PRAC6635 Week11: Journal Entry

Approaching the practicum, I was yearning to develop specific skills in working in multidisciplinary teams, providing psycho-education to diverse patient groups, and prioritizing differential. The practicum has widened my perspectives in these areas. I am now confident in working with various medical teams and can verbalize best practices in healthcare collaborations. I am also confident in providing psycho-education and have acquired cross-cultural communication skills. Likewise, I am mostly confident in prioritizing differentials.

The practicum provided me with insights into various clinical complexities and manifestations. The first challenging client case that I encountered involved a Latino male with severe depression and significant suicidal ideations and tendencies who was refusing therapy. The most difficult aspect of managing the patient was convincing him of the benefits of therapy and the ability of the healthcare system to improve his wellness. The second case involved a 21-year-old female with a panic attack. She had developed shortness of breath just before sitting for her examinations. The challenging part of the case was to distinguish whether the client had a panic attack or met the criteria for a panic disorder. Another case involved a middle-aged male with major depression and substance use disorder. The case enabled me to appreciate the amount of suffering persons with psychiatric illness comorbidities go through. The patient had had multiple suicidal attempts, social dysfunctionalities, and physical impairments that led to his incarceration.

The encounters changed my perspectives on mental health illnesses. To begin with, I got to recognize that psychiatric illnesses are common across the lifespan and are a reason for significant suffering and social dysfunctionalities. As Tesfaye et al. (2021) report, the underlying suffering attributed to mental health illnesses, coupled with their impact on life, makes them a health concern. I also learned of the compounding effects of mental health illness comorbidities. They increase the cost of care and result in incarcerations and deterioration in the quality of life (Udupa et al., 2023).

Several resources were at my disposal during the practicum. Foremost, I interacted with the hospital library, leveraging resources such as the practice guidelines, DSM-V, and online textbooks on psychiatry. Human resources, such as my preceptor and other caregivers, were also present whenever their consult was required.

An evidence-based practice that emerged in the practicum is healthcare engagements through collaborative paradigms (Reist et al., 2022). Throughout the practicum, I engaged other caregivers in decision-making processes and the development of therapeutic plans for the patients. I leveraged best practices in collaborative paradigms such as effective communication, information sharing, and role interdependence (Rugkåsa et al., 2020). Moving forward, I am sharpening my skills in cross-cultural communication. Apparent diversification in modern healthcare systems warrants healthcare professionals who can engage patients from different backgrounds. One thing I would do differently is increase my engagement with my preceptor and other senior nurses. I am managing patient flow and volume by planning.

To improve my skills and knowledge, I intend to expand the scope of revision. By reading from diverse sources and allocating more time to the revision process, I will improve my skills and knowledge. These efforts will be communicated to my preceptor through an email. I am currently doing good. I, however, need more time to bolster my understanding of the clinical landscape. The formal and informal feedback from my preceptor informed me about various areas for improvement and areas to focus on during the practicum.

References

Reist, C., Petiwala, I., Latimer, J., Raffaelli, S. B., Chiang, M., Eisenberg, D., & Campbell, S. (2022). Collaborative mental health care: A narrative review. Medicine, 101(52). https://doi.org/10.1097/md.0000000000032554

Rugkåsa, J., Tveit, O. G., Berteig, J., Hussain, A., & Ruud, T. (2020). Collaborative care for mental health: A qualitative study of the experiences of patients and health professionals. BMC Health Services Research, 20(1). https://doi.org/10.1186/s12913-020-05691-8

Tesfaye, Y., Agenagnew, L., Anand, S., Tucho, G. T., Birhanu, Z., Ahmed, G., Getnet, M., & Yitbarek, K. (2021). Knowledge of the community regarding mental health problems: A cross-sectional study. BMC Psychology, 9(1). https://doi.org/10.1186/s40359-021-00607-5

Udupa, N. S., Twenge, J. M., McAllister, C., & Joiner, T. E. (2023). Increases in poor mental health, mental distress, and depression symptoms among U.S. adults, 1993–2020. Journal of Mood and Anxiety Disorders, 2, 100013. https://doi.org/10.1016/j.xjmad.2023.100013

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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 “Advanced Nursing Practice Competencies and Guidelines” 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 (57788), 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. Reflect on your observations and experiences.
  

  PRAC6635 Week11: Journal Entry

In 450–500 words, address the following:

• Learning From Experiences
  • Revisit the goals and objectives from your Practicum Experience Plan (57841). 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 did you have available?
  • What evidence-based practice did you use for the patients?
  • What new skills are you learning?
  • What would you do differently?
  • How are you managing patient flow and volume?
• Communicating and Feedback
  • Reflect on how you might improve your skills and knowledge and how to 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

• Submit your Journal Entry.

submission information
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• To submit your completed assignment, save your Assignment as WK11Assgn_LastName_Firstinitial
• Then, click on Start Assignment near the top of the page.
• Next, click on Upload File and select Submit Assignment for review.