PRAC 6665 WEEK 11 Journal Entry

PRAC 6665 WEEK 11 Journal Entry

PRAC 6665 WEEK 11 Journal Entry

My practicum experience has allowed me to achieve my previously set goals and objectives adequately. For example, I feel mostly confident when conducting a complete comprehensive psychiatric evaluation. I also feel confident when providing psychoeducation to individuals, families, and groups. I can also select an appropriate medication and psychotherapeutic plan for my patient despite needing some supervision. With supervision, I can select and implement an appropriate screening instrument, interpret the results, and make recommendations and referrals to other specialties.

During the rotation, I also encountered some challenging cases. For instance, I encountered a middle-aged male with a Bipolar I diagnosis who presented with a manic episode due to medication non-adherence.He had been on lithiumbut had been stopped for three months after developing chronic kidney disease and was placed on olanzapine only. Another example includes a 23-year-old male who had developed suicidal ideations following the use of fluoxetine due to an underlying major depressive disorder. The third case that I found challenging was that of a thirty-five-year-old male who presented with a psychotic episode due to an underlying grade II glioma.

The three cases have taught me the importance of understanding and managing medication side effects. I have also learned the importance of comprehensive history taking, physical examinations, and diagnostic testing as a routine in patients presenting with psychiatric symptoms, as some conditions may be due to underlying conditions such as brain tumors, syphilis, and medication or substance use (Stein et al., 2022). To establish a diagnosis, I mainly used the DSM-V and ICD-11 to guide in establishing a diagnosis for each case.We used evidence-based cognitive-behavioral therapy, surgical resection, and chemo-radiation to help improve medication adherence, alleviate suicidal ideations, and manage glioma (Craske, 2022). Unlike my preceptor, I would ensure patient and family involvement in their management to help promote recovery (Galletta et al., 2022). The facility has utilized electronic medical records to reduce documentation while ensuring patient information is updated (Modi et al., 2022). This has helped improve efficiency as patient information is easily retrieved by any healthcare provider. I would use my skill set to join volunteering programs in various communities (Gaber et al., 2020). This will allow me to offer psychotherapy and patient education to a larger group of patients and community members.

Communicating and Feedback

Within the following weeks, I will need to actively participate in ward rounds and engage with more patients to help improve my knowledge and skill in patient assessment and developing management plans. As a result, I will need to inform my preceptor that Iwill be taking more patient cases so that she can supervise my work. My experience in the practicum has been good, and I have learned a lot from my preceptor and other professionals. In addition, my preceptor has provided feedback and discussed the areas that need improvement. She has also been a good mentor for my current and future practice.PRAC 6665 WEEK 11 Journal Entry

References

Craske M. G. (2022). The future of CBT and evidence-based psychotherapies is promising. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 21(3), 417–419. https://doi.org/10.1002/wps.21002

Gaber, J., Oliver, D., Valaitis, R., Cleghorn, L., Lamarche, L., Avilla, E., Parascandalo, F., Price, D., &Dolovich, L. (2020). Experiences of integrating community volunteers as extensions of the primary care team to help support older adults at home: a qualitative study. BMC Family Practice, 21(1), 92. https://doi.org/10.1186/s12875-020-01165-2

Galletta, M., Piazza, M. F., Meloni, S. L., Chessa, E., Piras, I., Arnetz, J. E., &D’Aloja, E. (2022). Patient Involvement in Shared Decision-Making: Do Patients Rate Physicians and Nurses Differently? International Journal of Environmental Research and Public Health, 19(21), 14229. https://doi.org/10.3390/ijerph192114229

Modi, S., & Feldman, S. S. (2022). The Value of Electronic Health Records Since the Health Information Technology for Economic and Clinical Health Act: Systematic Review. JMIR Medical Informatics, 10(9), e37283. https://doi.org/10.2196/37283

Stein, D. J., Shoptaw, S. J., Vigo, D. V., Lund, C., Cuijpers, P., Bantjes, J., Sartorius, N., & Maj, M. (2022). Psychiatric diagnosis and treatment in the 21st century: paradigm shifts versus incremental integration. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 21(3), 393–414. https://doi.org/10.1002/wps.20998

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Journal Entry

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.

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

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 information

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

1. To submit your completed assignment, save your Assignment as WK11Assgn+last name+first initial.
2. Then, click on Start Assignment near the top of the page.
3. Next, click on Upload File and select Submit Assignment for review.

Rubric

PRAC_6665_Week11_Assignment_Rubric