Over the last 8 years I have been supporting nurses, midwives, nursing associates and other associated professionals who are undergoing Fitness to Practice investigations with their regulator. Predominantly this has involved the Nursing and Midwifery Council members. I have been doing this through my organisation NMCWatch: registrant care CIC.

A common theme is how ill prepared the people we support are, in being able to prepare appropriate reflective work and evidence of good practice when faced with ongoing proceedings against them. Despite reflection having been a part of our professional revalidation for maintaining our registrations when faced with the Quasi judicial process they are thrown into turmoil and find it incredibly difficult to navigate without assistance. I have been spending a great deal of these last 8 years educating NMCWatch members on this area.

So why do  nurses and midwives find it so hard to respond to allegations in a reflective manner?

Fear and Anxiety

Being accused of wrongdoing is a serious and often traumatic experience. It can trigger fear about job security, professional reputation, legal consequences, and our registration with a governing body like the NMC (Nursing and Midwifery Council). That fear can shut down someone’s ability to reflect openly, because:

• They may be afraid that honest reflection will be used against them.
• They might not be thinking clearly due to stress or panic.

Shame and Guilt

When someone feels ashamed or guilty, their instinct might be to avoid thinking too deeply about the situation. Reflecting honestly means confronting possibly painful truths about their actions or decisions. That can be really hard to do when emotions are high.

Defensiveness

Accusations can feel like personal attacks—even if they’re not meant to be. This can lead to a defensive mindset where a person is more focused on protecting themselves than learning from the situation. In that state, reflection can feel like admitting fault, even when reflection isn’t the same as blame. If the nurse or midwife is denying the allegations or says things occurred in a different way than they are being portrayed, then they can enter defensive mode rather of one that is open to introspection.

Lack of Support

Many nurses and midwives don’t receive enough emotional or professional support when they’re under investigation. Without guidance, mentorship, or a safe space to talk, reflective practice can feel isolating and even unsafe.

Misunderstanding What Reflection Is

Sometimes, people think reflection means admitting guilt or blaming themselves. In reality, it’s about learning—what happened, why it happened, and how things might be done differently next time. If someone hasn’t been trained to reflect in a non-judgmental way, they might avoid it altogether.

Fit2Practise aims to make this process a whole lot scary and we are enjoying working with many registrants and seeing their growth. It’s not an easy journey for any of us but together we can get through it professionally so that a constructive forward process is achieved.

In our blogs we will look at specific issues people face and give some insight into how these can be addressed. We will also pick up on some key elements around learning and reflection that you will find helpful in your reflective journey.