Psychiatric Clinic Journal Entry
Entering the practicum, my objectives were to be able to distinguish psychopathologies from other pathological conditions, select appropriate screening tools for the presenting clinical situation, and be able to interpret results from various screening tools. I am now confident in differentiating psychopathologies from other pathological conditions. Throughout the practicum, I learned the defining symptoms of various pathologies and how I can use diagnostic tools such as the DSM-V to make an accurate clinical diagnosis. I am also confident when selecting the appropriate screening tool for any presenting psychopathologies. The practicum equipped me with knowledge of various screening tools and their appropriateness when screening for psychopathologies. I am most confident in interpreting results from screening instruments. This is an area I can further improve on as I still consult regularly when interpreting results from various screening instruments. Our assignment writing help is at affordable prices to students of all academic levels and academic disciplines.
During the practicum, I got to experience clinical presentations with varying complexities. The first case was of a 22-year-old referred to the clinic with severe depression and anxiety. At the time of her presentation, she was non-adherent to fluoxetine. The patient was advised to continue fluoxetine. The second case was of a 31-year-old male referred to the clinic after failed suicide attempts. He was diagnosed with major depressive disorder and was scheduled for psychotherapy. The third case was of a 71-year-old male presenting to the clinic for his routine refill for bipolar management. He says that the medications seem not to be working, as he has been experiencing severe depressive episodes. He was diagnosed with bipolar with substance abuse disorder and is scheduled for admission.
The clinical experiences gave me further insight into psychiatric presentations. I got to learn the precipitants and causal factors of depressive disorders, such as job losses. As Christensen et al. (2020) report, life stressors such as job losses may sometimes precipitate or potentiate depressive symptoms in some individuals. I also learned the significance of medication adherence in the management of depression. Non-adherence to medications may exacerbate depressive symptoms (Dell’Osso et al., 2020). This was the case in the first case scenario.
Several resources were available during the practicum. Guidelines on psychiatric management, the DSM-V, and online resources such as journals were all at my disposal during the practicum. An evidence-based practice I used with my clients was team collaboration and effective communication during care delivery. Schmutz et al. (2019) report that team collaboration facilitates information sharing and is a best practice in psychiatric care.
I am currently learning how to interpret readings from various screening instruments. My objective is to be confident in that area. To better my understanding, I intend to use video and engage other caregivers to mentor in this area. To manage patient flow and volume, I availed all the resources I would need when handling my clients to eliminate wastages that may be presented by looking for them.
Several strategies can be used in skill development. I intend to increase my knowledge and skills by using diverse reading materials, engaging in group work, and consulting with my superiors. I intend to communicate these efforts to my preceptor verbally and in writing. I will verbally discuss my plan to get their input and feedback with them. I can also write these efforts and forward them to their email address to get feedback on the effectiveness of these strategies.
I am now doing good. I have gained a lot of experience in psychiatric care. I feel I am not missing much, except that I should revise further to enhance my grasp of my acquired knowledge. Both the formal and informal feedback I received from my preceptor was helpful to my practicum. They helped me identify weak areas and how to improve them.
References
Christensen, M. C., Wong, C. M., & Baune, B. T. (2020). Symptoms of major depressive disorder and their impact on psychosocial functioning in the different phases of the disease: Do the perspectives of patients and healthcare providers differ? Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.00280
Dell’Osso, B., Albert, U., Carrà, G., Pompili, M., Nanni, M. G., Pasquini, M., Poloni, N., Raballo, A., Sambataro, F., Serafini, G., Viganò, C., Demyttenaere, K., McIntyre, R. S., & Fiorillo, A. (2020). How to improve adherence to antidepressant treatments in patients with major depression: A psychoeducational consensus checklist. Annals of General Psychiatry, 19(1). https://doi.org/10.1186/s12991-020-00306-2
Schmutz, J. B., Meier, L. L., & Manser, T. (2019). How effective is teamwork really? the relationship between teamwork and performance in Healthcare Teams: A systematic review and meta-analysis. BMJ Open, 9(9). https://doi.org/10.1136/bmjopen-2018-028280
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Question 
Psychiatric Clinic Journal Entry
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 their 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. 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 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.