Katherine

Tan
November 11th, 2015
Reflection Journal #3

Reflection Journal: Due by midnight on the day of clinical. This is a brief summary (generally a single
spaced page of page and 1/2) of each clinical days experiences. You may then focus your reflections
on a particular event or issue which you observed or experienced. Reflective journaling is designed to
help you organize your thoughts about patient care, analyze clinical thinking and judgment, and
demonstrate your participation in your own learning process. The journal will address:
Goals (for the day and practicum experience)-
o I wanted to be available to calmly have a conversation with my patient and explore her
diagnosis further.
Daily experiences and personal responses-
o I had an overall interesting day and Im grateful to have had a positive this clinical day.
Knowledge applied / used / needed-
o I used some therapeutic communication skills and looked to improve my listening skills.
Constructive critique of self and others (peers, staff, instructor) performances-
o I could have had better responses to some of the things that my patient was explaining
to me.
Learning and performance adjustments-
o I still need to improve on formulating care plans.
Goals planned for the next clinical day-
o I would like to explain further into a diagnosis with my patient again but a patient with
a different disorder.


Today was the most rewarding day I had at clinical thus far. I arrived on the unit at
approximately at 6:35 am. We received report with the morning shift. There seemed to be a lot of
interesting cases on the unit. I was very happy to hear that the patient I had last week had greatly
improved. I had chosen the patient that stuck out to me the most. She was a female who identified as
gay. She was diagnosed with major depression and anxiety. I spent the very beginning of the day in
rounds with the medical student, charge nurse and physician. It was interesting to hear the interactions
between the medical student, physician and the patient. Prior to going into psych, I had thought that
psych patients would be incredibly hard to deal with and uncooperative. From what I got to observe
today, all of the patients were involved in their care and could recite their medications to you if you had
asked them too. I was very impressed with this. They are also are able to articulate how they are feeling
and willing to work with the team to make changes to their therapy. I believe in general, that I was
shocked at how many of the patients had the desire to get better; however, this was due to my
misconception of psychiatric mental health nursing. I was able to meet a lot of the patients when they
came into rounds and they were all very polite. I was surprised to see that there was an 18 years old
man on the unit. He was kind and made an effort to say hello to me and other students on the floor. I
had briefly met my patient after the end of rounds. She was excited to be working with me and that
made me even more excited to work with her. She had a morning routine that she followed so while she
did that, I was able to work on my SOAPIE note. I attended the team meeting and spoke up during it. It
was nice to see the interdisciplinary aspect of care. I was able to meet with my patient later in the day.
Her and I sat in her room and began to talk. It was a very natural conversation and I let her determine
the direction she wanted to talk with the conversation, which I believe, played to my advantage in
establishing rapport and getting information and details about her life. She had confided in me very
personal details of her life. I was incredibly touched that she made herself vulnerable to me and was
comfortable enough to express her feelings to me. She started to tear up when her and I talked about
her relationship with her wife and how she had physically hurt her and how guilty she felt. At this

Katherine Tan
November 11th, 2015
Reflection Journal #3

moment, I could almost feel how genuine of a person she was. She had told me about the hardships she
was going through and had been through throughout her lifetime and how it has affected her as a
person. It was also rewarding to hear that this is the best she has felt about herself in 20+ years. I could
see that she felt ready to return to her home and family and that she was ready to make necessary
changes to her lifestyle in order to be a better version of her. Along with the many misconceptions of
psychiatric mental nursing, I did not really expect to see recovery, but I was wrong and it was such a
great feeling knowing that this woman has changed for the better. During our conversation, she had
shared with me many gruesome details of previous relationships and I was worried that some of my
responses were inappropriate. In my next clinical day, I hope to be able to respond in a more
appropriate manner. I also keep forgetting that sometimes addressing that I have nothing to say at all in
response to what she has told me is a good technique and shows my interest in what she is saying. At
the end of the day, I was so sad to be leaving her and she was sad that I was leaving as well. While I was
leaving, she gave me a hug and wished me luck in my future and I said the same to her. It was great to
see a story with a happy ending. After I had said goodbye to her, I was able to travel to the other side of
Crossroads and observe a woman who claimed to have catatonia. It was interesting because the woman
was clearly pretending. I was able to palpate a bruit on a patient with a fistula. It was very interesting to
see how prominent it was just on palpation. Overall, I was pleased with the experience I received on the
unit. I was able to take away of lot of information and come in contact with great patients.