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In Focus: Self-Awareness in Nursing Students in Psychiatry

Submitted by on August 11, 2016 – 9:47 PM

selfawarness572x4291“Understanding of another human being begins with understanding of self” (Jones & Learning, 2005). Everyone has different strategies to know their inner feelings, thoughts and realities. Understanding of self can help people to differentiate their own values, beliefs and personal boundaries. Thus, the process of understanding and accepting one’s own believes, feelings, state of mind, standards, different approaches, inspirations, biases, strengths and boundaries and recognizing how they affect others is called self-awareness.


Ongoing process of becoming aware of self, allows a nurse to admit the values and beliefs of others that may vary from his/her own (Videbeck, 2004). According to Mount Royal University (2011), self-awareness represents the ability of pointing one’s own strengths and weaknesses. This is a state in which people willingly identify, process, and store information about themselves. Furthermore, the main function of self-awareness consists of self-evaluation, get away from the self, and strengthening of one’s individual experience, improves self-knowledge, self-regulation, and inferences about others’ mental states (Mount Royal University, 2011).


Self-awareness is being aware of both our mood and our feelings about mood. Dubrin (2007) defined self awareness as, “insightfully processing feedback about oneself to improve one’s effectiveness”. Self-awareness is tremendously essential for nurses. Nurses need to know themselves so that their individual emotional state, attitudes and desires do not confine quality care provided to clients (White, Duncan, & Baumle, 2010).


Dealing with mentally ill patient is very challenging for a nurse and it has also a significant impact on mental status of psychiatric nurses (Ahmed & Elmasri, 2011). Engin & Cam (2009) explained that it is very important for psychiatric clinics, to have professional values, self-awareness and self-sufficiency to accomplish a concrete nursing practice.


Recently, I encountered a patient diagnosed with schizophrenia at a mental rehabilitation Centre. During the interview, I realized that I am overly sympathizing and accepting whatever the patient is telling. So, I was unable to accept the present illness of the client, which made it difficult for me to make realistic goals and interventions for the patient. I was unable to explore the disease process correctly so it was a big challenge for me to differentiate the values of client and self.


For a nursing student, it is necessary to keep aside their own values in any health care setting. Whenever our own values and beliefs become dominant during care, a biased approach is developed which blocks the therapeutic communication with the client. According to videback (2011), an individual who does not judge individual approaches and dogmas may hold a bias towards a group of people because of rigid thoughts or conventional descriptions of that group.


Self-awareness affects the care of client directly by discouraging the client and distracting the interviewer, and indirectly by blocking the therapeutic relationship of communication. Literature also supports that, establishing and upholding strong relationships can be encouraged as long as individuals are mutually aware of their views, moods, and actions. It leads to regulate one’s actions and existence (Ahmed & Elmasri, 2011). We can see the impact of self-awareness on the rapport building with client. The development of self-awareness needs an acceptance for being indrawn and to examine personal motivations, attitudes and beliefs.


These beliefs and attitudes can be made proficient by clarifying certain discrete features, such as self-awareness and ability to provide and take feedback to and from others. Jo Luft and Harry Ingham are the two psychologists who designed Johari window model and was published in 1959. It indicates how a people know themselves and communicate with others. There are four quadrants in this window named as (i) Open (ii) Blind (iii) Hidden and (iv) Unknown. Each quadrant contains and represents information, feelings and motivation in terms of whether the information is known or unknown to self and to others.


Refer to the appendix for model of johari window. The open self consists of all the information that is known to you and to others because you have disclosed. In contrary to that, the hidden self contains all the information that you know about yourself but others are unaware. On the other hand, blind self contains the information that you don’t know about yourself but others know. Furthermore, the unknown self includes information is not known to you and to others (West & Turner, 2008, p. 274).


Being a student nurse, the first step to assess my own qualities is by creating a list of moral and ethical values, attitudes, feelings, strengths and weaknesses, behaviors, requirements, wishes, and judgments. The second step is to uncover hidden positive and negative qualities of self by asking others for what they see in me as a student nurse. The remarks mentioned above must be true and honest. There must not be strict prohibitions for those who are enlisting negative qualities.


The third step is to put the list side by side and allocate qualities to the suitable quadrant. If the size of the open quadrant is large, it indicates that the people are open to others while a smaller quadrant implies that people are sharing less about themselves. If the open and hidden quadrants both are small, it implies a little insight.


The aim of self awareness via johari window is to bring qualities of people from blind, hidden and unknown quadrants to open quadrant (Videbeck, 2011). As discussed in the scenario earlier that I had a problem in providing holistic care without any bias. The reason for that was lack of self-awareness which hindered the continuity of care. The VCAT model best explains the chain of interventions regardless of personal value-belief conflicts.


Besides skills training, participating in values-clarification exercises can help providers differentiate their own personal beliefs and attitudes from those of clients (Turner, Andersen, Pearson, & George, 2013). For VCAT frame work please refer to appendix. Lack of self-awareness can bring about various issues in mental health care setting. These factors make it clear that how easily judgments can become wrong and how the professional point of view can be lost in the framework of a situational relationship.


Thus Johari window and VCAT are the most suitable frameworks to be self-aware in professional health care settings. To avoid these, I recommend that it is important to develop a great contract of energy on maintaining an independent viewpoint during passionate discussions and other affectionate response. Therefore staff needs to watch out for themselves, accept feedback from their friends and colleagues, and guard themselves against such behaviors.



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