Enhancing Childrens Nursing Care


Reflective practice is referred to the ability of an individual to analyse personal actions so as to engage them in the process of continuous learning. This is important to understand the changes in personal skill and actions to be made so that effective quality of care can be offered to the service users. In this reflection, based on Gibb’s cycle of reflection one cross-field experience undertaken by is to be reflected to identify the strengths and the weak actions which are to be changed for delivering quality care to individuals in future.



My placement was in an educational institution in the UK where I was working as children’s nurse. I was entrusted to take care of the health as well as well-being of the children to ensure them better future. As mentioned by Kraft and Eriksson (2015), the children nurse have the role to provide care, monitor the health needs of the children, develop long-term care plan, advise parents regarding the way to manage and care for the child and others. This is done with the intention to ensure holistic and quality care is received by the children to make them develop proper behaviour and development. In the placement, I was mainly involved to work with the children below the age of 5 years. The initial five years of the children are fundamentally important as these years act as the foundation stage of the children where their future growth, development, happiness, learning achievement and health are developed (Barnett et al. 2016). I have the opportunity to work with the teaching profession to understand and evaluate the way they are interacting with the children. Moreover, in the placement, the parents who are acting as key carers for the children were also involved and I had the opportunity to work with them to develop interaction with the children.


At my placement, I was initially thinking that I would not be able to take proper care of the children and fulfil my responsibilities as a children’s nurse. This is because I have no previous experience about the way to interact and establish close relationships with the children so that they can trust and comply with me to help me provide them proper care. As asserted by Longobardi et al. (2019), close relationship with the children is important as it makes them develop trust towards the individual and avoid showing unnecessary tantrums. This is because the close relationship makes the children feel secure in the company of the individual making them comply with the person without fear and making hindrance. In my placement, I initially thought that the children are not properly cared by the teachers as I saw few children are being punished by the teachers by only allowing them to go out to play on a playdate after 10 minutes when all other children have left the class. However, afterwards, I understand that it is done for children who behaved in a bad manner in the class to make them understand that showing bad behaviour leads the individuals to get punished. Later, I also understand that I have the efficiency to develop close relationship with the children and my previous thought about my inefficiency due to lack of experience is not valid. The individuals without practical experience face doubt about their performances due to lack of confidence (Tucker and Lanningham-Foster, 2015). This indicates that I lack proper confidence about my skills and actions. Since I was a new children’s nurse in the school, I thought that I would not get assistance from the teachers and parents to help me develop proper relationship and care for the children. However, I later identified that the teachers and parents are cooperative in nature which made thought that I have weakness of being agitated and anxious in new situations.


In the initial condition, at the placement, I felt that I would fail to execute my responsibilities as children’s nurses as I doubt about my communication skill. This is evident as before the placement I have often failed to develop proper communication with the children as they avoid interacting with me. The communication skill is important in child nursing as it the way in which needs and demands of the children can be identified by the children’s nurse to develop effective care plans for the children (Bohnenkamp et al. 2015). However, afterwards, in the placement, I felt that I have developed efficiency in making communication with the children. This is because by looking at other teaching staffs and parents I realised that I need to develop friendly approach and lower the voice tone to effectively interact with the children at the placement which I did and this led me to get fruitful results. Before joining the placement, I felt that I would not be able to develop mutual trust and would develop conflicts with other colleagues at the workplace. However, after joining the school as a children nurse, I felt that all the teachers who were my colleagues were cooperative in nature as they personally took me to interact and introduce to each child in the classes. Thus, I found that my fear of conflict with my colleagues is vague. However, I do face trust issues from few of my colleagues and parents at the school as they doubted about my skill and efficiency to execute my responsibility. Before the placement, I felt that I would not be able to arrange proper activities for the children to ensure their effective cognitive development. However, afterwards, in the placement, I found that with assistance I was able to resolve issues and develop proper activities for the children to ensure their good health. This indicates that I lack problem-solving skill as issues faced by me cannot be personally resolved by me at the workplace.


In the placement, I think that my confidence to work as children’s nurse was improved. This is evident as at the end of the placement it was seen that I was able to confidently interact and manage the behaviour of the children to ensure their better future. In the placement, the other thing which went well is that I was able to understand why children show differential performance level while I execute my responsibilities in a proper manner. This is evident as in the placement I realised that some children are fast learners whereas others are slow due to which all the children may not show progress at similar level. Thus, I have to be patient and execute my responsibilities in a proper manner in different way by analysing the efficiency of each child to help them develop positive behaviour and improved cognitive development. The other thing that went well in the placement is that I was able to improve my communication skill to interact with the children in proper manner. This is because my colleagues cooperated with me to help me improve my skills by informing me about the way I require to talk to the children. The other thing which went well is that I was able to resolve my negative thinking regarding the activity of the teachers for the children at the school. However, the thing that went bad in the placement is that I was unable to develop proper decision regarding the way to meet all the needs of the children through effective care planning. This is evident as through interaction though I understood the needs of the children but could not understand the way activities are to be set for each individual to meet their needs properly. Moreover, I experienced trust issues within the placement which is evident as few of my colleagues and parents of the children doubt on my efficiency to care for their children at school.


