PRAC 6675 Week 11 Assignment: Journal Entry 

 PRAC 6675 Week 11 Assignment: Journal Entry 

 PRAC 6675 Week 11 Assignment: Journal Entry

I successfully achieved each of the goals and objectives set for the practicum experience. I conducted comprehensive patient assessments for more than10 psychiatric patients weekly with guidance from my preceptor. Besides, I achieved the objective of developing at least three differential diagnoses for each of the ten patients I assessed weekly using the DSM-V guidelines. In addition, I worked with my preceptor to develop psychotherapeutic treatment plans for the patients I diagnosed.

The most challenging patient case was of a 16-year-old female with Anorexia nervosa, who was unwilling to change her dietary behaviors and was continually committed to dieting despite a series of psychotherapy sessions. Another challenging case was a patient with paranoid schizophrenia who was suspicious of the therapist and often became aggressive. The third case was a female patient with Multiple personality disorder. This was challenging because each personality was complex and integrated with its behavior patterns and interpersonal relationships.

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From the practicum experience, I learned that PMHNPs could avoid liability by responding to clients appropriately, complying with the standards of care, and documenting each patient interaction carefully. I learned that PMHNPs have a role in educating the client about their mental health issues and behaviors, and they should follow up and evaluate care. Besides, I learned how to maintain good interpersonal relationships with clients and their families, which is essential in attaining the desired treatment outcomes (Hartley et al., 2020). Various resources were available, including psychiatric treatment protocols, psychotherapy protocols, drug handbooks, and the DSM 5 handbook. Besides, the preceptor was highly resourceful since she guided me in taking patient history, conducting mental assessments, making diagnoses, and developing treatment plans.

Several EBP practices were applied in providing psychotherapy, including Trauma-focused therapy and exposure therapy for PTSD patients. Patients with depression and schizophrenia were taken through CBT, Problem-Solving therapy, and Social Skills Training (Locher et al., 2019). If I were to redo the practicum, I would adhere to the nursing process and ensure that I follow up and evaluate patient care to determine if the desired outcomes were achieved (Leichsenring et al., 2018). My preceptor and I have managed the high patient flow by using technology to schedule clients’ appointments and Telemedicine to offer online consultations, reducing the number of patients visiting the clinic. I can utilize my growing skillset by educating individuals in the community about mental health to change their attitudes and lessen the social stigma on mental health.

Communicating and Feedback

I will improve my knowledge and skills in psychiatry by practicing more in history taking, mental status exams, developing treatment plans, and providing psychotherapy. I will use case studies to practice diagnosing and planning treatments for various psychiatric conditions. I am learning immensely through the help of my preceptor and other health providers in the facility. However, I need to improve my participation in the interprofessional team to learn more from other providers. The preceptor has commended my learning progress but has advised me against getting too much connected to patients, especially during psychotherapy.

References

Hartley, S., Raphael, J., Lovell, K., & Berry, K. (2020). Effective nurse-patient relationships in mental health care: A systematic review of interventions to improve the therapeutic alliance. International journal of nursing studies, 102, 103490. https://doi.org/10.1016/j.ijnurstu.2019.103490

Leichsenring, F., Abbass, A., Hilsenroth, M. J., Luyten, P., Munder, T., Rabung, S., & Steinert, C. (2018). “Gold standards,” plurality and monocultures: The need for diversity in psychotherapy. Frontiers in psychiatry, 9, 159. https://doi.org/10.3389/fpsyt.2018.00159

Locher, C., Meier, S., & Gaab, J. (2019). Psychotherapy: A World of Meanings. Frontiers in psychology, 10, 460. https://doi.org/10.3389/fpsyg.2019.00460

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Assignment: Journal Entry

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Critical reflection on your growth and development during your practicum experience in a clinical setting helps you identify opportunities for improvement in your clinical skills, while also recognizing your strengths and successes.

Use this Journal to reflect on your clinical strengths and opportunities for improvement, the progress you made, and what insights you will carry forward into your next practicum.

To Prepare
Refer to the “Population-Focused Nurse Practitioner Competencies” in the Learning Resources, and consider the quality measures or indicators advanced practice nurses must possess in your specialty.
Refer to your “Clinical Skills Self-Assessment Form” you submitted in Week 1 and consider your strengths and opportunities for improvement.
Refer to your Patient Log in Meditrek; consider the patient activities you have experienced in your practicum experience and reflect on your observations and experiences.
In 450–500 words, address the following:

Learning From Experiences

Revisit the goals and objectives from your Practicum Experience Plan. Explain the degree to which you achieved each during the practicum experience.
Reflect on the 3 most challenging patients you encountered during the practicum experience. What was most challenging about each?
What did you learn from this experience?
What resources were available?
What evidence-based practice did you use for the patients?
What would you do differently?
How are you managing patient flow and volume? How can you apply your growing skillset to be a social change agent within your community?
Communicating and Feedback

Reflect on how you might improve your skills and knowledge and how to communicate those efforts to your Preceptor.
Answer these questions: How am I doing? What is missing?
Reflect on the formal and informal feedback you received from your Preceptor.