Reflective Essay: Experience of a Nurse in Counselling Session

This reflective essay provides an in-depth analysis of a nurse's counselling session with a patient struggling with substance abuse and mental health issues. The essay explores the challenges of communicating with a disturbed individual, the importance of empathy in therapeutic communication, and the nurse's attempts to understand the patient's past experiences and present circumstances. The author discusses the patient's guardedness, expressions of distrust and anger, and the underlying feelings of insecurity and violence. The essay also highlights the difficulties in addressing the analytic lag between past events and present addiction, and the significance of managing the patient's emotional instability. The nurse reflects on the outcomes of the session, including the patient's self-motivation to seek further help, and the importance of allowing the patient to make their own decisions. References to relevant literature are included.

Running head: REFLECTIVE ESSAY
REFLECTIVE ESSAY
Name of the Student
Name of the University
Author Note

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REFLECTIVE ESSAY
The interview with Joe went in a very curious way from the interviewer’s perspective
was extremely experiential, for so many covert mechanisms underlined Joe’s conversation
with me. Coming across an anxious or delusionary subject always challenges the
communicative skills of a nurse, but it also can lead to the development of a practitioner’s
personal and professional skills (Desmond & Lenz, 2010).
Counselling a psychologically disturbed subject is quite different compared to
understanding a subject’s mind who is about to undergo a conventional medical or surgical
intervention (Akol et al., 2018). I attempted to investigate Joe’s past experiences that have
led to substance abuse and its implications in his present life. In the initial stage of the
counselling session, Joe was pretty guarded and the fact that he was unable to communicate
his feelings, made him more anxious and agitated. Joe was oriented though about his present
condition, and gradually he found a way to speak out about his inner distrust and anger
towards his family members. The way he began to express himself to me, in the course of the
counselling is a good thing.
I came to know during the interview, that Joe is depressed due to his family members
and present circumstances (Stone & McMillan, 2012). I related this information to the
presenting symptoms. Gradually with the progress of the interview process, Joe started to
come out of his ‘guarding’ and started interacting with me, which is worth the counselling
session. I felt underlying feelings of insecurity, agitation and violence brewing inside Joe. I
attempted to know about the reason behind the first adherence of Joe’s substance abuse and
how cannabis became an object of likeness to him, but the fact remained unknown to me.
Being an individual suffering from anxiety and possible undiagnosed depression, Joe let out
many hints of his distorted emotions (Rudge, 2016). The information regarding his negative
feelings towards his family members under the given situational circumstances was an
important piece of information.

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REFLECTIVE ESSAY
As a nurse, I came across many disturbed people who were very violent as well as
aggressive. Throughout our conversation, I found out that Joe is in a state of self-denial, but
towards the end, he was willing to understand the problems and how to come out of it. Over
the years, my experiences with patients like Joe had been both positive and mixed. I learned
early in my career that understanding a person’s personality is the key to comprehending a
person’s covert behaviour which at times expresses itself as overt as well. Empathy, I believe
is the most important tool in therapeutic communication which helps us to ‘feel’ a person’s
psyche and it, also helped me to cure many disturbed patients over the years.
Joe was mentally disturbed as well as angry with his mother, and he had trust issues
with his sister. The main challenges in interviewing depressed and substance abuse subjects is
the analytic lag between the past events relating to the onset of substance abuse and the
present situational turmoils perpetuating the addiction process. The other challenge is the
individual personality trait which reinforces a counselling process uniquely. Some subjects
are open to directive counselling while an eclectic process better counsels others. The present
situation plays a critical role in biasing a subject’s behaviour and must be handled carefully.
The most vital thing is to manage the subject’s emotional instability in a complex situation.
After taking the interview with Joe, I felt the need of making Joe realise the problem
are hovering around his present situation, and at every point, I left the decisions to his
judgments. Understanding his personality was a major roadblock as he has pretty guarded
regarding his covert mechanisms. Finally, his decision to return for a second interview with
me shows his self-motivation - to get on with life in the right way which is a bright outcome
of this interview.

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REFLECTIVE ESSAY
References:
Akol, A., Makumbi, F., Babirye, J. N., Nalugya, J. S., Nshemereirwe, S., & Engebretsen, I.
M. S. (2018). Does mhGAP training of primary health care providers improve the
identification of child-and adolescent mental, neurological or substance use disorders?
Results from a randomized controlled trial in Uganda. Global Mental Health, 5.
Desmond, B. C., & Lenz, P. J. (2010). Mental health courts: An effective way for treating
offenders with serious mental illness. Mental & Physical Disability L. Rep., 34, 525.
Rudge, T. (2016). (Re) thinking violence in health care settings: A critical approach.
Routledge.
Stone, T., & McMillan, M. (2012). Warning–this Job Contains Strong Language and Adult
Themes: Do Nurses Require Thick Skins and Broad Shoulders to Deal with
Encounters Involving Swearing? (Re) thinking Violence in Health Care Settings: A
Critical Approach, 259.