Learning from Experiences (Psychiatric Evaluations-Nursing Paper Examples)
Explain the degree to which you achieved each goal during the practicum experience.
My goals for the practicum were to confidently conduct psychiatric evaluations and acquire pharmacotherapeutic skills necessary for treating patients. I excellently achieved these goals since I could effectively recognize psychiatric signs and symptoms in patients, including confidently conducting forensic evaluations for the patients (Psychiatric Evaluations-Nursing Paper Examples).
Besides, I also gained pharmacotherapeutic skills through a comprehensive assessment of patients with various mental health conditions, such as major depressive disorder (MDD), moderate depression, generalized anxiety disorder, and bipolar disorders. I also developed suitable medication plans for the patients, including conducting follow-ups to determine their response to the prescribed medications (Psychiatric Evaluations-Nursing Paper Examples).
Reflect on the three (3) most challenging patients you encountered during the practicum experience. What was most challenging about each?
The first patient exhibited intense MDD with comorbid substance abuse, which forced him to be extremely irritable and violent. He disagreed with the mental assessment results and was not ready to comply with medication requirements. Providing mental care for the patient enabled me to understand that such patients need empathy and compassion. As such, it requires nurses to employ effective communication and interpersonal skills to develop positive relationships for improved treatment (Psychiatric Evaluations-Nursing Paper Examples).
I combined haloperidol with a benzodiazepine to reduce the patient’s aggression before administering treatment. Hirsch and Steinert (2019) observe that the medications offer rapid tranquilization to patients, enabling nurses to manage aggressive and violent patients effectively. If given another chance to care for the patient, I would use de-escalation techniques like allowing them to calm down and avoiding confronting them instead of the tranquilization method (Psychiatric Evaluations-Nursing Paper Examples).
The second patient was concerned about confidentiality and did not conclusively respond to the assessment questions, such as her history of the disease or the substances she was using. To compel her to disclose the necessary information, I assured her of the hospital’s comprehensive measures to ensure patient confidentiality, such as storing the data in secure systems and conducting the assessments in isolated rooms with no cameras or mobile phones (Psychiatric Evaluations-Nursing Paper Examples).
Lustgarten et al. (2020) observe that patient data should be stored in secure, encrypted servers or devices to avoid third-party access. I also learned the benefit of maintaining the confidentiality of patients’ data, such as increasing patients’ trust and confidence in the process. If given another chance to care for the patient, I would explain to them first about the confidentiality measures before initiating the assessment process (Psychiatric Evaluations-Nursing Paper Examples).
The third patient suffered from generalized anxiety disorder (GAD) and was traumatized to the extent that he felt worthless and was not optimistic about the importance of therapy. I enrolled him in imaginal exposure therapy to help reduce the trauma symptoms like fear and restlessness (Psychiatric Evaluations-Nursing Paper Examples).
The therapy involves exposing the patient to the feared scenario, such as compelling them to recall the experience to help confront the feelings of fear (Whiteside, 2023). If given the chance to care for the patient again, I would combine medications like Lexapro or Paxil with exposure therapy to enhance the achievement of positive outcomes within the shortest period (Psychiatric Evaluations-Nursing Paper Examples).
How are you managing patient flow and volume?
I prioritized the urgency of patients’ needs to ensure that emergency cases were resolved first. This helps improve workflows and ensure timely provision of necessary care (Palese et al., 2020) (Psychiatric Evaluations-Nursing Paper Examples).
The practicum allowed me to comprehensively understand the context of mental health care and the importance of early intervention. As a result, I can become a social change agent by raising awareness about mental health conditions to educate community members on mental health symptom identification and the need for early intervention for improved treatment outcomes (Kudva et al., 2020) (Psychiatric Evaluations-Nursing Paper Examples).
Communicating and Feedback
Reflect on how you might improve your skills and knowledge, and communicate those efforts to your Preceptor
I can improve my skills through collaboration with other mental health practitioners to help gain practical knowledge and skills about mental health care. I should also research evidence-based practices to understand the context of mental health care adequately (Psychiatric Evaluations-Nursing Paper Examples).
Answer the questions: How am I doing? What is missing?
The practicum has equipped me with the essential skills to care for mentally ill patients. Continued training and collaboration with other practitioners will increase my knowledge and experience in mental health care. However, I still experience challenges complying with ethical and legal issues in patient care, especially when dealing with aggressive patients or those who do not perceive the importance of the treatment process (Psychiatric Evaluations-Nursing Paper Examples).
References
Hirsch, S., & Steinert, T. (2019). The use of rapid tranquilization in aggressive behavior. Deutsches Ärzteblatt International, 116(26), 445.https://doi.org/10.3238%2Farztebl.2019.0445
Kudva, K. G., El Hayek, S., Gupta, A. K., Kurokawa, S., Bangshan, L., Armas‐Villavicencio, M. V. C., … & Sartorius, N. (2020). Stigma in mental illness: Perspective from eight Asian nations. Asia‐Pacific Psychiatry, 12(2), e12380. https://doi.org/10.1111/appy.12380
Lustgarten, S. D., Garrison, Y. L., Sinnard, M. T., & Flynn, A. W. (2020). Digital privacy in mental healthcare: current issues and recommendations for technology use. Current Opinion in Psychology, 36, 25-31. https://doi.org/10.1016/j.copsyc.2020.03.012
Palese, A., Bottega, M., Cescutti, A., Caruzzo, D., Danielis, M., Fabris, S., … & Grassetti, L. (2020). Depicting clinical nurses’ priority perspectives leading to unfinished nursing care: A pilot Q methodology study. Journal of Nursing Management, 28(8), 2146-2156. https://doi.org/10.1111/jonm.13036
Whiteside, S. P. (2023). Examining community clinicians use of imaginal exposure with childhood anxiety disorders. Child Psychiatry and Human Development, https://doi.org/10.21203/rs.3.rs-2763135/v1
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