NU245CL Unit 10 Closing Reflective Essay Example

By the Door, Behind the Glass, in a Dayroom Chair: A Closing Reflective Essay Tracing a Composite Student's Psychiatric Rotation Through Where She Physically Stood, Tested Against Mezirow's Account of Transformative Learning, With One Reaction That Never Changed

[Student Name]

Purdue University Global

NU245CL: Mental Health Nursing Clinical

Unit 10 Closing Reflective Essay

[Instructor Name]

[Date]

The writer, unit and patients are composite; the essay draws on the term's own journal entries and assignments.

The Watcher Assumption

I began the rotation with an assumption I did not know I held: that the safest and most useful place for me was where I could see everything and engage with no one. Two years as an emergency department sitter had taught me that. My objectives statement in Unit 1 named it as a habit to watch, but I did not yet see it as a belief about what nursing is.

The First Day: By the Door

On the first day I stood near the dayroom door for most of the morning, then retreated to the station to read charts for forty minutes. My Unit 2 journal described it honestly. My position said what I believed: I was there to watch.

A Dilemma With a Date

In Mezirow's account, transformation tends to start when an experience will not fit what a person already assumes, and it continues through critical reflection on those assumptions, exploring new roles and acting on a new perspective (Mezirow, 1991). My dilemma came on [day 9], with the silent woman in Unit 3. I filled her silence with reassurance, she turned away, and then I offered simply to sit, and she began to talk. Sitting beside her, not watching from the door, was what helped. That did not fit my assumption that distance was safe and useful.

The most useful thing I did all term was the thing my old job had trained me never to do: sit down and stay.

Midterm: Behind the Glass

The change was not immediate. My Unit 4 milieu observation, written at midterm, was written from my seat inside the station, looking out at the room. When a patient knocked on the window, I did not go out. I wrote in that paper that a seat behind glass is a position in the room too, and I meant it, but I was still behind the glass. A new idea and a new habit are not the same thing, and the glass was a stubborn habit.

The End: A Dayroom Chair

In the last three weeks my journal notes, which recorded where I stood each day, changed. I sat in the dayroom for most of each shift. The conversations I wrote about required a chair: the lithium teaching in Unit 9, where a landscaper's questions only came because I had time to listen, and the case formulation in Unit 8, built from a man's account of one season, which took two long conversations sitting at a table. Peplau described the nurse-patient relationship as something built through repeated contact and presence (Peplau, 1952). I could not have built any of those relationships from the doorway.

Testing Whether the Change Was Real

Mezirow's test is whether a new perspective is acted on, not only held. By that test, the change was real but partial. I now act on the belief that conversation is nursing work: my position changed, my notes changed and my assignments show it. But I tested the change only on a calm unit with my instructor nearby.

A Flinch That Stayed

One reaction never changed. When a patient shouted suddenly near me, I flinched and stepped back, every time, from the first week to the last. As a sitter I was trained to step back and call for help, and that response is still in my body. Some of it is appropriate; stepping back can be safe. But I noticed I also stepped back from patients who were loud and upset but not dangerous, and that may have told them I was afraid of them. I do not have a fix for this yet. I plan to practice de-escalation in simulation and to ask my next preceptor to watch for it (Halter, 2022).

What the Term's Documents Show

Rereading my assignments in order, the change is visible in small details. The early pieces are written about patients; the later ones are written with them, quoting what they said in conversations I was part of. The Unit 4 observation has no dialogue at all. The Unit 8 formulation is built almost entirely from one man's words. That shift in the documents is better evidence of change than my own sense of it.

What I Take Forward

I will keep the observer's eye I brought, because noticing early is valuable. I will use it from a chair. And I will keep a record of where I stand, because it showed me what I believed before I could say it.

References

Halter, M. J. (2022). Varcarolis' foundations of psychiatric-mental health nursing: A clinical approach (9th ed.). Elsevier.

Mezirow, J. (1991). Transformative dimensions of adult learning. Jossey-Bass.

Peplau, H. E. (1952). Interpersonal relations in nursing. G. P. Putnam's Sons.