PROFESSIONAL DEVELOPMENT
Reflection: from staff nurse to nurse consultant
Part 7: Reflective management John Fowler
What is your management role? Many readers of BJN will have the word ‘manager’ in their job title, such as ward manager or unit manager. For others, management will be an implicit part of their role.This is true of the staff nurse, clinical nurse specialist, nurse consultant and nursing lecturer. Whatever our title and role, our status as registered nurses means that we are responsible for managing ourselves, other people, our patients and a number of other valuable resources.To what extent do you think about and reflect on your management responsibilities and decisions? Nurses are becoming more familiar with the practice of reflection as it affects direct clinical care, but are we are becoming reflective managers?
Reflective management process Reflection, as we have discussed in previous articles, involves taking time out to examine what we are doing, why we are doing it and what the implications are for ourselves and others. There are three important stages to consider when attempting to build reflection into your management role. This process is about taking time and energy to reflect on what you are going to do before you do it, then reflect on what is happening when you are doing it, and finally reflect on the events after they have occurred. If you are beginning to think that you are too busy for all this reflection and you haven’t the energy to put into the reflective process, then believe me I do understand and accept your busyness. However, consider your role as a manager; management is essentially helping other people and yourself to work smarter, not harder, and in
492
today’s health service it is about achieving more with less. Reflective management can help you to do that.
Reflection before action Management is about assessing and planning, it is not about jumping in without thinking. So, the first stage in the reflective management process occurs before you do anything. Think about what needs to be done and why. What are the key objectives and how can those be achieved? If there are various options that will achieve a similar outcome, think through the implications of each option. If you are like me you will want to write a list; lists help clarify issues and are a great reflective tool. Having identified what you need to do, think through what the implications will be for other people—put yourself in their shoes and imagine how they will feel. Finally, think through and identify how you will deal with the people involved. This is where management and leadership overlap. As a leader you want to draw people together and take them forward. Reflect on how you will do this before you jump in with your management action.
Reflection during action Reflecting on what you are doing, while you are doing it, is one of the more difficult skills of reflection. It requires you to be aware of and responsive to feedback from numerous sources, while you are concentrating on actually implementing the action. It is the mark of an advanced reflective practitioner. Consider the following scenario: you are the ward manager and are allocating work in your team for the morning shift. You have already reflected beforehand on the skills of your team, the needs of the patients, the ward routines and other key tasks and have identified which staff are best suited for particular duties. During the morning briefing you begin allocating staff and you become aware—but can’t quite identify why—that one of your healthcare assistants (HCAs) is not quite her usual self in the way she is responding.Your ability to reflect during your action allows you to first recognise
that something is not quite right, then your reflection gives you some very quick options: do you ignore the feelings you have and just dismiss the briefing, do you ask the HCA if everything is OK, or do you have a private word with her outside the briefing? A manager who doesn’t reflect during action will not even have noticed that something was amiss.
Reflection after action Once you have carried out a management action you then need to take a little time out to reflect on what has happened as a result. It will be a rare management plan that achieves exactly what was intended and you will need to reflect on and examine to what extent your outcomes were achieved.You will need to identify if there were any unintended casualties from your actions and if so, how will you deal with those people. You will need to identify if there were important objectives that have not been achieved and if not, why not? How will you take those outcomes forward? Finally, you need to spend time looking at yourself. What did you do well? What can you learn from this action that you can use to become a better manager in the future? Remember what was said earlier: reflective management is about helping ourselves and others to work smarter, not necessarily harder. Reflection is about learning how to work smarter and more efficiently; it is time and BJN energy well spent. Dr John Fowler is a general and mental health nurse. He has worked as an Educational Consultant to primary care trusts and as a Principal Lecturer in Nursing for many years. He has published widely on educational and professional topics and is series editor of the Fundamental Aspects of Nursing Series and the Nurse Survival Guide Series for Quay Books
© 2014 MA Healthcare Ltd
T
his series is exploring what reflection is and how it can be applied to your clinical practice. The previous articles have examined the importance of reflection, ways to aid reflection, its relationship to feedback, reflective practice and reflective teaching. This article is looking at how you, the clinically based nurse, can use reflection to enhance your management role.
British Journal of Nursing, 2014, Vol 23, No 9
British Journal of Nursing. Downloaded from magonlinelibrary.com by 138.253.100.121 on December 4, 2015. For personal use only. No other uses without permission. . All rights reserved.
