What Is Mental Health? | MentalHealth

Running head: MENTAL HEALTH
Mental health
Name of the student:
Name of the University:
Author’s note

1MENTAL HEALTH
All new graduate nurses expect to become work ready during their clinical placements.
Work readiness is achieved when they effectively apply on-campus theoretical learning and get
exposed to the realities of the clinical setting during clinical placements (Patterson et al. 2016).
Thus, workplace learning is obtained when nurses engage in reflective practice. This involves the
process of reviewing an experience, analysing what was done right and wrong and using this as
an approach to learn about practice. It enables nurse to scrutinize their previously held views by
reflecting on prior learning and identifying the opportunity to improve future practice. Thus,
reflection is an effective learning strategy that provides assistance to nurse to become an
independent professional with sound clinical judgment. This reflective essay will reflect on a
recent clinical placement that I participated as a student nurse and the key lessons that I learnt
during the process (Al-Kofahy and James 2017). The Gibb’s reflective model of reflection will
be used to base the reflection and the significance of using this model in the essay is that it will
allow systematically describing and reviewing the experiences during the clinical placement. The
experience and key professional learning gained will be expressed through the six reflective
steps of description, feelings, evaluation, analysis, conclusion and action plan.
During the clinical placement in a health care setting as a student nurse, a 65 year old
woman named Mrs. Williams (patient’s real identity has been kept confidential) was admitted to
the hospital two days ago because of self-harm behaviour. I was supposed to provide care to
patient on behalf of the medical team by conducting some assessment on patient and
administering the prescribed medication. The patient had a history of depression and her attempt
to cause harm to herself brought her to the hospital. She had tried to cut her hands when she
found a knife in front of her at the dining table. Though she had been taking anti-depressive
medications since the past two years, her condition deteriorated significantly since the past six

2MENTAL HEALTH
months after the death of her husband. Through the review of her case history, I got to know that
social isolation was the main reason for her deterioration of symptoms as currently she was
living with her daughter, aged 26 years old. Due to her work routine, her daughter could remain
with her only till the morning. She lived alone throughout the day until her daughter arrived by
evening. The problem was that she started showing unusual behaviour since the past two weeks.
During my clinical placement, I was supported to give certain prescribed medication to the
patient. I started with normal greetings and tried to administer her medications. However, she
became very aggressive and started abusing and harming me physically. I was impulsive at time
and in an attempt to protect myself, I quickly tied her hands to the bed and went away.
I had started with a very positive mindset. I was aware that this clinical placement will
give me the opportunity to learn more about practice in real settings. However, the experience of
witnessing sudden aggression in the patient was very overwhelming and fearful experience as I
was a student nurse. I was taken aback by the patient’s sudden attempt to harm me. Though
during my learning experience, I had learnt about symptoms of aggression in some mentally ill
patient, however experiencing the same practically was a different experience. Feeling of fears
and anxiety became dominant for me at that time. Evidence shows that nurses who encounter
such type of violence in clinical settings often suffer from negative physical and psychological
consequences. Psychological outcomes of patient violence include anger, fear, guilt, self-blame
and shame. Similarly, I also experienced these feelings (Al-Kofahy and James 2017; Pekurinen
et al. 2017). However, when reflecting back on my action, I feel that I should have made an
attempt to use other means to controlling Mrs. William’s aggression too. I found my action of
restraining patient to be a very disappointing strategy and I often guilty about my act done during
the placement.

3MENTAL HEALTH
When reflecting back on the action that I took to control the aggression of mentally ill
patient, there were many things that went wrong. Firstly, I used restraint as a means to protect
against any harm from an aggressive patient. This action was wrong because I did not take any
permission from my higher authorities neither did I escalated the matter to the other medical
team. As a reflex action, I thought restricting the patient was the best act. However, this was an
unprofessional behaviour as I should have collaborated with other interdisciplinary team to
manage such situations. My behaviour not only resulted in poor collaboration process, but also
violation of patient dignity. Kamel, Maximos and Gaafar (2007) report that ordering of restraint
is the responsibility of physicians and their experience determine whether it should be used in
any patient or not. But as nurses are frontline carer of mentally ill patients, they choose restraint
influenced by psychological reactions to the violence. This action was against professional
nursing standards too.. According to the Nursing and Midwifery Board standards (NMBA)
(2017) of practice for registered nurse in Australia, registered nurse must communicate
effectively and be respectful of person’s dignity, culture and rights. Implementation of structured
team approach is an evidence based approach as Wong et al. (2015) supports regarding the use to
team approach that promotes inter-professional collaboration to manage patients with
behavioural emergencies like violence and aggressions. Thus, I feel that I failed to comprehend
the gravity of the situation and improving comprehension of patient violence is an area that I
have prioritized to improve my skills in managing the same situation in the future.
Secondly, the next wrong thing about my action was that I used restraint measures
instead of any therapeutic approach to control aggression. This action was wrong because it
violated patient’s dignity, self-respect and their freedom of choice. I engaged in an act of blindly
implementing physical restraint without thinking about its consequences. Ye et al. (2018) argues