Becoming a Reflective Practitioner, 6th Edition

CHAPTER 18Guiding Trudy

Christopher Johns

Insights shift the way we perceive and respond to practice

Trudy Smith is a district nurse. She shared her experience of working with Catherine and Gary in guided reflection with me over six consecutive clinical supervision sessions.¹ The narrative illustrates the idea of reflexivity – how insights from one session feed the next session, and how insights create dilemmas as how best to act. The text also illuminates Trudy’s growth as a reflective practitioner and how she becomes more aware and sensitive to her practice.

Session 1

Trudy read from her reflective diary:

Catherine is a 47‐year‐old woman with cancer in her bowel and peritoneal secondaries. She has a colostomy. Her husband called the clinic at 17.45, requesting me to visit. The message was ‘wife unwell/colostomy blocked?’ It was taken by another nurse. My dilemma was – do I visit now or do I refer to the evening nurse? I left it to the evening nurse. I rationalised this by thinking that it would be good for her to make Catherine’s acquaintance. On my way home I pass nearby this family’s house. I was feeling guilty that I had not responded personally, so I popped in. The curtains were drawn upstairs. Catherine was blind, confused, she had ‘gone off her legs’. She was lying in the bathroom. I helped to move her onto the bed and she then commenced fitting. Her two sons who were present could not cope with this. They fled. Her husband was shocked. She was fitting for about ...