Reflection: from staff nurse to nurse consultant
Part 7: Reflective management John Fowler
What is your management role? Many readers of BJN will have the word ‘manager’ in their job title, such as ward manager or unit manager. For others, management will be an implicit part of their role.This is true of the staff nurse, clinical nurse specialist, nurse consultant and nursing lecturer. Whatever our title and role, our status as registered nurses means that we are responsible for managing ourselves, other people, our patients and a number of other valuable resources.To what extent do you think about and reflect on your management responsibilities and decisions? Nurses are becoming more familiar with the practice of reflection as it affects direct clinical care, but are we are becoming reflective managers?
Reflective management process Reflection, as we have discussed in previous articles, involves taking time out to examine what we are doing, why we are doing it and what the implications are for ourselves and others. There are three important stages to consider when attempting to build reflection into your management role. This process is about taking time and energy to reflect on what you are going to do before you do it, then reflect on what is happening when you are doing it, and finally reflect on the events after they have occurred. If you are beginning to think that you are too busy for all this reflection and you haven’t the energy to put into the reflective process, then believe me I do understand and accept your busyness. However, consider your role as a manager; management is essentially helping other people and yourself to work smarter, not harder, and in
492
today’s health service it is about achieving more with less. Reflective management can help you to do that.
Reflection before action Management is about assessing and planning, it is not about jumping in without thinking. So, the first stage in the reflective management process occurs before you do anything. Think about what needs to be done and why. What are the key objectives and how can those be achieved? If there are various options that will achieve a similar outcome, think through the implications of each option. If you are like me you will want to write a list; lists help clarify issues and are a great reflective tool. Having identified what you need to do, think through what the implications will be for other people—put yourself in their shoes and imagine how they will feel. Finally, think through and identify how you will deal with the people involved. This is where management and leadership overlap. As a leader you want to draw people together and take them forward. Reflect on how you will do this before you jump in with your management action.
Reflection during action Reflecting on what you are doing, while you are doing it, is one of the more difficult skills of reflection. It requires you to be aware of and responsive to feedback from numerous sources, while you are concentrating on actually implementing the action. It is the mark of an advanced reflective practitioner. Consider the following scenario: you are the ward manager and are allocating work in your team for the morning shift. You have already reflected beforehand on the skills of your team, the needs of the patients, the ward routines and other key tasks and have identified which staff are best suited for particular duties. During the morning briefing you begin allocating staff and you become aware—but can’t quite identify why—that one of your healthcare assistants (HCAs) is not quite her usual self in the way she is responding.Your ability to reflect during your action allows you to first recognise
that something is not quite right, then your reflection gives you some very quick options: do you ignore the feelings you have and just dismiss the briefing, do you ask the HCA if everything is OK, or do you have a private word with her outside the briefing? A manager who doesn’t reflect during action will not even have noticed that something was amiss.
Reflection after action Once you have carried out a management action you then need to take a little time out to reflect on what has happened as a result. It will be a rare management plan that achieves exactly what was intended and you will need to reflect on and examine to what extent your outcomes were achieved.You will need to identify if there were any unintended casualties from your actions and if so, how will you deal with those people. You will need to identify if there were important objectives that have not been achieved and if not, why not? How will you take those outcomes forward? Finally, you need to spend time looking at yourself. What did you do well? What can you learn from this action that you can use to become a better manager in the future? Remember what was said earlier: reflective management is about helping ourselves and others to work smarter, not necessarily harder. Reflection is about learning how to work smarter and more efficiently; it is time and BJN energy well spent. Dr John Fowler is a general and mental health nurse. He has worked as an Educational Consultant to primary care trusts and as a Principal Lecturer in Nursing for many years. He has published widely on educational and professional topics and is series editor of the Fundamental Aspects of Nursing Series and the Nurse Survival Guide Series for Quay Books
© 2014 MA Healthcare Ltd
T
his series is exploring what reflection is and how it can be applied to your clinical practice. The previous articles have examined the importance of reflection, ways to aid reflection, its relationship to feedback, reflective practice and reflective teaching. This article is looking at how you, the clinically based nurse, can use reflection to enhance your management role.
British Journal of Nursing, 2014, Vol 23, No 9
British Journal of Nursing. Downloaded from magonlinelibrary.com by 138.253.100.121 on December 4, 2015. For personal use only. No other uses without permission. . All rights reserved.
