Registered Nurses' Perceptions of Reflection as a Process for Exploring Experience

Reflection is required by Registered Nurses to maintain registration with the Nursing and Midwifery Council of the United Kingdom but the structured mechanisms through which this happens officially do not necessarily foster reflection in practice. This research aims to explore Registered Nurses’ (RN) perceptions of reflection with a particular focus on exploring, learning from and sharing workplace experiences. Using an approach which combined an interpretative phenomenological approach with aspects of narrative methodology, it addresses three questions: How do RNs perceive reflection? What are the features of shared reflection? And how might opportunities for sharing experience provide contexts for reflection? A particular focus here was reflection as a collective, rather than an individualised, activity. The participants were 22 RNs with varying numbers of years and levels of work experience following registration. Qualitative data were collected using audio recordings, field notes and memos from four focus groups, seven follow-up interviews and five individual interviews. The recordings were analysed using the double-listening method which led to constant comparative and iterations of narrative analysis to produce codes, categories and themes. Four overarching themes were identified: perceptions of reflection; the significance of emotions to reflection; confidence, self-deprecation and humour in RN’s accounts and belonging. The findings suggest that, contrary to common recommendations on reflection in nursing practice, it is possible for nurses to benefit from reflecting on each other’s practice, rather than just their own. The findings also demonstrate an emotional, embodied component to reflection that can create and sustain a sense of belonging through sharing stories during reflective conversations. It is argued therefore that sharing stories can form part of the collective reflective practice of nursing, and that collective reflective practice has potential to sustain and develop communities of reflective nursing practice and shared confidence in practice. These conclusions lead to two recommendations. First, experienced nurses should have opportunities to consider their perceptions of reflection as an activity that supports the reflective practice of nursing. Secondly, registered nurses would benefit from sharing reflective stories about their practice to sustain and further develop collective reflective nursing practice.