Writing reflective nursing essays: a practical guide

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Reflective nursing essays are a common nursing assignment where students critically examine their clinical experiences to draw lessons for future practice. In these essays, you reflect on personal encounters such as patient interactions, clinical decisions, or ethical dilemmas, and analyse them to demonstrate learning and growth. They require you to describe what happened and how you felt. You must also discuss what went well (and what could be improved), and explain what you learned from the situation. Reflective writing in nursing is more than a diary of events – it is an academic exercise that shows insight, emotional awareness, and commitment to professional development (Artioli et al., 2021).

Reflective essays help bridge the gap between theory and practice. They encourage you to connect classroom knowledge with real-world nursing care (Naber and Markley, 2017). This guide provides practical steps and tips to help nursing students excel in reflective essay assignments. It also introduces common reflective models and includes examples.

The purpose of reflective writing in nursing

Reflective practice is highly valued in nursing because it promotes continuous learning and improved patient care (Mantzoukas and Jasper, 2004). The Nursing and Midwifery Council (NMC) emphasises that reflection is essential for personal and professional development, helping nurses make sense of clinical situations and identify ways to enhance their practice (NMC, 2024). By writing reflectively, students learn to critically evaluate their own actions and decision-making. This process fosters critical thinking, self-awareness and better clinical judgement (Artioli et al., 2021).

For example, writing about a challenging experience (such as managing a confused patient or dealing with a medication error) forces you to think deeply about why events unfolded as they did. It also makes you examine how you felt and responded. Through this analysis, you may discover gaps in your knowledge or skills and then plan how to address them. Reflective writing also encourages the development of empathy. By examining your feelings and reactions, you become more attuned to patients’ perspectives and emotional needs (Artioli et al. 2021).

In short, reflective essays are not busywork – they are intended to make you a more thoughtful and effective nurse. This commitment to reflection continues beyond nursing school. Even registered nurses in the UK must produce five written reflections for NMC revalidation every three years, demonstrating what they learned from practice events and how it relates to the professional Code (NMC, 2018; Royal College of Nursing, 2016).

Key characteristics of a reflective nursing essay

A successful reflective nursing essay has several specific characteristics that distinguish it from other academic papers. These include:

Focus on a concrete experience:

Reflective assignments usually ask you to concentrate on a particular clinical incident or situation. It could be an event during placement. For instance, perhaps an encounter with a patient experiencing a mental health crisis, or observing an ethical dilemma in end-of-life care. You should clearly describe the context and the events in enough detail for the reader to understand what happened (Gibbs, 1988).

Personal perspective (first person):

It is appropriate – and often expected – to write in the first person (using “I”) in reflective essays, since you are discussing your own experiences and feelings. For example, “I felt anxious when the patient refused treatment…”. Using first person creates an authentic narrative voice and shows that you are taking ownership of your reflections.

Description, analysis and outcome:

A reflective essay is not just a narrative of what occurred. You must move beyond description into analysis. This means examining why things unfolded as they did, what consequences and meanings arose, and how you and others behaved. You should evaluate what went well (perhaps comparing it with best practice or guidelines).

Then explore your own reactions and decision-making. A hallmark of good reflection is showing how the experience will influence your future practice. Finally, outline the outcome of this reflection: what you learned and what you will do differently in future. A good reflection shows how the experience will change your behaviour or approach going forward (Royal College of Nursing, 2016).

Integration of theory and evidence:

Even though reflective writing is personal, it is still an academic assignment. This means supporting your analysis with relevant theory, research, or professional guidelines. For instance, if you reflect on a communication issue with a patient who has dementia, you might reference communication strategies or NICE guidelines on dementia care. Using such evidence can help you analyse the situation in depth.

Tying your experience to literature demonstrates that you can generalise lessons beyond a single event and align with evidence-based practice (Naber and Markley, 2017). Additionally, linking your reflection to the NMC Code (NMC, 2018) or other professional standards can strengthen your essay. For example, if your story involves a patient safety issue, you could cite the Code’s requirement to prioritise patient safety. This shows that you recognise the broader professional expectations.

Honesty and self-critique:

A reflective essay should be candid about your feelings, uncertainties, and mistakes as well as successes. Nursing educators value honesty and self-awareness – recognising your own areas for improvement is a sign of maturity. If you found yourself unprepared or anxious in a situation, say so and explore why. Reflective writing is a safe space to acknowledge errors and vulnerabilities (within reason), provided you then discuss what you learned. The goal is not to portray yourself as perfect, but to show growth. Use a professional tone of self-critique: avoid overly casual language or excessive self-criticism, but do critically evaluate your actions. For example: “I realise now that I did not communicate effectively with the patient due to my own assumptions; in future I will take time to ask open-ended questions to understand their perspective.” This kind of statement demonstrates insight and willingness to change, which is the essence of reflection.

