Practicum Journal Entry-Comprehensive Nursing Paper Sample

Practicum Journal Entry-Comprehensive Nursing Paper Sample

Learning from Experiences

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. 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.(Practicum Journal Entry-Comprehensive Nursing Paper Sample)

Practicum Journal Entry-Comprehensive Nursing Paper Sample
Practicum Journal Entry-Comprehensive Nursing Paper Sample 1

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. 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. (Practicum Journal Entry-Comprehensive Nursing Paper Sample)

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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. 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.(Practicum Journal Entry-Comprehensive Nursing Paper Sample)

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. 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.(Practicum Journal Entry-Comprehensive Nursing Paper Sample)

How are you managing patient flow and volume?

I prioritized the urgency of patients’ needs to ensure that emergency cases were resolved first. This help improve workflows and ensure timely provision of necessary care (Palese et al., 2020).(Practicum Journal Entry-Comprehensive Nursing Paper Sample)

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How can you apply your growing skillset to be a social change agent within your community?

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).(Practicum Journal Entry-Comprehensive Nursing Paper Sample)

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.(Practicum Journal Entry-Comprehensive Nursing Paper Sample)

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.(Practicum Journal Entry-Comprehensive Nursing Paper Sample)

Practicum Journal Entry-Comprehensive Nursing Paper Sample
Practicum Journal Entry-Comprehensive Nursing Paper Sample 2

References

Hirsch, S., & Steinert, T. (2019). The use of rapid tranquilization in aggressive behavior. Deutsches Ärzteblatt International116(26), 445(Practicum Journal Entry-Comprehensive Nursing Paper Sample).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 Psychiatry12(2), e12380.(Practicum Journal Entry-Comprehensive Nursing Paper Sample) https://doi.org/10.1111/appy.12380

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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 Psychology36, 25-31. (Practicum Journal Entry-Comprehensive Nursing Paper Sample)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 Management28(8), 2146-2156.(Practicum Journal Entry-Comprehensive Nursing Paper Sample) https://doi.org/10.1111/jonm.13036

Whiteside, S. P. (2023). Examining community clinicians’ use of imaginal exposure with childhood anxiety disorders. (Practicum Journal Entry-Comprehensive Nursing Paper Sample)Child Psychiatry and Human Development, https://doi.org/10.21203/rs.3.rs-2763135/v1

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