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Reflection on diagnosing as a nurse in ITU.

Brookfield's (1995) four critically reflective lenses are adapted from teaching and applied to nursing within this article. The lenses are used as a framework for exploring the author's feelings associated with diagnosing a life-threatening problem in intensive care in the presence of a disagreeing doctor. The issues surrounding the distinctions between medicine and nursing are explored. Wellington and Austin's (1996) five orientations to reflection provide the framework for the author's 'metacognition'--his thoughts about his thoughts. These are communicated by way of a critical commentary.