In professional practice reflection is an essential component. Reflection is the process of learning through active process of experience. It also contains writing, discussion, and learning from conversations with colleagues and friends. To become confident or effective practioner in UK reflective practice is very essential , that means for nurses reflective practice is central in clinical practice . Reflective practice helps to analyse and value your experience. ‘ Boyd’s and fales , 1983, states that reflective practice is the process of internally examining and exploring an issue of concern , triggered by an experience ,which creates and clarifies meaning in terms of self , and which results in changed conceptual perspective.’ (BOYDS AND FALES, 1983) There are many models of reflective practices like Kolb’s learning cycle, Gibbs reflective model, Sheckley and Keatons leaning cycle. Here I am using Gibbs reflective model (1988) , to reflect a situation which was happened to a client with renal failure during my professional practice . This model consists of 6 steps. these are description (what happened ), feeling-what were you going to thinking and feelings ), evaluation – what was good and bad about this experience , analysis – what sense can you make the situation , conclusion – what else could you have done , action plan – if it arose again what you would do .

Renal failure is a condition in which waste products are accumulated in the body because of the inability of the kidney to excrete waste product and to maintain the fluid and electrolyte balance (Bucher and Melander ,1999).The harmful substance which are accumulated in the blood because of the improper functioning of the kidney are urea, acids and electrolyte imbalances(Clark and etal,2002)It is mainly caused by the injury to the kidney cells toxic agents and ischemic condition

The national services frame work (NSF)for renal services places a strong emphasis on identifying the condition of renal problems in primary care settings , to slow down its progress through that minimise its risk on clients lives .
In UK very few number of people die of chronic renal failure .Chronic illness are the greatest future challenges faced by modern societies , so the aim of the NHS is to recognise and make expertise of patients themselves and also make a partnership with health care professionals (Hincliffs . et al, 2003)
In this essay according to the NMC 2004, the clients name and the nursing home did not mention (NMC, 2004)

CARE MANAGEMENT AND REFLECTION

Mr.X who was admitted in nursing home four years back. He was in his 50’s and has one daughter and son. They visited him regularly. He is also suffering from oedema on her both legs and eyes. He is diagnosed with chronic renal failure and angina. He was regularly taking (once in a month) in nearest hospital. He was observed by the doctor and t dietician at least once in month. His diets are observed dietician because he was restricted foods and fluids. He needs support for all his activities and he was using wheelchair for mobile. He was assessed under Roper – Logan- Tierney (1996) nursing model. it contains 12 activities of daily life which are , maintaining safety , mobility , communication , elimination , eating and drinking , cleansing and dressing sleep and rest , work and play , body temperature , sexuality , breathing and dying . In these he was assessed under eating and drinking, safe environment and maintaining of intake and output. He is very interested in joining chatting with other members of the nursing home and watching TV .His nutritional condition was assessed monthly and has been maintained well and stable. The care plan shows his renal problem as at risk of malnutrition and dehydration due to the problem of restricted fluid intake and diet. I am going to follow six phases of Gibbs model (1988) to reflect an episode which involved MR .X.

In the descriptive phase of