becoming a competent and confident practitioner. One of the aims of the NMBI Code of Professional Conduct and Ethics is to support and guide nurses and midwives in their ethical and clinical decision making, their ongoing reflection and professional self-development. Nurses and midwives must be pro- active in identifying areas where they require improvements in their scope and quality of practice since they have a man- date to provide the highest standards of evidence-based practice under NMBI regu- lations and under the Nurses and Midwives Act 2011. One of the ways nurses and midwives ensure they provide the highest standards of practice is through reflecting on their day-to-day practice to consoli- date theory and practice. This is also an essential component of any undergradu- ate programme and must be supported by Higher Education Institutions (HEIs) and Associated Healthcare Providers (AHPs). The Nurse Education Forum 2000 rec- ommended that within the clinical learning environment there should be agreed effec- tive ways to maximise the opportunity for students to reflect on and learn from their clinical experience. For the purposes of consolidating theory and practice, stu- dents must develop a capacity to gain understanding of nursing and midwifery issues through observation, analysing, and critically contextualising aspects of practice. Kolb’s cycle of learning demon- strates a continuum whereby a person learns through the progression of four stages. Learning commences with an expe- rience, is supported by reflection, leading on to forming concepts and conclusions. This enhances the learner’s capacity to
consolidation of theory to practice. For internship students their contract of employment sets out the allocation of PRT as four hours per week. This is also compre- hended by HSE HR Circular 030 – 2009. In 2014 it was agreed by unions and the HSE under the auspices of the Labour Rela- tions Commission (C-140721-13) that “four hours reflective time constitutes a prede- termined and scheduled block outside of the 35 hour per week clinical roster”. It is imperative that the four hours PRT is allocated in a manner that supports the student in achieving exactly what was envisaged by the Nurse Education Forum 2000 and adheres to the standards of practice in learning for professional grades. Student learning must be supported by the opportunity to reflect on experiences that are specific to the profession or disci- pline and must have inherent value to the student in achieving their required level of academic progression and professional development. Any HEI or AHP that does not support students by allocating protected time for reflective practice is in breach of the NMBI Nurse/Midwife Registration Programmes Standards and Requirements and a breach of the LRC agreement. Failure to pro- vide internship students with PRT is also potentially a breach of their contract of employment and an unacceptable failure to adhere to HSE HR directives. Where an employer or a HEI does not support the allocation of PRT in the spirit in which it was intended, it constitutes an undermin- ing and degrading of nursing and midwifery professional standards that cannot be accepted. Neal Donohue is the INMO’s student and new graduate officer. If you have a question about the above article or need support or further information, you can contact him at email: neal.donohue@inmo.ie or atTel: 01 6640628 References and source material available on request from nursing@medmedia.ie (Quote Donohue WIN 27(9): 31)
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