Confidentiality:

Maintaining confidentiality is paramount in any clinical reflection. You must not use real names or identifying details of patients, staff, or healthcare settings (NMC, 2018). Use pseudonyms like “Mr A” or general descriptors like “an 80-year-old male patient in a care home” to describe individuals. Also avoid mentioning specific ward or hospital names. This is both an ethical requirement and often explicitly mandated in assignment guidelines. Showing that you understand and uphold confidentiality demonstrates professionalism. Before submitting, double-check that nothing in your essay could identify a real person or place. This includes omitting names, unique job titles, or specific dates that might reveal someone’s identity.

Logical structure:

A reflective essay should be well-organised so the reader can follow your thought process easily. Typically, it will begin with a brief introduction to the scenario and the purpose of the reflection. The main body will then recount and analyse the experience (often following the stages of a reflective model). Finally, a conclusion will summarise key insights and possibly your action plan.

Clear headings or separate paragraphs for each stage can be very helpful. For example, use one paragraph for description, one for feelings, and so forth. The writing should flow in a cause-and-effect manner. Transition words like however, because, and therefore guide the reader through your reasoning. For instance: “I initially felt frustrated; however, upon reflection I realised that the patient was not being ‘difficult’ on purpose but was in pain.” Using such language explicitly links causes and effects in your analysis, which is key to critical reflection.

Models of reflection commonly used in nursing

Several theoretical models can guide the structure of a reflective nursing essay. These models provide a step-by-step framework for thinking about an experience. While your assignment may not mandate a specific model, using one (even implicitly) can ensure you cover all important aspects of reflection. Here are some of the most commonly used reflection models in nursing:

Gibbs’ Reflective Cycle (1988)

Graham Gibbs’ reflective cycle model is one of the best-known frameworks for reflection in healthcare education. Gibbs (1988) proposes a cycle of six stages: Description, Feelings, Evaluation, Analysis, Conclusion, and Action Plan.

• In the Description stage, you objectively describe what happened, setting the scene.
• Next, in Feelings, you honestly recount your emotional responses and thoughts at the time.
• Evaluation involves assessing what was positive about the experience and what was challenging.
• In Analysis, you delve deeper into why the events unfolded that way, examining contributing factors and applying theory or guidelines.
• After understanding the situation, you form a Conclusion about what you have learned and what you could have done differently.
• Finally, you create an Action Plan for future practice – detailing how you will apply this learning or what steps you will take to improve.

Gibbs’ cycle is popular because it systematically ensures that you reflect on both emotions and practical aspects, and that you translate reflection into an actionable outcome. Many UK nursing programmes encourage students to use Gibbs’ reflective cycle in assignments, because it provides a clear and comprehensive structure. If your essay is structured around Gibbs’ stages, you might even use those as subheadings (if permitted), or at least make sure each of those elements is covered in your narrative.

Kolb’s Experiential Learning Cycle (1984)

David Kolb’s model is a broader educational theory but highly relevant to reflection. Kolb (1984) describes a four-stage learning cycle: Concrete Experience, Reflective Observation, Abstract Conceptualisation, and Active Experimentation. In essence, one starts with a concrete experience (e.g. a clinical event), then reflects on it, then draws general conclusions or theories from it, and finally applies those lessons in new situations. For a nursing student writing a reflective essay, Kolb’s cycle is a reminder that experience alone does not automatically lead to learning – it’s the reflection and subsequent application that matter.

For example,

• After a concrete experience like assisting in an emergency,
• …you would reflect on what happened and your role.
• You might then connect it to abstract concepts (such as stress response or teamwork principles)…
• …and determine how you will actively experiment by applying this learning in future emergencies.

Kolb’s terminology is less commonly used explicitly in nursing assignments than Gibbs’, but the principle of moving from experience to reflection to theory to action underpins most reflective practice.

Driscoll’s “What? So What? Now What?” model

John Driscoll (1994) developed a simple yet effective model of reflection, based on three questions originally posed by Terry Borton. The questions are: “What?”, “So what?”, and “Now what?” (Driscoll, 2007). This framework is straightforward:

• What? asks you to describe the situation (context, who was involved, what happened, what you and others did – similar to the description stage in Gibbs).
• So what? prompts analysis: why does this event matter, what were the implications, how did you feel, what have you learned about yourself or clinical practice?
• Now what? focuses on future actions: what will you do next, how will you apply or change your approach as a result of this experience?

