PRAC 6635 Journal Entry

Sample Answer

Learning From Experiences

The goals for the Practicum Experience were to Perform comprehensive mental health assessments, Develop differential diagnoses for patients with psychiatric and substance use disorders across the lifespan, and Develop treatment plans for patients with psychiatric and substance use disorders. I fully achieved each of the practicum goals with the guidance of my preceptor. During the experience, I encountered some challenging cases in which I required assistance in assessment, diagnosing, and treatment. The most challenging case was a 42-year-old female with dissociative identity disorder. This was challenging because the patient had secondary personality disorders that came out during therapy. The second challenging case was a 32-year-old male with a paranoid personality disorder. This was challenging because the client was hesitant to confide with the therapist because of fear that the information would be used spitefully against him. Another challenging case was a 16-year-old female with Anorexia nervosa who was uncooperative during therapy.

The challenging experiences taught me that a mix of social and psychological factors causes abnormal behavior. In most patients, environmental and psychological triggers complement one another, resulting in emotional stress, which in turn activates a mental illness (Moyo et al., 2022). I also learned that each individual is unique in how they will react to psychological stressors. What may break one person may have little to no effect on another. The available resources included the DSM 5 handbook, psychotherapy guidelines, drug handbooks, and psychiatric treatment protocols. The patients were managed using evidence-based therapies like Cognitive Behavioral Therapy, Dialectical Behavior Therapy, Interpersonal Psychotherapy, Mindfulness-Based Cognitive Therapy, and Motivational Interviewing (Cai et al., 2022).

The practicum experience has taught me new skills like providing patient-centered care, demonstrating empathy, active listening, and using appropriate body language. In a different situation, I would increasingly involve patients and their families in decision-making to engage them in a patient’s care. I would also exhibit more confidence in making decisions and taking charge, especially in challenging situations (Hartley et al., 2020). The practicum site has a high patient flow since it is a mental health referral center providing inpatient and outpatient mental health services. We are managing the high patient flow through electronic patient scheduling and using group therapy for patients with common conditions to attend to more patients.

Communicating and Feedback

I aim to improve my psychiatric skills and knowledge by practicing more in clinical settings and involving my preceptor in developing patients’ treatment plans. I will inform my preceptor that I want to practice more so that she can give me more opportunities to assess patients independently and collaboratively (Fraino & Selix, 2021). Overall, I am doing great in the practicum and achieving personal and course objectives. The preceptor has been supportive throughout the course and appreciated my efforts in taking detailed assessments and following guidelines in assessing, diagnosing, and treating patients.

References

• Cai, A., Mehrotra, A., Germack, H. D., Busch, A. B., Huskamp, H. A., & Barnett, M. L. (2022). Trends In Mental Health Care Delivery By Psychiatrists And Nurse Practitioners In Medicare, 2011-19. Health affairs (Project Hope), 41(9), 1222–1230. https //doi.org/10.1377/hlthaff.2022.00289
• Fraino, J., & Selix, N. (2021). Facilitating Well-Rounded Clinical Experience for Psychiatric Nurse Practitioner Students. The Journal for Nurse Practitioners JNP, 17(8), 1004–1009. https //doi.org/10.1016/j.nurpra.2021.05.015
• Hartley, S., Raphael, J., Lovell, K., & Berry, K. (2020). Effective nurse-patient relationships in mental health care A systematic review of interventions to improve the therapeutic alliance. International journal of nursing studies, 102, 103490. https //doi.org/10.1016/j.ijnurstu.2019.103490
• Moyo, N., Jones, M., & Gray, R. (2022). What are the core competencies of a mental health nurse? A concept mapping study involving five stakeholder groups. International journal of mental health nursing, 31(4), 933–951. https //doi.org/10.1111/inm.13003