How to Write a Nursing Reflection

The incident that still bothers you is almost always the one worth writing about.

Reflective writing is embedded in nursing education and in continuing registration requirements, and it serves a genuine purpose: it converts experience into learning that can be examined and improved. It is also assessed against professional standards, which makes it different from ordinary academic reflection – what you write connects to a code of conduct, not just a marking rubric.

Choose an incident worth analysing

Students often choose events where they performed well, which limits the grade because there is little to examine. The productive choice is usually an incident that left you uncertain: a communication that went wrong, a decision you would now make differently, a moment when the protocol and the situation did not fit each other.

It does not need to be dramatic. A routine interaction that revealed an assumption you were carrying is often richer material than an emergency, because emergencies tend to be analysed in terms of procedure rather than judgement.

Protect confidentiality absolutely

This is a professional requirement, not a stylistic preference. Never use patient names, and avoid the combinations of detail – age, condition, ward, date – that would allow identification. Refer to “the patient” or a clearly stated pseudonym, and say that you have done so. The same applies to colleagues and to the organisation.

The NMC Code and your institution’s guidance both address this directly, and breaching it can have consequences well beyond the mark for the assignment. Where an incident cannot be described without identifying someone, choose another incident.

Use a model, and use it properly

Gibbs’ reflective cycle is the most widely used in nursing and works well because it forces you past description into analysis and action. Its six stages are description, feelings, evaluation, analysis, conclusion and action plan. Driscoll’s simpler what / so what / now what is common for shorter revalidation accounts.

Use the model as a structure for thinking rather than a set of headings to complete. The stages that carry the marks are analysis and action planning; description and feelings should be brief.

Give feelings their proper weight

Nursing reflection asks explicitly about emotional response, which many students find uncomfortable and handle by minimising it. Recording that you felt out of your depth, frustrated or upset is legitimate and analytically useful – emotional responses shape clinical decisions, and naming them is the first step to understanding how. Keep it factual rather than dramatic, and connect the feeling to what you did next.

Analyse with the literature and the standards

The analysis stage is where a reflective account becomes academic. Connect what happened to evidence and to professional expectations: what does the literature say about handover communication, about pain assessment in patients with dementia, about escalation when you are the most junior person present? Reference the NMC Code where a standard is relevant.

This is also where you examine your own assumptions. Why did you interpret the situation the way you did? What did you not ask? What would a more experienced colleague have noticed?

Make the action plan specific and achievable

Vague commitments are the most common weakness in reflective accounts. “I will communicate more effectively” is not assessable and will not change your practice. Concrete alternatives look like this:

• Use SBAR for every escalation call rather than only for emergencies.
• Ask one clarifying question before accepting a handover.
• Complete the trust’s dementia communication module within the month.
• Discuss the incident with my practice supervisor at the next meeting.

Two or three specific commitments are worth more than a longer list of intentions.

Watch the length and the register

Reflective accounts are usually short – often 500 to 1,500 words – which means description has to be efficient. A useful proportion is roughly a quarter describing and three quarters analysing and planning. Write in the first person, in the past tense for the incident and the present for your current understanding, and keep the tone professional: reflective does not mean informal, and your account may be read by an assessor, a supervisor or, in revalidation, a confirmer.

Reflection for revalidation

NMC revalidation requires five written reflective accounts covering practice, continuing professional development or feedback, along with a reflective discussion with another registrant. These are shorter and less formal than academic reflections, but the requirements are specific: each must relate to the Code and explain what you learned and how it changed your practice. Keep them as you go rather than assembling three years of reflection the month before the deadline, when the detail has gone.

Build a reflective habit

The nurses who write good reflections are usually the ones who make brief notes at the time rather than reconstructing incidents weeks later. A few lines at the end of a shift – what happened, what you felt, what you would change – takes two minutes and preserves the detail that makes analysis possible. It also spreads the work, so a reflective assignment becomes a matter of developing existing notes rather than starting from a blank page and a fading memory.

Keep contemporaneous notes

Reflection written months after an event is reconstruction, and it shows. A few lines at the end of a shift — what happened, what you felt, what you would change — preserves the specific detail that makes analysis possible. It also spreads the work, so a reflective assignment becomes a matter of developing notes rather than mining a fading memory.

Keep those notes anonymised from the outset, so nothing identifiable exists even in your private records.

Choose the model your programme expects

Gibbs is the most widely taught and its six stages suit assignment-length reflection. Driscoll’s three questions suit shorter revalidation accounts. Johns’ model prompts more explicitly on ethics and on knowing. Kolb underpins several of the others.

Where the brief names a model, use it. Where it does not, choose one and say why — an explicit rationale for the framework is itself evidence of reflective thinking.

Connect to professional standards precisely

A nursing reflection is assessed against a professional framework as well as an academic one. Reference the specific standard your incident engages — a particular section of the Code, a clinical guideline, a local policy — rather than gesturing at professionalism in general. Precision here distinguishes a reflective account from a personal essay.

Show clinical reasoning, not just feeling

Emotional response belongs in the account, but the marks concentrate on reasoning: what you noticed, what you inferred, what you decided and why. Making that chain visible is what demonstrates developing clinical judgement.

• What cues did I pick up, and which did I miss?
• What did I conclude from them, and was that justified?
• What alternatives did I consider and reject?
• What would have changed my decision?

Write about others carefully

Incidents frequently involve colleagues, sometimes ones who acted poorly. Describe behaviour and its consequences factually, without naming or characterising the person. Where an incident raises a genuine safety concern, the reflection is not the mechanism for raising it — follow your organisation’s escalation route, and say in the account that you did.

Close the loop on your action plan

The strongest reflections revisit earlier commitments. If a previous reflection produced an action plan, say whether you carried it out and what happened. That continuity demonstrates that reflection is changing your practice rather than being produced for assessment, which is precisely what the exercise exists to develop.