Driscoll’s model is praised for its simplicity, which makes it easy to remember during writing. However, because it is so brief, you must expand each question sufficiently to achieve meaningful depth (Rolfe et al. 2001). By thinking about each stage, you are likely to engage more critically with your learning experience. In an assignment, you could structure the main body around these three questions. For example, have a section that addresses “What?” (description), then “So what?” (feelings and analysis), and “Now what?” (conclusion/action plan).

Johns’ Model of Structured Reflection

Christopher Johns (2000) introduced a more detailed model for reflecting, often used by nurses who want to deeply explore complex practice situations. Johns’ model uses a series of cue questions under domains like “looking in” (your own thoughts and emotions) and “looking out” (the situation objectively), influenced by Carper’s ways of knowing (Johns, 2000). Some questions in Johns’ model include:

• What was I trying to achieve?
• Why did I respond as I did?
• How were others feeling, and how did I know this?
• What are the ethical and professional aspects of this situation?
• What knowledge can support me in understanding this experience?
• Could I have handled it better?

By systematically answering such questions, a nurse can examine the experience from multiple angles. This model encourages consideration of various aspects: the aesthetic (the art of nursing in the situation), personal (your feelings and thoughts), ethical (values and principles involved), empirical (scientific or evidence-based knowledge), and reflexive (what this means for you personally). Johns’ framework can yield very insightful reflection, though it is more time-consuming. It may be useful for longer reflective essays or research projects. If you choose Johns’ model, be sure to address its key questions in a logical flow, rather than simply providing disjointed answers. The result should be a narrative that covers the context, your reactions, relevant factors or theory, and plans for future action.

Choosing a model:

In many cases, your instructor or assignment brief might not specify a model. You can choose one that fits best, or even combine elements from several. The important thing is that your reflection includes description of the experience, exploration of feelings, critical analysis, and forward planning – these core elements are common to all major models (Jasper, 2013). Markers will expect to see the thinking structure of a model in your writing, even if you don’t explicitly name it. It can help to jot down notes for each stage of your chosen model when planning your essay, to ensure you don’t skip an important aspect of reflection.

Steps to writing a reflective nursing essay

Writing a reflective essay involves both reflective thinking and effective academic writing. Below is a step-by-step guide to tackle a nursing reflective assignment:

Carefully read the assignment brief:

Start by clarifying what the essay question or prompt is asking. Identify the key focus for reflection – is it an experience with a particular patient population, an interprofessional teamwork scenario, an ethical dilemma, or something else? The prompt might be specific (e.g. “Reflect on an instance where you had to advocate for a patient’s needs”) or open-ended. Make sure you understand any required structure or model mentioned in the instructions. Also note the word count and marking criteria. This will help you allocate space appropriately (for instance, description might be one part, analysis a larger part).

Select a relevant experience:

Choose a clinical experience that fits the assignment criteria and from which you learned something meaningful. If possible, pick a scenario that had a significant impact on you – for example, something challenging or thought-provoking. It doesn’t have to be dramatic or life-or-death. Even a seemingly routine interaction can yield deep insights if you reflect properly. What matters is that you can discuss what you learned and how you changed because of it. Ensure you remember enough details to describe it vividly. If the experience involved other people (patients or staff), consider how you will anonymise them (e.g. no real names or identifying details).

Recall and jot down details:

Before writing full sentences, take time to reflect on the event. It may help to write informal notes or bullet points about aspects of the experience, such as:

• What happened step by step
• What you and others did
• How you felt at different moments
• What your concerns or thoughts were
• What went well or what was challenging
• Why it might have happened.

Also note any relevant knowledge that comes to mind (for example, if later you learned a technique that would have helped, or if a policy was relevant). This brainstorming corresponds to the Description and Feelings stages in Gibbs’ cycle. Be truthful and include sensory details and emotions as you remember them – those will make your reflection richer.

Identify learning points:

Next, consider why this experience was significant. Ask yourself key questions aligned with a reflective model. For example: So what did I learn? Why did I respond as I did? What were the consequences? What do I understand now that I didn’t at the time? Answering these questions will help you identify the important lessons from the experience (for instance, perhaps you realised the importance of clear communication, how bias can affect care, or noticed a gap in your clinical knowledge).

List a few key insights or lessons you gained. These points form the central message of your essay: what you want the reader to take away about your development. In essence, these will form your thesis for the reflection – the main things you discovered about yourself or practice.

