NU245CL Unit 6 Safety Rounds Reflection Example

A Charger Cord Inside a Paperback: A Safety Rounds Reflection From a Composite Student Who Joined an Environmental Round, Traced the Cord Back to a Bag Check That Missed It and Weighed a Necessary Search Against Handling a Stranger's Belongings

[Student Name]

Purdue University Global

NU245CL: Mental Health Nursing Clinical

Unit 6 Safety Rounds Reflection

[Instructor Name]

[Date]

The unit, patient and staff are composite; the student joined the round with staff, did not search alone and followed the unit's policy on belongings.

What Happened

At [1000] I joined the charge nurse and a technician on the unit's weekly environmental safety round, which checks rooms, bathrooms and common areas against a checklist of hazards. In room 4, the technician picked up a paperback from the windowsill. A white charger cord, about a meter long, was coiled inside a hollow cut into the pages. The room's patient, [Mr. R.], 44, admitted [three] days earlier with depression and suicidal thoughts, was in group. The cord was removed, documented and reported to the charge nurse, who informed the provider and arranged to talk with him.

Following the Cord Backward

Where did it come from? Patients' belongings were searched on admission, and the cord was not in his admission inventory. Visitors' bags were checked at the entrance. The day before, his brother had visited and brought books. The bag check looked inside the bag, but not inside the books. I mapped the layers. Admission search: held. Room checks each shift: did not find it, because the book looked like a book. Visitor bag check: missed it. Weekly environmental round: found it. The checklist approach to environmental safety on mental health units has been associated with sustained reductions in inpatient suicide in a large health system (Watts et al., 2017), and the round did its job here, but only after the cord had been on the unit for a day.

The cord passed two checks because it was hidden in something nobody thinks of as dangerous; the round found it because it was looking at everything, not only at bags.

Handling a Stranger's Belongings

I felt uncomfortable during the whole round. We opened drawers, lifted mattresses, looked through toiletry bags and flipped through books, while their owners were in group down the hall. I kept thinking about how I would feel if someone went through my things. On a locked unit, people have already given up much of their privacy, and searches can feel like another loss of control and identity (Goffman, 1961). The technician moved quickly and neatly and put everything back as it was. I noticed I was hesitating before touching anything.

Was the Search Necessary?

Yes. A cord is a ligature risk on a unit where several patients, including Mr. R., had recently thought about suicide. My discomfort did not mean the search was wrong; it meant that something necessary still carries a cost for the person searched. Holding both of those at once is part of the work (Halter, 2022).

An Apology Harder Than Anger

In the afternoon, the charge nurse spoke with Mr. R. with me present. She explained that a cord had been found in his book, that cords are not allowed for safety, and asked if he wanted to talk about it. I expected him to be angry. Instead he said quietly, "I'm sorry. I asked my brother to bring it. I wasn't going to do anything." He looked ashamed. His apology was harder to sit with than anger would have been, because it showed how much he understood what we had been worried about. The nurse thanked him for telling her, said that she would let the provider know what he said and asked how he was feeling today.

His Brother

The charge nurse also called his brother, with Mr. R.'s permission, to explain why cords are not allowed. His brother said he had not known and had only wanted Mr. R. to be able to use his phone during visits. He was upset to have brought something that worried staff. The call turned a safety lapse into a teaching moment for the family, who will be part of his life after discharge and may need to think about cords, medications and other risks at home.

What I Learned

Safety rounds work because they are systematic, and they find what other checks miss. The cost to patients' privacy is real and should be reduced where possible, not ignored. And a patient whose item is found may need support as much as supervision.

What I Will Do

On future rounds, I will state the purpose before touching anything, even if the patient is not there, by following the unit practice of telling patients in the morning that rounds will happen. Where a patient is present, I will say, "We're checking all rooms for safety today, and I'll put everything back." I will also suggest to my nurse that visitors be told what may not be brought and why, since his brother likely did not know.

References

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.

Watts, B. V., Shiner, B., Young-Xu, Y., & Mills, P. D. (2017). Sustained effectiveness of the Mental Health Environment of Care Checklist to decrease inpatient suicide. Psychiatric Services, 68(4), 405-407. https://doi.org/10.1176/appi.ps.201600080