NU245CL Unit 2 Locked Unit Reflective Journal Example

Someone Else Had the Key: A Reflective Journal Entry Using Atkins and Murphy's Model on a Composite Student's First Day on a Locked Unit and the Forty Minutes Spent Reading Charts Nobody Had Asked Her to Read

[Student Name]

Purdue University Global

NU245CL: Mental Health Nursing Clinical

Unit 2 Reflective Journal Entry

[Instructor Name]

[Date]

The unit, staff and patients are composite; no patient information from charts is included, and the student followed the site's rules on record access.

Awareness of Uncomfortable Feelings

Atkins and Murphy's model begins with an awareness of uncomfortable feelings or thoughts (Atkins & Murphy, 1993). Mine came at [0715] on my first day, in the space between the two locked doors at the entrance of the unit. The first door closed behind us before the second opened. My instructor had the badge. I had a sudden, clear thought: I cannot leave unless someone lets me out. It lasted only a few seconds, but my chest tightened, and I noticed that I was relieved when the second door opened.

Describing the Situation

After orientation, my assigned nurse went to a medication pass and told me to "get to know the unit." The dayroom had about ten patients. Two were watching television, one was pacing, and a woman near the window was talking loudly to no one I could see. I walked once around the dayroom, then sat down at the nursing station and began reading the charts of the patients on my assignment, and then of patients who were not. I read for forty minutes. Nobody had asked me to. When my nurse came back she said, "Did you meet anyone?" I had not.

Critical Analysis

Why did I read charts? I told myself I was preparing. Some of that was true; I learned diagnoses and histories. But I read far more than I needed, and I read in a place protected by glass, with my back to the dayroom. I think the charts were a hiding place. They let me learn about patients without having to speak to them, which is what I did as a sitter, watching from a distance.

I knew everything the charts could tell me about the woman at the window and nothing she could have told me herself.

The locked doors also mattered. If I felt uneasy for a few seconds about not being able to leave, patients who cannot leave for days may feel that and more. On a locked unit, a door means safety to staff and confinement to many patients (Goffman, 1961). I had felt the second meaning before I could name it. That should make me more careful about how I talk about doors, keys and passes. Reading charts beyond my assignment also raised a question I had not thought about. Students may access the records of the patients they are caring for. Reading others out of curiosity is not part of that purpose, and I am not sure all of what I read was mine to read (Halter, 2022).

What My Nurse Said

When I told my assigned nurse about the forty minutes, she laughed and said that almost every student does it, and that she did it too in her first week as a new graduate. She said the charts would still be there at two in the afternoon, but the patients would be in group or asleep, so the morning was the time to meet them. That small piece of practical advice reframed the morning for me: the order of my day was a choice, and I had chosen the order that kept me safe from awkward conversations.

Synthesis: What I Learned

I learned that my reflex in an unfamiliar, uncomfortable place is to find a task that keeps me at a distance. On a psychiatric unit, that task is easy to find, because charts are always available. I also learned that I can feel a small part of what confinement means, and that this feeling is useful information rather than something to push away.

Evaluation

The chart reading was partly useful and partly avoidance. Its cost was forty minutes without speaking to anyone, on a day meant for getting to know the unit. It may also have crossed a line on privacy.

New Plan

1. Ten minutes before any record: on arriving, I will spend ten minutes in the dayroom, introduce myself to at least two patients and then read only my assigned patients' charts.

2. Doors: I will notice how often patients ask about passes and doors, and how staff answer.

3. Privacy: I will ask my instructor which records I may read and stick to them.

The next day I spoke to the woman at the window. She told me she was waiting for her daughter and asked whether visiting hours had changed. I did not know, and I found out for her.

References

Atkins, S., & Murphy, K. (1993). Reflection: A review of the literature. Journal of Advanced Nursing, 18(8), 1188-1192. https://doi.org/10.1046/j.1365-2648.1993.18081188.x

Goffman, E. (1961). Asylums: Essays on the social situation of mental patients and other inmates. Anchor Books.

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