Link to theory or guidelines:

For each insight, think about relevant literature or professional guidelines. For example, if one lesson was “I learned the value of listening to a patient’s concerns even when busy,” you could connect this to the principle of person-centred care or cite a communication technique from the literature. If you realised “I struggled to manage a distraught relative,” you might recall de-escalation techniques or a communication model (and perhaps reference a source on family communication).

Jot down any sources (textbooks, research articles, or official guidelines) that could support or illuminate aspects of your experience. This will strengthen your analysis and shows that you can integrate external knowledge with personal reflection (Naber and Markley, 2017).

Choose a structure (model) for the essay:

Decide how you will organise your reflection in writing. Using one of the models mentioned earlier can help give structure. For instance, you might decide to structure the main body according to Gibbs’ six stages. Alternatively, you could opt for a narrative that still covers what happened, what it means, and what’s next (similar to Driscoll’s questions). It’s often useful to outline your essay briefly before writing. For example, you might plan the following structure:

• Introduction of the scenario
• Description of the event
• Feelings and reactions
• Analysis (could be split into two paragraphs)
• What you learned from the experience (conclusion of the reflection)
• Action plan or future changes
• Conclusion of the essay

Having an outline in place prevents rambling and ensures a logical flow.

Write the introduction:

In your introductory paragraph, set the scene for the reader. State what the reflection will be about in general terms without yet going into deep detail. You might mention the setting (e.g. “during my mental health nursing placement in a community clinic”) and the general nature of the incident (“I will reflect on a communication challenge with a patient experiencing acute anxiety”). Also, state the purpose of the reflection – for example, to highlight how the experience contributed to your development in a particular area. This could be phrased as: ‘to illustrate how this experience contributed to the development of my communication skills and professional confidence.’ Keep the introduction brief (perhaps 10% of the word count) but engaging. The reader should grasp what you’re reflecting on and why it matters from the introduction.

Describe the experience (“What?”):

After the introduction, give a concise narrative of what happened, from your perspective. This is the descriptive part of the essay. Stick to the relevant facts – who was involved, when and where it occurred, and what unfolded. For example:

“During an evening shift on an elderly care ward, I was caring for Mr A, an 80-year-old patient with dementia. After administering his medication, I noticed he appeared upset and was repeatedly asking for his wife. I tried to reassure him, but he became increasingly agitated, raising his voice.”

Write this section clearly and chronologically, so the reader can visualise the scenario. Do not analyse or comment on it yet – just present the facts and context. Also include what you did or felt at the time (“I felt unsure how to calm him and asked a senior nurse for help”). Aim to be objective in this section, though it’s fine to note if something seemed challenging or unexpected at the time.

Explore your feelings and initial responses:

Next, describe your internal experience during and immediately after the event. This often overlaps with the description, but you may choose to make it a separate paragraph (as in Gibbs’ Feelings stage). Here you reveal your emotions and thoughts: How were you feeling at the time? What was running through your mind? Continuing the example:

“I felt a growing sense of helplessness and anxiety as Mr A became more agitated. My heart was pounding because I did not know how to soothe him. I was also worried that I had done something wrong to trigger his distress. When my senior colleague stepped in to help, I felt relief, but also embarrassment for needing assistance.”

Be honest – include both emotional and physical reactions if relevant (e.g. nervousness, confusion, sympathy, fear, etc.). Acknowledging feelings is critical because it shows self-awareness and that you’re not just recounting events mechanically. If others in the scenario had reactions, mention your perceptions of those as well (“The senior nurse remained very calm, which made me realise how visibly anxious I must have appeared”). Describing feelings naturally sets the stage for analysing why you felt that way.

Evaluate the experience (“So what?”):

Now step back and consider the positives and negatives of the situation. Evaluation is about making judgments in hindsight. Ask yourself: What went well? What was challenging or could have been better? For instance:

“On reflection, there were some positive aspects: I did recognise my limits and sought help quickly, which ensured the patient received support. That was appropriate and showed that I put the patient’s safety first. However, I also see negative aspects: my communication with Mr A was not effective. I spoke to him in a rushed manner and didn’t address his underlying distress, which perhaps escalated his agitation. I also realised I wasn’t familiar enough with dementia care techniques at that point.”

In this section, be fair to yourself – note things you handled well or any extenuating circumstances (like being a new student), but also candidly identify what could have been improved. Consider the perspectives of others too: perhaps the patient’s perspective (“the patient felt frightened and I didn’t acknowledge that”) or your colleague’s view (“my mentor later noted I seemed very nervous”). This balanced evaluation demonstrates your ability to critically appraise the incident rather than just narrating it.