The improvement in communication with the children happened at the workplace because by watching others I was able to understand the way friendly approach is to be used and to what extent the voice has to be lowered while speaking to the children to make them comfortable to communicate with me. Thus, this learning helped to lower the voice tone and use words that would make the conversation with the children friendly in nature. I think communication with the children was also improved because I was able to use easier words and interacted with them by being at the same level where the children were to convey me any message. This activity makes the children avoid to fear me, in turn, making them develop confidence to interact with me helping me in understanding their key needs. I was able to understand that children have different rates of progress because I think that I assessed each child properly to understand the way each of them was progressing. I was able to resolve my negative thinking related to facing conflict at the workplace because of the cooperation received from each of them. The cooperation from the colleagues at the workplace makes the individual understand that the person is well-accepted by others due to which the other employees are helping them to improve their skills (National Association of School Nurses et al. 2015). However, I experienced trust issues with few of my colleagues at the workplace because I think I reported against their lack of quality at work to the higher management without first interacting with them regarding the way they can resolve the issue. I also think I failed to properly arrange care plan for all the children because I lacked adequate knowledge regarding the way to manage and meet the needs of the children at school to ensure their well-being.


According to the reflection, I think I require gathering more knowledge to understand and identify variety of ways in which the different needs of the children at school while acting as children’s nurse is to be fulfilled. In this process, I could read books to develop theoretical knowledge regarding the way to determine different ways in which a successful care plan for children by meeting their needs can be framed. Moreover, I think I need to discuss with my mentor to resolve issues that I am facing while framing effective care plan for the children at school. I also think I require examining and analysing previous works of experienced children nurse who have develop successful care plan to determine the techniques to be used by me in my placement as the student children’s nurse for developing successful care plan. In relation to trust issues, I think as an alternative I require communicating with the colleagues to determine the exact reason for their lack of belief towards me. This is because while interacting with them I think the wrong perception they have towards me which is instigating them to avoid trusting me at work can be resolved. The trust issues required to be resolved at the workplace so that collaborative work environment is established and conflicts at the workplace can be avoided (Park, 2015).

Future Actions

The reflection led me to learn that communication skill is essential being a children nurse and through its effective interaction with the children can be built to understand and identify the health and well-being needs of the children. I also learned that self-confidence is required to act effectively within the workplace. This is because self-confidence leads individuals to have more energy and gather effective self-determination to prove them being able to execute any task. It is also required for individuals at workplace to be able to control their emotions and behaviour in a responsible manner (Koo et al. 2016). This is evident as after I developed confidence to work as a children's nurse at the school with the help of others I was able to effectively control my negative emotions such as anxiety, stress and others at work which led me to execute my responsibilities properly. I also learned that communication is the way through which close relationship with the children can be built by the children’s nurse at school to initially understand their needs. This is because effective communication leads the children to develop trust over the nurse, in turn, helping them to develop close relation making the children share their needs without hindrance of fear.

In future, I require working on my way of interacting with colleagues and taking actions regarding any situation at the workplace so that trust issues can be avoided. This is to be done by developing personal interaction with the colleagues when I would join a new workplace so that they understand me and avoid developing manipulating information that may hinder their development of trust towards me. I would also interact with my colleagues to make them realise of any wrong actions and would later report the issue to the authority if changes are not being made. Moreover, in the future, I would take more intensive training of being a successful children nurse so that I can update my skills and knowledge to develop proper care plan as the complex needs of each and every child at school.

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The above discussion informs while acting as children’s nurse in the school I have efficient communication skill but experienced trust issues and hindrance to develop effective care plan for the children. In order to resolve the issues, training and effective knowledge development is required.


Barnett, L.M., Lai, S.K., Veldman, S.L., Hardy, L.L., Cliff, D.P., Morgan, P.J., Zask, A., Lubans, D.R., Shultz, S.P., Ridgers, N.D. and Rush, E., 2016. Correlates of gross motor competence in children and adolescents: a systematic review and meta-analysis. Sports medicine, 46(11), pp.1663-1688.

Bohnenkamp, J.H., Stephan, S.H. and Bobo, N., 2015. Supporting student mental health: The role of the school nurse in coordinated school mental health care. Psychology in the Schools, 52(7), pp.714-727.

Koo, L.W., Horowitz, A.M., Radice, S.D., Wang, M.Q. and Kleinman, D.V., 2016. Nurse practitioners' use of communication techniques: Results of a Maryland oral health literacy survey. PloS one, 11(1), p.e0146545.

Kraft, L.E. and Eriksson, U.B., 2015. The school nurse’s ability to detect and support abused children: A trust-creating process. The Journal of School Nursing, 31(5), pp.353-362.

Longobardi, C., Badenes‐Ribera, L., Gastaldi, F.G.M. and Prino, L.E., 2019. The student–teacher relationship quality in children with selective mutism. Psychology in the Schools, 56(1), pp.32-41.

National Association of School Nurses, Maughan, E., Bobo, N., Butler, S., Schantz, S. and Schoessler, S., 2015. Framework for 21st century school nursing practice: An overview. NASN School Nurse, 30(4), pp.218-231.

Park, A.L., 2015. The effects of intergenerational programmes on children and young people. International Journal of school and cognitive psychology, 2(1), pp.1-5.

Tucker, S. and Lanningham-Foster, L.M., 2015. Nurse-led school-based child obesity prevention. The Journal of School Nursing, 31(6), pp.450-466.

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