Tuesday, September 1, 2009

Reflecting on Regret and the Gibbs Reflective Cycle

Here is another entry from my previous blog which covers the topics of regret
and also presents my take on the Gibbs Reflective Cycle and how it can apply to
both nursing and ambulance work...

I wish I updated this blog on a regular basis. I wish I didn't drink so much last night. I wish I didn't treat my parents like dirt when I was younger. I wish I didn't attend that ambulance callout. I wish I could have saved that little boy's life...

I wish. I wish. I wish...

Unfortunately, life is full of things we wish we did or didn't do. It's full of regrets. Big regrets, and little regrets. I have a list as long as my arm. My regrets make me feel less confident about myself. They lower my self-esteem, like a bully - but more personal. When I think about them, I feel negative emotions, such as shame, guilt and helplessness. Some more than others.

Do you have regrets?

Why do we feel so terrible when we think about things we did wrong? I mean, everybody makes mistakes. Why should I feel terrible about the things I did, while other people sit in jail cells for doing way more unacceptable things? Is it to do with the way we were bought up by our parents or guardians? Perhaps. Is it because it keeps society in line with the morals and standards of the wider community? Maybe. Or is it a way to help us reflect on and evaluate past actions and experiences, and making them a negative memory in our minds so we don't readily repeat the same route we took previously? I believe this might be so.

Recently, I have been studying a process called 'Gibbs Reflective Cycle' in one of my units called Foundations of Nursing: Social, Indigenous & Cultural Perspectives. It is basically a list of steps to take after an experience - negative and positive - to better understand what you did, why you did it, and what you would do differently in the future. It is a great way to structure your thought process after a negative experience or even while thinking about a regret you have from the past. It not only prompts you to think and acknowledge your feelings, but helps you formulate an action plan for future similar experiences.

It has six components:

  • Description: What happened? Describe the event in detail.
  • Feelings: What were you thinking and feeling?
  • Evaluation: What was good and bad about the experience?
  • Analysis: What sense can you make of the situation? Break-down the components.
  • Conclusion: What else could have you done?
  • Action Plan: If the situation arose again, what would you do differently, or the same?

As you can see, it covers the whole range of thought processes, from what actually happened and how you felt, to what more you could have done and why.

This relates well to nursing and ambulance work, as you are faced with numerous new experiences and you cannot be expected to handle these 100% correctly all - or any - of the time. Also, you can be faced with some very traumatic incidents which need to be thoroughly thought about and dealt with. By answering the questions that the Gibbs Reflective Cycle probes, you can not only get a lot of conflicting thoughts out of your head, you can make more solid plans for future experiences so you are not continually making the same mistakes over and over.

An example of mine is the first ambulance callout where a sudden death occurred. It was about 23:30 hrs when the call came through and by the time I arrived in the ambulance with a Volunteer Ambulance Officer and a Volunteer driver, the gentleman involved was receiving CPR and advanced life support from the local Police Officers and the Remote Area Nurse. After determining that the man was asystolic and his pupils were dilated and fixed, the nurse - under the direction over the phone with a Doctor in the next town - pronounced life extinct at approximatly 00:00 hrs.

I knew the man who died, and I knew his distraught wife who had been with him for 40 years. It was 0330 hrs by the time I got home after assisting my colleagues with putting the man into a body bag, transporting him 70km to the closest morgue, having a coffee and making the trip back. It was quite the night.

At the innocent age of 18, the whole experience of sudden death was a foreign concept to me. Weeks after I felt quite confused as to why I was thinking the incident over and over an a daily basis. I also was full of "what ifs". What if we were quicker to respond? What if we had of tried for a little bit longer? I felt quite helpless in regards to where I could go from there. What actions could I take so I feel I'm actually making a difference relating to the incident?

If I had known about the Gibbs Reflective Cycle during this crucial debriefing period, I believe my 'cooling off' time would have been reduced, and I would have gotten more sleep at night. I not only would have thoroughly thought over the incident itself, I would have addressed my feelings during and after the job, thought about some of the good things that came of the incident (eg: gained valuable experience) - not just the bad and I would have formulated an action plan as to what I would do differently if a similar scenario arises - which is quite likely considering my line of work.

So regret is a natural response to a negative situation - whether you were the cause of the situation or merely witnessed it. It is a prompt for us to evaluate or 'mull over' our experiences and if done correctly, we can decrease our levels of regret, shame and guilt by creating a plan that we will always take with us in the future in the anticipation of a similar event taking place.

1 comment:

  1. Excellent post mate. Very reflective and insightful - thanks for sharing your story. Keep up the good work.