Analyse the situation and your actions:

Analysis is the heart of reflection – here you dig into the why and how, linking the experience to your knowledge and broader context. This often spans one or more paragraphs. You should connect what happened with theory, guidelines, or past learning. For example:

“I learned later that patients with dementia can become more agitated if they sense anxiety in their carer. In this case, my own anxiety likely communicated to Mr A that something was wrong, inadvertently worsening his distress. According to the Alzheimer’s Society, maintaining a calm tone and using validation (acknowledging the person’s feelings) can help de-escalate such situations. I did not use these approaches, as I wasn’t aware of them at the time, which explains why my efforts were ineffective.”

In analysis, introduce external sources to deepen the discussion: perhaps a textbook on dementia care, a journal article on communication strategies, or the NMC Code’s guidance on compassionate care. Also analyse your decision-making and behaviour:

“My quick resort to seeking help reflects my lack of confidence – consistent with Benner’s description of novice nurses relying on experienced colleagues (Benner, 2001). In hindsight, I had no de-escalation plan because I had never encountered this scenario before.”

Consider alternative actions: What else could have been done? Why did things happen as they did? Were there factors beyond your control? For example, “If I had known Mr A was worried about his wife’s absence, I could have tried to comfort him by talking about her or finding a familiar object, rather than just saying ‘It’s okay.’” By analysing in this way, you demonstrate critical thinking – you’re not just describing what happened, but examining why and what it means. Support each analytical point with either evidence (literature, policies) or logical reasoning. This section shows your ability to learn from the experience by understanding it in depth.

Draw conclusions (what you learned):

After thorough analysis, summarise the key lessons learned from the experience. This corresponds to the Conclusion stage in Gibbs’ model (not to be confused with the essay conclusion). Here you answer: Knowing what I know now, what would I do differently? What insight have I gained? For example:

“In hindsight, I learned that managing agitation in a person with dementia requires patience, empathy, and specific communication techniques. I concluded that my initial approach was too hasty and task-focused – I tried to reassure Mr A quickly so I could continue the drug round, instead of addressing his emotional needs. I also realised the importance of being familiar with behaviour management methods for dementia care.”

Ensure you phrase these as generalisable lessons, not just specific to that one patient. The aim is to show how you have grown or what principle you will carry forward. If the situation went well overall, you might conclude by reinforcing what made it successful (“I will continue to use the gentle tone that worked effectively in calming him”). Often, this part naturally leads into the action plan for the future.

Create an action plan (“Now what?”):

A strong reflection looks ahead and describes how you will apply your learning. Conclude your main body with a clear plan for future improvement or professional development. For instance:

“To address the gaps identified, I have arranged to attend a dementia care workshop next month to develop better communication strategies. In future similar situations, I will remain calmer – I plan to use a slower, soothing tone and validate the patient’s feelings (e.g., “I can see you’re worried about your wife; let’s talk about her”). I will also practise grounding techniques for myself (like deep breathing) to manage my own anxiety. Furthermore, I intend to discuss this incident with my mentor to get feedback and advice on handling such challenges.”

This action plan shows concrete steps (attending training, practicing specific techniques, seeking feedback). It indicates that you are proactive in using the reflection to become a better nurse. Ensure your action plan is realistic and directly related to the lessons you discussed. If your assignment is graded, providing a thoughtful action plan often earns credit, because it closes the loop of reflection – it demonstrates that you are using what you learned to change your practice.

Write a brief conclusion for the essay:

Finally, add a short concluding paragraph to wrap up the entire reflective essay. This is not the same as the “conclusion” in the reflective cycle, but rather a closing of the assignment. Here, you don’t introduce new details; instead, you succinctly reiterate the significance of the reflection. For example:

“In conclusion, this essay reflected on a challenging incident of caring for an agitated patient with dementia. Through structured reflection, I identified how my communication fell short and how I can improve in the future by staying calm and using validation techniques. This experience has become a valuable learning point in my training – it has increased my self-awareness and prepared me to handle similar scenarios more competently. Ongoing reflection on experiences like this will be essential as I continue to grow as a nurse.”

A well-crafted conclusion leaves the reader with a clear understanding of your main takeaways and reinforces the value of the reflective process in your development.

Revise and refine:

Good writing is rewriting. After drafting your essay, take the time to revise it. Check that the narrative flows logically and that each part of the reflection is covered in sufficient depth. Ensure there is a good balance between describing events and analysing them – avoid the common pitfall of writing too much story and not enough reflection. Edit for clarity and conciseness. Use active voice and first person, and maintain a professional tone. Verify that you have maintained confidentiality throughout (no stray names or details).

