Teaching Manual Observations to Student Nurses

I wrote this reflection whilst on a third year placement using the REFLECT (Butcher and  Whysall). I like the layout of this reflection. You can find the Nursing Times article in which I found it here.Reflective

Reflective account: Teaching Manual Observations to Student Nurses (Dec 2017)
What was the nature of the CPD activity and/or practice-related feedback and/or event or experience in your practice?
R – RECALL the events (stage 1)

Give a brief overview of the situation upon which you are reflecting. This should consist of the facts – a description of what happened

The situation that I am reflecting upon was teaching the importance of evidence based practice and manual vital observations within children’s Nursing. I taught 2 first years and a third year on 3 separate occasions. In order to prepare for teaching them, I read through and printed off copies of the Royal College of Nursing’s “Standards for Assessing, Measuring and Monitoring Vital Signs in Infants, Children and Young People 2017”. The reason I used this publication is because it is the most up to date evidence based practice available. I started each session asking open ended questions around how and why we take vital signs. This allowed me to bring Evidence Based Practice into the conversation and gave me the opportunity to give each student nurse a copy of the guidelines. We then went into the child, introduced ourselves, cleaned our hands, explained what we were going to and gained consent and proceeded to do a full set of vital observations using manual techniques where possible. We did manual pulse readings, (focusing on rhythm, rate and depth,) manual respiration’s, in which we talked about the best place to stand to assess the properties of breathing (bilateral chest movement, rhythm, recession and accessory muscle usage) and how to do manual blood pressure readings using palpitation and stethoscope as well as the theory behind doing a Doppler as well as the importance of deflating the cuff between attempts. After that, we checked the child’s pain score before thanking the child and their relative and having a debrief outside in which we discussed what went well and what challenges we may have come up against.

E – EXAMINE your responses (stage 2)

Discuss your thoughts and actions at the time of the incident upon which you are reflecting

I feel I explained the reasoning behind evidence based practice well. We went to a quiet part of the ward to discuss the rationale behind manual observations so neither myself or the other student nurses could get distracted. I attempted to use positive reassurance when student nurses were not sure of the answers to questions and did my best to not make the student nurse feel silly during the conversation. Whilst in the child’s room, I tried my best not to come across as condescending and asked leading questions such as “where would you stand to assess this child’s breathing”. The debrief afterwards, I would focus on what went well and only briefly touched upon anything that did not go well. I would also double check manual observations that were uncharacteristically out of range or that a student nurse was not sure about, such as an irregular pulse rate. 

F – Acknowledge FEELINGS (stage 3)

Highlight any feelings you experienced at the time of the situation upon which you are reflecting

I really enjoyed the opportunity to teach other students. As an objective that was set by my mentors, I was able to prepare myself to give the short session by reading up on relevant guidelines and going through the theory under pinning the practice. I did my best to allow each student nurse time to think and speak without awkward silences and tried not to allow students to feel inadequate.

What did you learn from the CPD activity and/or feedback and/or event or experience in your practice?
L – LEARN from the experience (stage 4)

Highlight what you have learned from the situation

From the situation, I have learnt that in order to teach a topic well and thoroughly, ones must be able to understand and explain it in simple terms. I have also learnt that continually carrying a stethoscope is good practice to do full patient assessments as the guidelines state that a stethoscope should be used to auscultate the apex heart rate of children age less than two years old.

How did you change or improve your practice as a result?
E – EXPLORE options (stage 5)

Discuss options for the future if you were to encounter a similar situation

I will continue to carry around my stethoscope and have the guidelines downloaded to my phone in case the opportunity to teach student nurses arises again. It also has me considering perhaps going into a educational role in the future of my nursing career.

C – CREATE a plan of action (stage 6)

Create a plan for the future – this can be for future theoretical learning or action

In order for me to be prepared for a situation such as this in the future, I have to be keep up to date with the latest evidence based practice relevant to my field. This will help me to use evidence based practice through out my studies. I will also look for opportunities for learning on wards and within departments through out my career to pick up skills that I can then teach other nurses regardless of what stage they are at within their career.

T – Set TIMESCALE (stage 7)

Set a time by which the plan outlined in stage 6 will be complete]

This will be an ongoing action plan as learning continues through out my career.

How is this relevant to the Code?
Promote professionalism and trust, prioritise people, practise effectively.


(Dann Gooding – student nurse) 

One thought on “Teaching Manual Observations to Student Nurses

  1. Reblogged this on Daniel’s Diary and commented:

    I wrote this reflection whilst on a third year placement using the REFLECT (Butcher and Whysall) model. I remember this with fondness as I was able to effectively teach about manual observations using evidence based practice.


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