Assignment: Journal Entry Paper

Assignment: Journal Entry Paper

Assignment: Journal Entry

During my practicum, I worked as a psychiatric clinical nurse, during which I set the following goals and objectives. The first objective was to develop and complete the Mental Status Exams (MSE) by incorporating all the necessary information. I achieved this goal by examining all the ten patients assigned to me and identifying the behavioral ad mental disorders as indicated in the status in the MSE. The second objective was to independently formulate DSM 5 diagnoses using the collected data. This goal was achieved by using the DSM-5 manual to diagnose patients. The third objective was to gain an in-depth understanding of the psychiatric screening and treatment for the disorders during the practicum. I achieved this goal by applying advanced skills in implementing the medication and screening instruments.

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The most challenging patient was a 40-year-old young adult with borderline personality disorder who had difficulties spending time alone. Unfortunately, the patient could not maintain a positive relationship with others and depended on alcohol to deal with distress. The challenging thing with this patient is that he was demotivated regarding treatment and did not consider any other available treatment options. The second challenging patient was a 30-year-old pregnant woman suffering from bipolar disorder but denied taking any medication due to her pregnancy. The most challenging situation about the patient is that the patient was fearful that the carbamazepine medications would interfere with fetal development because she had read about the same on the internet. The third challenging patient I encountered during the practicum was a 13-year-old with selective mutism. The challenging aspect about this patient is that I experienced challenges communicating with her, and she could hardly talk to me when I first met him. Hence, the mutism, which was also associated with aggression, impacted treatment.

The lesson I learned from this experience is that educating patient concerning their possible treatments is not enough. Instead, we need to motivate and empathize with them. Besides, many patients suffering from mental disorders are not educated on alleviating their health concerns. Therefore, it is always important to educate these patients and remove such misconceptions to understand why they need to take the medications. The resources available for patients include emergency help, online and phone consultations, support groups, mental health websites, financial aid, and local health services.

The evidence-based practice I used includes cognitive-behavioral therapy (CBT) for patients with MDD and Bipolar disorder, as recommended by the Clinical Practice Guideline for the Management of Depression and Bipolar (Avasthi & Grover, 2018; Walter et al., 2020). One of the things I would do differently is to recommend implementing family-focused therapy (FFT) to educate patients about their condition. FFT is effective in helping reduce incidences of mental health disorders, as demonstrated by Miklowitz et al. (2020).

           Patient flow was managed by automating the entire process whereby no patient was assigned a number to avoid the long queues. The patients were always notified when to come for treatment using the numbers. My experience during the practicum helped improve my confidence in attending to a patient with mental disorders. Therefore, using the same knowledge and confidence, I can advocate for mental health in my communication and even connect those suffering from the disorder with the clinical facility.

Communicating and Feedback

           I plan to improve my skills and knowledge by doing more patient assessments in the future. I will also spend some time going through other colleagues’ work to learn what they did differently regarding the EBP they used in developing the treatment plans. This will enable me to be more competent in developing treatment plans and apply them in real-life situations. However, despite the need for further improvement, I can affirm that my practicum was a success, considering the immense knowledge acquired in the end. Besides, my preceptor has been very helpful through the process by always ensuring that I was always on the right track when developing the treatment. The motivations and encouragements kept me going despite the challenges that I encountered. Besides, the formal and informal feedback that I received from the receptor played a critical role in ensuring the treatment plans were well planned and organized. Each patient was prescribed treatment that matched their conditions.

References

Avasthi, A., & Grover, S. (2018). Clinical practice guidelines for the management of depression in the elderly. Indian journal of psychiatry, 60(Suppl 3), S341.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5840909/

Grunze, A., Amann, B. L., & Grunze, H. (2021). Efficacy of Carbamazepine and Its Derivatives in the Treatment of Bipolar Disorder. Medicine, 57(5), 433.https://doi.org/10.3390/medicina57050433

Miklowitz, D. J., Schneck, C. D., Walshaw, P. D., Singh, M. K., Sullivan, A. E., Suddath, R. L., … & Chang, K. D. (2020). Effects of family-focused therapy vs. enhanced usual care for symptomatic youths at high risk for bipolar disorder: a randomized clinical trial. JAMA Psychiatry, 77(5), 455-463.https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2758325

Walter, H. J., Bukstein, O. G., Abright, A. R., Keable, H., Ramtekkar, U., Ripperger-Suhler, J., & Rockhill, C. (2020). Clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 59(10), 1107-1124.https://doi.org/10.1016/j.jaac.2020.05.005

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Assignment: Journal Entry

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Critical reflection of your growth and development during your practicum experience in a clinical setting has the benefit of helping you to 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” found in the Week 1 Learning Resources, and consider the quality measures or indicators advanced nursing practice nurses must possess in your specialty of interest.
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, and consider the patient activities you have experienced in your practicum experience and reflect on your observations and experiences.
Journal Entry (450–500 words)
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 three (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 communicate those efforts to your Preceptor.
Answer the questions: How am I doing? What is missing?
Reflect on the formal and informal feedback you received from your Preceptor.
By Day 7 of Week 11
Submit your Journal.

Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK11Assgn+last name+first initial.(extension)” as the name.
Click the Week 11 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Week 11 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK11Assgn+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:

Week 11 Assignment Rubric

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