Also, review your work against the assignment criteria or rubric: have you demonstrated critical analysis, insight, emotional awareness, integration of theory, and professional values? If possible, ask a peer or mentor to read your essay to see if it is coherent and genuinely reflective. They might catch areas that are unclear or suggest further depth. Finally, proofread carefully for grammar, spelling (use British English, e.g. “organisation”, “behaviour”), and referencing accuracy.

Tips for excelling in reflective assignments

In addition to the steps above, consider these practical tips to elevate the quality of your reflective essay:

Be critical but fair to yourself:

Reflective writing involves critiquing your own actions and decisions. Use a questioning approach – ask why something happened, why you felt a certain way, and how you might improve – rather than simply self-blaming. Back up your points with reasons. For example, instead of writing “I was terrible at communicating,” you might say “I found communication difficult in this instance because I lacked experience with distressed patients, and as a result my approach was not effective.” This phrasing shows analysis (identifying cause and effect) rather than just a negative judgement. Always follow up any criticism of yourself with what you’ve learned or how you’ll improve.

Keep the patient’s perspective in mind:

While the essay is about your learning, in nursing the focus is ultimately on the patient. Show that you are considering the patient’s perspective and welfare in your reflection. For instance, mention how your actions affected the patient (positively or negatively) and what you would do to ensure better patient outcomes next time. This demonstrates empathy and adherence to the value of patient-centred care (NMC, 2018). It also aligns with what assessors look for – evidence that you are growing into a nurse who prioritises safe and compassionate care.

Use plenty of transition words:

Words and phrases like however, therefore, for example, as a result, in addition, meanwhile, because and so make your writing flow logically. They guide the reader through your thought process and indicate relationships between ideas. For instance: “I initially hesitated to speak up. However, I have learned that timely communication is crucial, so I will voice concerns more promptly in future.” Using these transitions frequently will improve readability and ensure that at least a third of your sentences show clear connections between ideas (a common expectation in academic writing).

Maintain an academic yet personal tone:

Even though you write in the first person and describe personal experiences, the assignment should not read like a casual diary entry. Avoid slang or overly conversational language. At the same time, you don’t need overly formal or convoluted sentences – aim for clarity. Use correct terminology (e.g. say “hypertension” instead of “high blood pressure” if writing academically, unless explaining to a layperson in the scenario). Also, avoid generic statements that aren’t reflective, like “communication is important in nursing” without context – instead, tie such statements to your experience (“this experience reinforced for me how vital clear communication is in nursing, as I saw how misunderstandings can cause distress”). Strive for a tone that is professional yet reflective – you are both the narrator and the analyst of your story.

Reference appropriately:

Even though it’s a personal reflection, you are expected to support your analysis with evidence. Use Harvard referencing (or the format specified by your school) for any sources you cite. Typically, you might reference works on reflective practice (e.g. Gibbs’ original work, or a nursing journal article on reflection), and clinical sources relevant to your scenario (e.g. guidelines, textbooks, research on the issue at hand). For example, if you mention Gibbs’ cycle, cite Gibbs. If you refer to the NMC Code, cite the NMC. In-text, include the author and year (e.g., (Gibbs, 1988)). Make sure to list all references in a bibliography at the end. Proper referencing shows academic integrity and indicates that you can connect personal experience with professional knowledge. It also lends credibility to your reflection by showing that your planned improvements or insights are backed by established principles (Naber and Markley, 2017). Remember not to put any identifying patient details in your references either (e.g., don’t cite a hospital incident report or patient’s name).

Observe confidentiality and ethical practice:

We’ve mentioned confidentiality several times, but it bears repeating as a top priority. Using pseudonyms and removing identifying details is a must. If your reflection involves sensitive issues (e.g. a colleague’s error or a patient’s personal story), be respectful and focus on your learning rather than gossip or blame. Ethically, your reflection should demonstrate professionalism – for example, the NMC Code requires nurses to work cooperatively, so avoid language that unduly blames others or breaches professional respect. If discussing an incident where something went wrong, frame it in terms of what you learned about better practice, rather than just pointing fingers.

Balance brevity and detail:

Aim to be concise but not at the expense of clarity. Each paragraph should have a clear point. Avoid rambling descriptions or tangents unrelated to the reflection focus. However, do provide enough detail to paint a vivid picture of the scenario and your thought process. A useful guideline is: description should be enough to understand context (but not overly long), analysis should be the longest section, and the action plan should be specific but succinct. Stick to the word count – if you are significantly over, you may need to trim some descriptive or repetitive parts. If under, ensure you haven’t skimmed over the analysis or missed a key aspect.

