Hello, below are the instructions for this reflection. My first clinical day was

Hello, below are the instructions for this reflection.
My first clinical day was a place called Reno Behavioral Hospital (inpatient psychiatric unit). Even though I alreacompleted a reflection I have to do another one. A the end of of the assigment instructions I am putting my initial rreflection to give you a guide on what my first day was like/some of my thoughts. You are welcome to add whatever you believe instructors would like to hear.
This is the assignment instructions:
Behavioral Health Reflection # 2 (when you complete your first clinical week)
Remember that this journal uses the theoretical concepts you have learned and applies them to clinical practice:
Discuss your feelings regarding your first clinical day. How did it compare with your expectations?
Discuss the milieu on the unit, is it a therapeutic milieu? Give examples of how it is or is not. Does it provide a safe “holding environment”?
Describe an interaction between nursing staff and a patient that demonstrated empathy, advocacy, or a therapeutic alliance. Yes the mental techs were great and they really seemed to care about the patients they demonstrated all the above).
Discuss a legal or ethical issue you have encountered during this clinical? Consider the ethical principles that were evident in the situation and how these principles were adhered to or violated. What did you learn from this experience & how will it impact your practice? Ex) non-adherent patients, you cannot help patients that refuse the help.
Discuss the role of the nurse in maintaining safety on the unit. What assessments are made by the nurse? What interventions support patient safety?
The reflection assignment should be a minimum of three pages in length
Rubric
Behavioral Health Reflection
Behavioral Reflection #1
Our first clinical day at Reno Behavioral Center (RBH) served as a reminder that I do not enjoy the feeling of being in a locked psychiatric unit. That morning our class waited anxiously in the lobby area for a staff member to come out and greet us and give us a tour of the facility. A short while later we were greeted by a vivacious red-haired lady. She introduced herself and welcomed us to RBH and then she directed us passed the security locked door located in the lobby. As we walked in for a brief second, I forgot I was entering a locked psychiatric facility because my gaze was occupied by the long hallway towards the center of the building there were large glass windows from floor to ceiling. These windows allowed in a lot of natural light and there was greenery that was accented with beautifully painted multi-colored rocks with positive messages on them. Looking at this made me feel very relaxed and hopeful. Of course, this all changed when I stepped foot inside the actual unit. This is when I felt as if time had stopped, and the never-ending clinical day began.
I am acutely aware for the need to prioritize safety. In these types of settings, it is required that each institution create and follow policies in order to promote safety for both patients and care team members. In addition, the design of the buildings (i.e., door design security, handles, furniture, windows around nurses’ station, patient room design & showers ect.) serve a reminder that you can never be too careful around this population. These rules and designs make me feel as I were in a prison. I was assigned to the male adolescent unit, and it went as well as I expected.
Many who work in the nursing field can agree that nursing is hard, so it’s not surprising to find that providing psychiatric nursing care can also be challenging. I am no stranger to the psychiatric world and my beliefs are heavily influenced by my professional experience. Psychiatric nursing is not a field I consciously chose but my options as a practical nurse were very (are) limited. So, when the opportunity presented itself, I decided to take it and make the best of it. Initially I found psychiatric care fascinating and it allowed me to learn skills that never imagined I needed such as learning to read a patients’ body language and adapt to their mood and needs. As the years passed, I began to understand, and feel the burden of the enormous systemic issues that plague our mental health system. As odd as this may sound, I have found that psychiatric nursing is one of the most emotionally draining jobs I have ever had. I have had the opportunity to work with psychiatric patients for over 10 years now and witnessed the difficulties faced by truly mentally ill patients and it has been heartbreaking to watch it all unfold.
That being said I am a strong advocate and support the reinstating of psychiatric asylums as I believe that there is a great need for them in our society. I do not support the horrific actions or conditions that were occurring in some of the these places, but I do believe more funding, re-organization, promoting healthier and safer conditions would have been a better solution. After the de-institutionalization of mental hospitals there was never a replacement for them, and it has created serious problems. I have seen that many of our mentally ill end up in jails and truly that’s no place for them. Jail and prison settings do nothing to truly help with mental illnesses. There is no better time for us as a society to make changes that can help change mental health, because we have more knowledge which we can apply to make these institutions safer and more healing places for mentally ill.
I do have concerns regarding the future of mental health. It seems that as a society we have placed our focus on a variety of issues but not prioritizing the more important issues leaving no room for addressing true mental health issues. For instance, political correctness has served as a double-edged sword. The one-sided constant re-education and rules imposed on healthcare workers surely cannot promote therapeutic relationships and therefore make it much more difficult to establish. In addition, I have noticed that in our community our mentally ill pediatric population has become more angry and physically aggressive towards care providers. I want to be clear that I do understand that any setting has the potential for violence, but I do believe that mental health patients are more likely to be verbally and physically aggressive.
As I mentioned before mental health care can be emotionally taxing on nurses because there are many situations where you must deal with patients with acute mental and physical health conditions, threats of physical and verbal violence. When I think about my own mental health, I now realize that in the last few years (3-4 years) this field has taken an emotional toll on me for a variety of reasons. In general, to help keep myself healthy, I participate in exercise, try to eat healthy, sleep, and usually make time for myself (massages), but I realized that was no longer helping me. My mental health was suffering, and I was miserable. When I would go in to work, I found myself not wanting to deal with the patients and found no joy in what I was doing. I was also losing my empathy. That’s when I made my choice to quit my job and start school so I could find something different.
What I would like to learn during this course is what mental health changes are taking place within our community. What direction is our mental health headed? Our recent pandemic serves as a reminder that not properly caring for our country’s mental health population is a recipe for disaster, creating the devastating consequences we are witnessing in our society. I would like to learn more about mental health first aid when and where the trainings are held so I could become more educated in this area.
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeThoughtful and reflective answers to the questions
12 pts
Exceeds Standards
Answers all questions in a thoughtful and reflective manner
6 pts
Meets Standards
Answers questions in a superficial manner
3 pts
Below Standards
Does not answer all questions, uses short answers
0 pts
No Marks
Does not meet guidelines
12 pts
This criterion is linked to a Learning OutcomeSelf Assessment
Applies self assessment to Mental Health Nursing
Discusses self care activities
Demonstrates critical thinking
10 pts
Exceeds Standards
Applies self assessment to Mental Health Nursing Discusses self care activities Demonstrates critical thinking
5 pts
Meets Standards
Superficial self assessment
2.5 pts
Below Standards
Minimal self assessment
0 pts
No Marks
Does not meet guideline
10 pts
This criterion is linked to a Learning OutcomePresentation of information
Appropriate length, timely submission, APA writing standards
8 pts
Exceeds Standards
Appropriate length, timely submission, APA writing standards
6 pts
Meets Standard
Meets standards but does not show excellence
3.2 pts
Below Standards
Submits assignment, but does not meet standards
0 pts
No Marks
Does not meet guidelines
8 pts
Total points 30