Journal Entry

The practicum gave me a learning opportunity. My first goal for the practicum was to be able to recognize the most commonly encountered psychiatric illnesses. In this respect,  I am now confident in diagnosing mental health disorders. My second goal was to be confident in distinguishing psychopathologies from pathophysiological disorders: Journal Entry.

Subsequently, I can now distinguish psychopathologies from pathophysiological disorders comfortably. My third goal was to be mostly confident in formulating differential diagnoses. Equally, I can formulate differential diagnoses upon assessing my patients.

The practicum was not short of challenging manifestations. The first challenging patient I encountered was an adolescent male with conduct disorder. What was challenging in this case was the fact that the patient was violent, making assessing him difficult. The second case was of a 32-year-old male with an opioid overdose.

The case was emotionally challenging to me. This is because it opened my mind to the reality of the opioid epidemic in the US. Going through these cases, I got to reflect and recognize how younger people were affected by opioid abuse and overdose.

The third case was of a 16-year-old female diagnosed with schizophrenia. The patient’s family was not aligned with Westernized medicine, as the father believed that her daughter was obsessed with an evil spirit. It had difficulty convincing the family that their kin had a mental health disorder and that she needed therapy.

The encounters made me appreciate how unique each patient is. They also widened my perspectives on how personal and social factors influence clinical decision-making processes. As Campbell et al. (2022) report, social and personal factors play a significant role in how mental health disorders develop. They may also impact how they are managed.

Several resources were at my disposal during the practicum. These included human resources and the hospital’s library. Human resources, such as my preceptor and fellow nurse practitioners, provided me with the information I required to assess and manage my patients.  I was able to leverage the library to research the challenging encounters I had.

Continuous evaluation is an example of an evidence-based approach that I used for my patients. Continuous evaluation is an evidence-based strategy that involves ongoing monitoring and evaluation to inform possible revisions and refinement of the therapy process (Maoz et al., 2024). Through continuous evaluation, I was able to assess how my patients were responding to therapy. This helped optimize the care process.

Something I would do differently is to integrate holistic approaches when engaging my patients. The practicum enabled me to recognize that there are more facets of wellness besides physical and mental health. By addressing all aspects of wellness, I can considerably improve the well-being of my patients.

To manage patient flow and volume, I ensured I allocated more time for my practicum. I also limited distractions that would have otherwise wasted my time. Moving forward, I intend to bolster my skills in patient management. This way, I will be able to impact the communities I serve positively.

I intend to improve my skills and knowledge in diverse content areas through extra learning and by enrolling in online short courses on psychiatric care.  This way, I will be able to enhance my competency in managing psychiatric manifestations. I am planning to communicate these plans to my preceptor via email.

I am doing good. I, however, feel the allocated time for the practicum may not be sufficient to cover all aspects of the healthcare environment. The formal and informal feedback I received from my preceptor helped streamline my operations during the clinical.

References

Campbell, F., Blank, L., Cantrell, A., Baxter, S., Blackmore, C., Dixon, J., & Goyder, E. (2022). Factors that influence mental health of university and college students in the UK: A systematic review. BMC Public Health, 22(1). https://doi.org/10.1186/s12889-022-13943-x

Maoz, H., Sabbag, R., Mendlovic, S., Krieger, I., Shefet, D., & Lurie, I. (2024). Long-term efficacy of a continuity-of-care treatment model for patients with severe mental illness who transition from in-patient to out-patient services. The British Journal of Psychiatry, 224(4), 122–126. https://doi.org/10.1192/bjp.2024.9

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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 (59639), 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

Journal Entry (450–500 words)

• Learning From Experiences
  • Revisit the goals and objectives from your Practicum Experience Plan (59748). 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.

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