Use appendices if allowed:

If you have additional material that is relevant but would break the flow of the essay, you might use an appendix (check if your assignment permits this). For example, a copy of a tool or a diagram of a reflective model could go in an appendix. In most cases, though, a nursing reflective essay won’t require appendices – markers are more interested in your narrative and analysis.

Practice reflection regularly:

Make reflection a habit, not just an assignment task. Engage in informal reflection after clinical shifts – even jotting down quick notes about what went well or what was challenging. This will improve your reflective skills and provide a “library” of experiences to draw on for assignments. Regular reflection can also reduce the emotional impact of stressful experiences by helping you process them, which supports your well-being (Mantzoukas and Jasper, 2004). When it comes time to write a formal reflective essay, you will find it easier because you’ve been exercising those reflective “muscles” all along.

Seek feedback and guidance:

Don’t hesitate to discuss your reflection with a trusted mentor, tutor, or peer (without breaching confidentiality) to gain additional perspective. They might point out an insight you missed or reassure you that your proposed actions sound appropriate. Ensure that any help still keeps the work your own. If you’re unsure about the assignment expectations, ask your instructor for clarification. Sometimes reviewing a sample reflective essay (if available from your university) can also provide guidance on tone and structure.

Example of reflection in practice

To illustrate how all these pieces come together, consider a brief example scenario and how a nursing student might reflect on it.

Scenario: A student nurse is assisting in a post-operative ward and is asked to remove a patient’s wound drain for the first time. While doing so, the student accidentally fails to clamp the drain tubing properly, causing a spill of fluid and some bleeding. The patient winces in pain and becomes upset. The student panics momentarily. A supervisor intervenes to help complete the procedure and to calm the patient. Later, the student feels upset and embarrassed about the incident.

In a reflective essay on this scenario, the student’s description would cover the context (post-operative ward, first time performing a drain removal under supervision) and what happened in sequence. For example, they might write how they removed the suture, then pulled out the drain but forgot to clamp it, leading to a sudden gush of fluid, the patient’s reaction of pain, and the immediate assistance from the supervisor. They would include their own initial action and inaction (perhaps they froze for a moment until the supervisor took over).

The student would then describe their feelings: perhaps “I was mortified at the possibility that I had hurt the patient. I also felt embarrassed, worrying that I looked incompetent in front of my supervisor.” These emotions of guilt, shame, and fear would be openly acknowledged. They might note physical sensations too (e.g. feeling hot or shaky).

In evaluation, the student would consider what was done well versus what was not. They might say:

“On the positive side, I maintained sterility of the site and I immediately called for help when I realised something was wrong. On the negative side, I did not reassure the patient or apologise in the moment – I was too flustered. The situation also revealed my lack of preparation for this procedure.”

This shows a balanced view – recognising both good practice (seeking help to ensure patient safety) and areas to improve (communication and technical skill).

During analysis, the student would explore why things went wrong and link to theory. They could reflect on the reasons behind their panic: “As a novice, I had limited procedural knowledge. Benner’s theory (2001) suggests beginners rely on rules and can be easily overwhelmed – I definitely felt overwhelmed when things didn’t go as expected.” They might analyse the patient’s experience, acknowledging that “the patient likely felt pain and fear seeing the blood; I did not respond to her emotional needs, which probably heightened her distress.”

They could connect this to the importance of patient communication, citing a source about patient anxiety and the need for calm reassurance. The student might also reference a clinical skill textbook to pinpoint what step was missed (clamping the tube) and explain how that caused the outcome. They should examine their own response: “I realised I defaulted to silence because I was afraid of the patient’s reaction and my supervisor’s judgment. In hindsight, a simple ‘I’m sorry, I’m fixing it now’ might have eased the patient’s worry.” Throughout the analysis, they’d integrate knowledge (e.g., safe drain removal technique, principles of managing patient pain, etc.) to make sense of what happened and why their reaction was as it was.

The conclusion (lessons learned) could be: “I learned the importance of being technically prepared and having a mental plan for procedures. I also learned that if something goes wrong, staying calm and communicating with the patient is crucial – silence or panic only makes the situation worse. Most importantly, I realised that making a mistake doesn’t mean I’m hopeless; it means I need more practice and support, and that I should use that experience to improve.” This shows personal growth and reframing of the incident as a learning opportunity.

The student’s action plan might include several steps. For example, they could decide to practise the skill in the lab before the next opportunity. They might arrange to watch a demonstration or ask a mentor to supervise them on a few more drain removals to build confidence. They could also plan to use a personal checklist or mnemonic before procedures to avoid missing steps (for instance, reminding themselves to clamp). Additionally, they might vow to speak up to the patient if a mishap occurs – perhaps rehearsing phrases like “I’m sorry, let me fix that” to be better prepared to respond empathetically. Finally, they could set a goal to discuss this incident in clinical supervision, seeking advice on managing such stress in the moment. By specifying these actions, the student shows they are turning reflection into concrete improvement.

