Journaling

Nurses General Nursing

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Hi all! I am the proud new owner of a job in a MICU! Woo hoo! And also, yikes!! I want to start journaling after my workdays. I'm thinking I would like to record not only my experiences and things I've learned, but also my emotional reactions and how I'm coping as I grow. My Sexy Man-Bear Fiancé does not like to hear about the "icky" stuff, so I'm thinking this will help me channel what I'm thinking and feeling without projecting it all in his face.

My questions: do you keep a professional journal? Is it strictly narrative, or do you get creative? Any thoughts? Advice? Pretty examples?? ������ Thanks!

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Specializes in Private Duty Pediatrics.

Work-specific journaling can run into HIPAA violations very quickly. Be very careful!

If you can keep patient-specific information very vague, you MIGHT be able to do it safely. For example, "When I have a demanding patient, I feel ___________." Or, "I was frustrated with a coworker today, and couldn't decide whether to talk to her or to my supervisor ..."

Here on AllNurses, you are anonymous, but your personal journal can be traced to you. While you need to be careful on AllNurses, you need to be even more careful in a personal journal.

Anything written can be read, and probably read by the wrong person. Never write anything that could bite you in court.

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Thanks for your response Kitiger RN! Happily this will be a personal, at-home journal. So in order to commit a HIPAA violation a person would have to trespass, unlawfully enter my home, likely by breaking-and-entering, and steal my personal property, all while escaping the wrath of me, my SMB, and my dogs, in order to read my entry. After all that effort, I sure hope they can figure out who "Jane Doe" is, 'cause I can assure you I have never and will never be leaving the floor with a patients' personally identifiable information on my person. That's just stupid. But sure, okay, the potential exists in some universe.... So back to advice about actual journaling!

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Specializes in CMSRN, hospice.

I journal about EVERYTHING. Like PP said, I keep anything super patient-specific out of there, but journaling had certainly helped me process different work experiences. I think it's helpful.

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Specializes in NICU.
Thanks for your response Kitiger RN! Happily this will be a personal, at-home journal. So in order to commit a HIPAA violation a person would have to trespass, unlawfully enter my home, likely by breaking-and-entering, and steal my personal property, all while escaping the wrath of me, my SMB, and my dogs, in order to read my entry. After all that effort, I sure hope they can figure out who "Jane Doe" is, 'cause I can assure you I have never and will never be leaving the floor with a patients' personally identifiable information on my person. That's just stupid. But sure, okay, the potential exists in some universe.... So back to advice about actual journaling!

Or they could issue a subpoena.

And I'd still be extremely careful about recording too much detail about any specific patient, even if you do use a pseudonym. I agree with Kitiger to keep it to as little about the patient as possible, and more about you and your feelings and actions/reactions.

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Specializes in ICU.

I have read the OPs post twice. I fail to see a HIPAA violation or how a personal journal could be subpoenaed in court. It would presumably be a personal journal that nobody knows about.

People have a gross misunderstanding of what HIPAA is. Keeping a personal journal is not violating that. Nor can it be subpoenaed as I'm guessing the OP is not telling her patients she is journaling about them.

OP, I journal. I was encouraged to do it as a new grad by my employer as a way to help deal with stress. Mine is creative. I enjoying writing and it truly helps, especially after a rough day. Good luck, and I hope it helps.

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Specializes in NICU.
People have a gross misunderstanding of what HIPAA is. Keeping a personal journal is not violating that. Nor can it be subpoenaed as I'm guessing the OP is not telling her patients she is journaling about them.

That's an assumption on your part, neither of us knows the OP and there are people out there who do all sorts of things you wouldn't expect of a sensible individual. I understand what HIPAA is, and keeping a personal journal can violate that depending on the level of detail recorded in it. My point is, I advise an (over)abundance of caution, as there are other ways to obtain documents than the physical confrontation the OP envisioned.

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Specializes in ICU.
That's an assumption on your part, neither of us knows the OP and there are people out there who do all sorts of things you wouldn't expect of a sensible individual. I understand what HIPAA is, and keeping a personal journal can violate that depending on the level of detail recorded in it. My point is, I advise an (over)abundance of caution, as there are other ways to obtain documents than the physical confrontation the OP envisioned.

If she's not sharing the info, then she's not. There's the misunderstanding of HIPAA. I won't get into the rest. It's actually a good read if people read and understand it. In writing a personal journal, in which no info is shared, it does not apply.

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Specializes in NICU, PICU, educator.

Yes, if you let it be known that you keep personal journals about work, they can be subpoenaed if there is a suit filed and you are called to give a deposition.

"Oh, I don't really recall but I probably have something in my journal"

Prosecuting attorney loves this,

"oh, you have a journal, did your defense team know this? No, oh goody, we are going to subpoena your journal!"

defense/hospital attorney will want to strangle you.

Everything in said journal is now an open book. You might even get to read some excerpts from it for a jury. Could even get you fired if there is any violation of HIPAA.

Keep it in the down low and lock and key.

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Specializes in Pediatrics, Women's Health, Education.

I think a journal is a great way to process what you are experiencing in your new role. Here is a helpful website on getting started.

Expressive Writing | Words that Heal

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If you insist on doing this, keep protected information out and password protect the file so no one other than yourself can ever read it. Also do not discuss doing this with anyone, just do it, secure it and keep it private. Fail to do it this way and you could find yourself without a job or with unwanted gossip in the workplace. This is a private activity, please, please keep it that way.

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Honestly just write somewhere in the front of the journal that "All writings in this are factitious works of art and are not to be taken seriously. Any likeness to any individual is purely coincidence, and any and all stories are fantasy."

But for real just don't write names or anything that could be specifically tied to a patient and your golden. I could write something like this:

"He was incontinent and had to be changed a thousand times. He also was demented and tried to get out of bed constantly. The hypotension was an issue, hope he doesn't fall and hurt himself, discharge is calling his name."

How many people does that describe? Just don't give a date and what does it matter?

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