How to write a nursing reflection paper

Writing a nursing reflection paper is a valuable exercise that bridges theory and practice. It’s not just a summary of an event, but a deep analysis of your experience to improve your future practice.

Here’s a step-by-step guide, structured like a standard nursing reflection model.

The Goal: Why We Reflect

In nursing, reflection is a core competency. The goal is to move beyond simply describing what happened to analyzing why it happened, how you felt, what you learned, and most importantly, how you will act differently in the future. This demonstrates clinical growth, self-awareness, and a commitment to patient safety and quality care.

Step 1: Choose a Framework (The Backbone of Your Paper)

A reflective framework provides the structure for your paper. Using one ensures you don’t just tell a story but engage in critical analysis. The most common and effective in nursing is Gibbs’ Reflective Cycle (1988) .

We will structure this guide using Gibbs’ Cycle. Other models exist (e.g., Johns, Driscoll), but Gibbs is excellent for beginners as it’s clear and cyclical.

Step 2: Structure Your Paper Using Gibbs’ Cycle

Here is how to structure your paper, section by section.

Introduction (Brief)

• State the purpose of the paper: “This reflection will use Gibbs’ Reflective Cycle to analyze a clinical experience involving [briefly state the situation, e.g., ‘managing a post-operative patient’s acute pain’].”
• Assure the reader of confidentiality: “All patient identifiers have been changed to maintain anonymity.”

1. Description (What happened?)

• Purpose: To set the scene. This section should be factual and objective. Keep it concise.
• Questions to answer:
  • What happened? What did you see, do, or hear?
  • Who was involved (patient, family, nurse, doctor)?
  • Where and when did it happen?
  • What was the outcome?
• Key Tip: Do not include any analysis or judgment here. Just state the facts.

2. Feelings (What were you thinking and feeling?)

• Purpose: To explore the emotional dimension of the experience. This is crucial for understanding your internal responses and biases.
• Questions to answer:
  • What were you feeling before the situation?
  • How did you feel during the event? (e.g., anxious, confident, overwhelmed, frustrated, empathetic)
  • How did you feel after it was over?
  • What were you thinking at the time?
• Key Tip: Be honest. This is for your growth. Acknowledging difficult feelings like fear or frustration is a sign of self-awareness, not weakness.

3. Evaluation (What was good and bad about the experience?)

• Purpose: To make an objective judgment about the experience. Separate the positive from the negative.
• Questions to answer:
  • What went well? (e.g., “I established good rapport with the patient,” “I correctly followed the protocol for vital signs.”)
  • What went poorly or could have been improved? (e.g., “I hesitated to call the doctor,” “I didn’t know how to use the new infusion pump.”)
  • What was your contribution to the outcome?
  • What was the contribution of others (patient, staff)?
• Key Tip: Be balanced. Acknowledge your successes and your areas for improvement.

4. Analysis (What sense can you make of the situation?)

• Purpose: This is the core of the paper. Here, you connect your experience to nursing theory, evidence-based practice, and professional knowledge. This section demonstrates your clinical reasoning.
• Questions to answer:
  • Connect to Theory: What nursing theories, models, or principles apply? (e.g., Maslow’s Hierarchy of Needs, pain management theories, communication models like the Therapeutic Relationship).
  • Connect to Evidence: What does the literature say? Refer to your textbooks or journal articles. (e.g., “Research by Smith (2020) suggests that post-operative pain is often under-assessed. In my case, I used the numeric pain scale, but perhaps a behavioral assessment would have been more appropriate for this patient…”)
  • Break it down: Why did the good things happen? Why did the bad things happen?
  • Ethical/Legal Aspects: Consider consent, patient dignity, confidentiality, and your professional code of conduct (e.g., NMC Code or ANA Code of Ethics).
• Key Tip: Use references! This is what elevates your paper from a story to an academic reflection.

5. Conclusion (What else could you have done?)

• Purpose: To summarize what you’ve learned from the analysis. This is a summary, not new information.
• Questions to answer:
  • What have you learned about yourself as a nurse?
  • What have you learned about your clinical practice?
  • What could you have done differently to achieve a better outcome?
  • What is the single most important takeaway?

6. Action Plan (If it arose again, what would you do?)

• Purpose: The most critical section for professional development. It shows how this experience will change your future practice.
• Questions to answer:
  • What specific steps will you take to improve?
  • If a similar situation occurs, what will you do the same? What will you do differently?
  • What do you need to learn? (e.g., “I will attend the IV cannulation workshop,” “I will review the hospital’s policy on falls prevention,” “I will practice using the SBAR communication tool.”)
  • How will you evaluate if your change was successful?

Conclusion of Paper (Brief)

• A short paragraph summarizing your overall learning journey from this experience.

Step 3: Writing Style and Key Principles

1. Use the First Person: This is a personal reflection. It’s appropriate to use “I,” “me,” and “my.” (e.g., “I felt anxious,” “My assessment revealed…”)
2. Maintain Confidentiality: This is non-negotiable. Never use real names, hospital names, or any identifying details. Use pseudonyms like “Mr. Jones” or describe the patient as “a 78-year-old male post-hip replacement.”
3. Be Critical, Not Descriptive: Avoid the “diary-style” trap. Instead of saying “First I did this, then I did that,” focus on the why. For every sentence that describes an action, try to have a sentence that analyzes it.
   • Descriptive: “I took the patient’s blood pressure, and it was high.”
   • Reflective: “I took the patient’s blood pressure and found it to be elevated. At the time, I wondered if this was due to pain or anxiety. In hindsight, I should have reassessed it after administering the prescribed analgesic, as pain is a known cause of hypertension.”
4. Integrate References: Support your analysis with evidence. This shows you are an evidence-based practitioner. Use a formal referencing style as required by your institution (e.g., APA, Harvard).

Step 4: A Simple Example (Analysis Section)

Let’s say you’re reflecting on a time you had to break bad news to a family.

Weak (Descriptive) Analysis:

“I told the family that the patient’s condition was deteriorating. They started to cry. I didn’t know what to say, so I just stood there. My mentor came in and sat with them. I felt bad that I didn’t know how to handle it.”

Strong (Reflective) Analysis:

“This experience highlighted a significant gap in my communication skills regarding the delivery of distressing news. My initial response was to stand silently, which may have been perceived as a lack of empathy. In contrast, my mentor utilized the principles of the SPIKES protocol (Baile et al., 2000), a framework for breaking bad news. She sat down, a non-verbal cue that conveyed presence and time, and used silence therapeutically, allowing the family to process the information. According to the NMC Code (2018) , we must ‘communicate clearly and sensitively’ (p. 5). My actions did not fully meet this standard. I recognize that my avoidance stemmed from a lack of confidence, not a lack of compassion. This experience demonstrates that effective communication in crisis is a learned skill that requires structured frameworks and practice.”

Common Mistakes to Avoid

• Just describing the shift: This is a diary, not a reflection.
• Being overly negative: It’s okay to discuss mistakes, but the focus must be on what you learned and how you’ll improve. Avoid self-flagellation.
• No action plan: The paper will feel incomplete if you don’t state how you’ll change.
• Ignoring feelings: Reflection is about the whole experience, including your emotions. Ignoring them makes the analysis superficial.
• No references: This makes the paper an opinion piece, not an academic or professional work.

By following this structure and using a model like Gibbs’, you can write a nursing reflection paper that demonstrates your clinical reasoning, self-awareness, and commitment to becoming a better nurse.