on gives scope for better understanding of oneself so that existing strengths can be used to build-up for future actions "(Somerville and Keeling, 2004). Every nurse registered under the Australian Nursing and Midwives Council or the ANMC needs to exhibit a certain degree of competency guided by the standard frameworks of competency standards designed by the ANMC (ANMC, 2005). High standards of competence can be maintained by the nurses through appropriate evaluation and examinations of ones own activities and performance, through clinical reflection. There are basically four domains of competency standards in nursing practice. They are professional practice, critical thinking and analysis, provision and coordination of care and collaborative and therapeutic practice (ANMC, 2005). In this essay, clinical reflection pertaining to critical thinking and analysis and provision and coordination of care will be discussed with reference to care of a a patient with diabetic ketoacidosis in an emergency setting. While the domain of critical analysis and thinking refers to "self – appraisal, professional development, and the value of evidence and research for practice" (ANMC, 2005), the domain pertaining to coordination of care deals with "the coordination, organisation and provision of nursing care" (ANMC, 2005). Gibbs model of reflection will be used because the framework is straight forward and includes a cycle of clear description of the clinical situation, analysis of the feelings of the practitioner, evaluation of the actions during the situation, analysis of the various activities and experiences during the situation and a conclusion for lessons in future (Online learning, 2006).
During my postings in the accident and emergency department, a 35 year old woman Mrs. X was brought to the emergency unit by her husband Mr.Y with history of fever since 2 days and abdominal pain and vomiting since few hours. The patient complained of easy fatiguibility and tiredness