The conclusion of the essay would then tie it all together, perhaps stating:

In summary, by reflecting on the drain removal incident, I identified how a lack of experience and composure led to a clinical error and patient discomfort. I have outlined steps to enhance my skills and response in the future, including more practice and better communication. This reflection has transformed an embarrassing moment into a catalyst for my learning. It has increased my awareness of my own reactions under pressure and highlighted the kind of nurse I aspire to be – one who stays calm, competent and patient-focused, even when things don’t go perfectly.”

This example demonstrates how a nursing student can turn an incident into a thoughtful reflective narrative, following the stages of a model (implicitly Gibbs’ in this case) and covering description, feelings, analysis, conclusions, and action plan. The specific content will vary with each experience, but the underlying approach – honest self-examination linked with theory and a forward-looking mindset – is the template for any good reflective essay in nursing.

Conclusion

Reflective essay writing is a journey through which nursing students develop professional insight and confidence. By critically examining your clinical experiences – looking at what happened, how it affected you and others, and what you can learn – you turn everyday practice into an opportunity for growth. In the process of writing a reflective assignment, you are practicing a skill that is indispensable for lifelong learning in nursing. Reflection fosters adaptability and continuous improvement: as you progress in your career, the ability to reflect will help you navigate complex situations thoughtfully and maintain a commitment to high-quality care.

When completing reflective essays, remember to be systematic (use a model or clear structure), analytical (don’t just tell the story – dig into it), and honest. Support your reflection with evidence and link it to the wider context of professional standards. Pay attention to details like confidentiality and writing style, as they add to your credibility. With practice, reflective writing becomes more natural and deeply rewarding, turning your experiences into lessons that shape you into a better nurse. As one author noted, reflection should be a continuous cycle where experience and reflection are interrelated (Chong, 2009). By following the guidance in this article, you will be well-equipped to write reflective nursing essays that not only meet academic requirements but truly enrich your learning and future practice.

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References and further reading:

• Artioli, G., Deiana, L., De Vincenzo, F., Amaducci, G., Bassi, M.C., Di Leo, S., Hayter, M. and Ghirotto, L. (2021) ‘Health professionals and students’ experiences of reflective writing in learning: a qualitative meta-synthesis’, BMC Medical Education, 21, p. 394.
• Benner, P. (2001) From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Upper Saddle River, NJ: Prentice Hall.
• Driscoll, J. (2007) Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals, 2nd edn. Edinburgh: Baillière Tindall.
• Gibbs, G. (1988) Learning by Doing: A Guide to Teaching and Learning Methods. Oxford: Oxford Polytechnic.
• Jasper, M. (2013) Beginning Reflective Practice, 2nd edn. Andover: Cengage Learning.
• Johns, C. (2000) Becoming a Reflective Practitioner. Oxford: Blackwell Science.
• Kolb, D. (1984) Experiential Learning: Experience as the Source of Learning and Development. Englewood Cliffs, NJ: Prentice Hall.
• Mantzoukas, S. and Jasper, M.A. (2004) ‘Reflective practice and daily ward reality: a covert power game’, Journal of Clinical Nursing, 13(8), pp. 925–933.
• Naber, J.L. and Markley, L. (2017) ‘A guide to nursing students’ written reflections for students and educators’, Nurse Education in Practice, 25, pp. 1–4.
• Nursing and Midwifery Council (2018) The Code: Professional Standards of Practice and Behaviour for Nurses, Midwives and Nursing Associates. London: NMC.
• Nursing and Midwifery Council (2024) Supporting information for reflection in nursing and midwifery practice. London: NMC. Available at: https://www.nmc.org.uk/globalassets/sitedocuments/standards/supporting-information-for-reflection-in-nursing-and-midwifery-practice.pdf (Accessed 24 July 2025).
• Royal College of Nursing (2016) Eight ways to improve your reflection. London: RCN. Available at: https://www.rcn.org.uk/professional-development/revalidation/eight-ways-to-improve-your-reflection (Accessed 24 July 2025).
• Smith, G. (2020) ‘Communication strategies for acute dementia care’, Nursing Standard, 35(1), pp. 45–50.
• Chong, W.Y. (2009) ‘Is reflective practice a useful task for student nurses?’, Asian Nursing Research, 3(3), pp. 111–120.