Reflections on Reflecting - Evolving as a Mental Health Nurse

 The first blog entry I wrote of I dare you to drink the vinegar seems like a lifetime ago. I guess it many ways it was. 

When I read that 2008 blog post all I can see is a big rant by 20-something me, before kids, before a nursing career. But underneath the f-words and sarcasm I see something in younger Michelle: a raw, unfiltered reflection on boundaries, emotional restraint, and the complexities of human behavior. At the time, I had just entered the world of mental health nursing. I didn’t know it then, but I was already forming the values and perspectives that would carry me through nearly two decades in the field.

Back then, I didn’t have the language of trauma-informed care or emotional regulation. I didn’t yet know the neurobiology of mania or the intricacies of professional boundaries. But I did know how it felt to witness cruelty disguised as honesty. I knew what it meant to hold space for someone else's pain, even when that pain was being dismissed by others. And I knew, instinctively, that responding with restraint, rather than with retaliation, was a form of strength. And I still hold that close to me. It's in my metaphorical fanny pack. 

What I wrote in that 2008 post, about being told I didn’t “emote,” about being misread as distant or indifferent, would become foundational to how I practice nursing today. I was learning the early lessons of what it means to listen, to observe, to hold space, and to not make it about you. These are essential nursing skills, especially in mental health.

Learning the Language of Boundaries

When I reread that post now, what I can see with my mid-career, parent of 4, 20-20 vision, is that most of it is about boundaries, mine, and the ones that others crossed. Back then, I was frustrated by how people made assumptions about me. I was angry that someone I cared about was being emotionally harmed under the guise of “telling it like it is.” And I was learning that walking away or not reacting didn't mean I didn’t care; it meant I was choosing not to engage in ways that would escalate harm.

As a new nurse, I used to think being a “good nurse” meant doing more, being available, taking on extra shifts, overextending to help everyone. I now know that’s not sustainable, and it’s not necessarily therapeutic. I mean...I would argue that it is more about the nurse and wanting to feel like a hero or being laser focused on hitting a finaicial goal rather than being a better nurse. Boundaries are not concrete walls, they are points of clarity. They make it possible to care deeply without losing yourself in someone else’s crisis.

Today, I teach early career nurses that establishing boundaries is not just a form of self-care and collective care; it’s a clinical skill. It protects therapeutic relationships, prevents moral injury, and sustains longevity in the field. I had to learn that for myself, sometimes the hard way.

What “Not Emoting” Actually Meant

In that post, someone had accused me of not emoting. What does that mean? I'm not even sure they knew. The way I took was a hot take that emotional regulation was a character flaw. But I see it differently now. That calm, reserved presence? It’s often what patients and colleagues need most when they’re in crisis. It’s what trauma-informed care asks of us: to remain steady, predictable, and safe.

Mental health nursing has taught me that people will project onto you what they don’t understand in themselves. I used to take it personally when someone assumed I was standoffish or indifferent. Now, I understand that what they were often reacting to was my ability to stay grounded, even when things around me felt chaotic.

This doesn't mean I'm unaffected. It means I’ve learned how and when to express emotion in a way that is helpful, not harmful. In moments of crisis, what people need is not a nurse who matches their energy but one who can stay with them in their experience of fear, confusion, and pain, and not reflect it or throw it back at them. I didn’t know how to describe it then, but I do now: I was practicing co-regulation, even if no one had taught me the term.

Mental Health Nursing is Holding Contradictions

The most heartbreaking moment in my 2008 blog came in the postscript: the realization that the person whose behavior had caused so much tension was, in fact, in the midst of a first episode of mania. At the time, I didn’t have the knowledge or the clinical tools to see that.

That’s the brutal honesty of mental health work: sometimes we don’t know what we’re seeing until we reflect on it after the fact. That’s why I’m cautious about judgment and careful about making assumptions. I’ve learned to ask: What else might be going on here? That curiosity, grounded in compassion, is now one of my strongest clinical instincts.

I’ve also learned that people often act in ways that reflect their own suffering. And while that doesn’t excuse harm, it can help explain it. A core principle of trauma-informed practice is assuming that behaviors make sense in context, even if we don’t yet know what that context is. The more I’ve learned, the more I’ve realized how little we can ever truly know about someone else’s inner world.

Evolution Through Practice

Since 2008, my career has taken me from inpatient mental health services to nursing leadership, policy work, and doctoral studies in nursing history. I’ve worked with individuals experiencing psychosis, addiction, trauma, and despair. I’ve stood beside patients in seclusion rooms and boardrooms alike, trying to advocate for more humane care. And every step of the way, I’ve returned to the principles I was starting to grasp in that early blog post: listen carefully, respond thoughtfully, and don’t assume you know what someone else is going through.

What’s changed is not my core values, but my ability to name them. I now have a language for what I’ve always known intuitively: that showing up with compassion and clarity is the most powerful thing a nurse can do. That not every battle needs to be fought to be won. That presence matters more than performance.

Full Circle

Now, many years later, I still reflect on that night described in my blog. I do this not because of the discomfort I felt, but because of what it taught me about who I wanted to be. Not just as a friend or a nurse, but as a person. I wanted to be someone who didn’t need to dominate a conversation to feel heard. Someone who didn’t force others to admit their pain to validate my opinions. Someone who could see past the behavior and stay curious about the person behind it.

That night, I chose restraint—not because I didn’t care, but because I did. And today, I still choose it. Not in silence, but in solidarity. Not in detachment, but in depth.

I’m still evolving. I’m still learning. But I no longer see my calmness as a weakness or my boundaries as walls. I see them as the scaffolding that allows me to keep showing up, day after day, in a field that demands everything—and deserves even more.

See nursing students? Reflecting journalling in action. Mic drop. 

Love,

Michelle D.