Sylvia Lee

Reflective Journal Week 5

For the past five weeks at Queens, my experience in the Psychiatric Mental
Health department of Kekela Mauka/Makai, and Family Treatment Center has been very
rewarding. The first few weeks took a bit of adjusting to the different units, but as I got
more comfortable with the staff, familiarized myself with the different mental health
illnesses, and utilized the therapeutic communication techniques, I realized that I really
enjoyed psychiatric mental health! Within the short amount of time, I learned how to
write a DAR note, which was completely different than the med surge DAR notes that I
have been writing. It was a challenging task, to say the least, but in the end, I was able to
make improvements. What I learned from the DAR was to really hone in on the patients
diagnosis. The clinical manifestations and characteristics of the illness were imperative
to understand in order to construct a good DAR. Professor Harrison mentioned that the
first few sentences of a DAR could give you a pretty good picture of who the patient was.
This was very true and important. I observed how the nurses give report in the morning.
They provided the most important details such as +SI, or current plan. I learned from
redoing the DAR notes throughout the weeks and listening attentively to the nurses
report, what pertinent information to provide when writing a good DAR note.
On the fourth week of clinical, I was able to participate in a community group
meeting by being a co-leader. My colleague and I passed around index cards and
instructed the patients to write down their names and on the opposite side of the card,
write down three sentences starting with, I am __________. The patients were
supposed to fill in the blank with positive characteristic about them. This assignment was

to help the patients emphasize on their strengths and positives, rather than on their
weaknesses and negatives. It was a quick way to remind each patient of his or her
positive affirmations. The meeting went well as we saw how each patient took their time
to think about their positives, and within the group milieu, each discussed what their
strengths were. I learned that this type of interaction promoted a positive group therapy
experience.
Throughout the five weeks, I also learned to not judge anyone based off of his or
her diagnosis. I spoke to around 15-20 patients during the past five weeks. Each patient
had his or her own unique story. Some of the patients stories saddened me, while others
I sympathized. I not only learned so much about them, but I learned a lot for myself. I
learned that about 90% of these patients were affected by their childhood and some even
had the mental illness diagnosis due to their childhood experiences. I learned that we
should never disregard the importance of family and nurture. This experience made me
more aware of being a good role model for my daughter. Although she is still too young
to verbally communicate, I realized that the way I nurture her, surround her with a certain
environment, and the way I communicate with her, all affects her emotional well being as
she grows up. From this experience, I learned that being a good mother by providing her
support, tender love, and care are all important to foster a healthy upbringing for my
daughter.
Lastly, I would like to end this journal by stating that I did a lot of self-reflecting
during this portion of N360. When I entered nursing school, I never once thought that I
would be interested in Psychiatric Mental Health. However, my mind has changed since
this semester. I am now very interested in this specialty. I think I not only have an

interest in this area, but luckily, theres a need (according to the professors that I have
spoken to). I can honestly say that I enjoyed and looked forward to every single PMH
clinical this semester and very sad that next week is our last. I wished we incorporated
more PMH into the nursing program. I do know, that PMH is challenging at times,
especially with all our endless paperwork, assignments, pretests, midterms, skills check
off, 12-step meetings, ROL and WCH, and presentations. However, I would not trade
this experience for any less paperwork, homework, or assignments. What I learned from
this clinical rotation was priceless. I am happy I survived thus far, but happier that I
found one of my interests in nursing. If time and money werent an issue, I would
definitely look into pursuing further education, such as obtaining my masters in
psychiatric mental health. I agree that PMH is widely ignored especially with the
negative stigma that still exists in our community. Albeit the stereotypes persist, it is still
apparent and a widespread problem. It will not go away. Therefore, I hope to one day, be
a part of the nursing staff to help within the psychiatric mental health community.