College of Nursing-PMHNP, Walden University

October 21, 2025 Claire B 0 Comments

Jan 24, 2024 College of Nursing-PMHNP, Walden University

Paraphrazing this work for me.

Week 11: Journal

Student Name

College of Nursing-PMHNP, Walden University

NRNP 6665: PMHNP Care Across the Lifespan I

Faculty Name

Assignment Due Date

This study source was downloaded by 100000853131049 from CourseHero.com on 11-10-2023 12:34:49 GMT -06:00

https://www.coursehero.com/file/164116055/Week-11-Journal-JKdocx/

Revisit the goals and objectives from your Practicum Experience Plan. Explain the degree

to which you achieved each during the practicum experience.

Objective 1: To achieve confidence in using evidence-based research in my interaction with

patients, allowing me to provide them with the most up-to-date clinical information.

One of the things I learned from this experience was how to execute more advanced

directive planning. With the directives of my clinical preceptor, I was able to establish the

symptoms and indicators of several mental health conditions, including bipolar disorder,

borderline personality disorder, depression, and schizophrenia. Using the most current and up-to-

date clinical data, I want to focus more on enhancing my ability to identify the symptoms of

bipolar illness and schizophrenia, which appear to be prevalent in adults.

Objective 2: To utilize the technologies available to enhance and optimize patient care.

Within ten weeks of my clinical rotation and preceptor’s confirmation, I could identify the

correct screening instrument in clinical settings. During my rotation, however, no screening tools

were used. Coursework and intensive reading was the only approach I could master screening

technologies and how they are applied. There is a need, therefore, for a bigger investment in

sophisticated clinical instruments, which I am looking forward to working with them.

Objective 3: To have a better grasp of mental illness, its progression, treatments, and diagnosis,

thus enhancing my career advancement as a nurse.

An evaluation demonstrated that I could identify and prioritize the most likely diagnosis

for patients in 10 weeks. My clinical rotation was part of learning about probable and

establishing correct diagnoses for patients at a hospital. There were few teenagers to deal with,

but I had much experience working with adults and the elderly.

This study source was downloaded by 100000853131049 from CourseHero.com on 11-10-2023 12:34:49 GMT -06:00

https://www.coursehero.com/file/164116055/Week-11-Journal-JKdocx/

Reflect on the three (3) most challenging patients you encountered during the practicum

experience. What was most challenging about each?

One of the most challenging patients I dealt with was a 29-year-old lady who presented

with Suicidal thoughts. This lady was struggling with feelings of abandonment and was thus

resentful. In addition, the patient was characterized by numerous outbursts during the interview.

This thus made it difficult to conduct psychotherapy at the time.

Another encounter was with a Caucasian man aged 30 who presented with a manic

episode. This patient had a history of opiate use. Subutex was the only drug that worked for this

patient. Trileptal was preferred, but he refused, citing that there was no other medication that

could help him as he had used them before. He was eventually administered subutex because of

his opiate use problem (Stupazzoni, 2022). The patient, however, wanted this medication in order

for him to stay sober.

The third most challenging patient was an abusive and arrogant patient. This patient had

presented complaining of Anxiety and sleepless nights. However, during the interview with this

patient, he was unclear and brief in his responses, making it hard to obtain critical information

concerning his condition.

What did you learn from this experience?

Typically, I learned about patient dishonesty. Some patients may provide inaccurate,

misleading information concerning their condition. This can thus lead to misdiagnosis and,

ultimately, a wrong approach in trying to mitigate the underlying health condition. Another

critical lesson I learned was dealing with arrogant and abusive patients with minimal empathy. I

maintained my calm and composure by listening intently to the patient’s words. Additionally, I

This study source was downloaded by 100000853131049 from CourseHero.com on 11-10-2023 12:34:49 GMT -06:00

https://www.coursehero.com/file/164116055/Week-11-Journal-JKdocx/

was comforting and acknowledged the patient’s concerns. Finally, I enabled the patient to express

their frustration while maintaining eye contact to gain more in-depth information.

What resources were available?

The DSM5 was the most useful and effective tool offered throughout this training

program. It was the most understandable and interesting of all the textbooks used in this mastery

program.

What evidence-based practice did you use for the patients?

Typically, the preceptor handled several patients who were opiate addicts when I was

doing my clinical rotations. Various suggestions were made to the patients, each differing. With

Naltrexone, for instance, I have observed the greatest success rate in sobriety (“Naltrexone,”

2018). When the psychiatrist refrained from issuing the medication to some of his patients, I was

perplexed. I then learned that Nonpharmacological approaches are practical when dealing with

patients with addiction and mental health conditions (“Naltrexone,” 2018). Even though

Naltrexone is backed by research, other medications and alternative Nonpharmacological

treatments are still practical and valuable to the patients (Nandita et al., 2020). From this, I

learned that there is a strong need for a scientific and methodical curriculum design for the early

introduction of EBM in pre-clinical years, which is best suited for the students (Greenhalgh et

al., 2022). The concepts should be aimed toward additional study for the efficient adoption of

EBM to strengthen clinical abilities (Greenhalgh et al., 2022).

What would you do differently?

Typically, my clinical rotation lacked consistency since I could attend to patients three

times a week for the most part. The clinical rotation would have been more valuable to my skills

and knowledge if I had allocated more time to seeing and following up on patients. First, regular

This study source was downloaded by 100000853131049 from CourseHero.com on 11-10-2023 12:34:49 GMT -06:00

https://www.coursehero.com/file/164116055/Week-11-Journal-JKdocx/

follow-up treatment helps patients remain healthy and improves the quality of their care (Imtiaz

& McLaughlin, 2022). A secondary benefit of early post-discharge treatment is a decrease in the

frequency of re-admissions to the hospital (Imtiaz & McLaughlin, 2022). Finally, regular post-

discharge follow-ups assist in detecting and preventing problems before they become serious,

reducing the number of patients needing to return to the hospital (Imtiaz & McLaughlin, 2022).

Resultantly, this would have enhanced my confidence as a healthcare provider.

How are you managing patient flow and volume?

Prioritizing patients in stable condition is an excellent technique for keeping patient flow

and volume in check (Vahdat, 2018). Certain patient follow-ups require less time, ensuring

maximum time utilization (Vahdat, 2018). Additionally, this allocates more time to patients with

more complex problems. Furthermore, this ensures that all patients are dealt with satisfactorily.

Finally, this ensures that I effectively and efficiently manage the flow and volume of patients.

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

community?

Typically, the DSM5 book helps me develop new abilities. During a clinical interview, I

knew exactly what questions to ask about a specific diagnosis. Moreover, the DSM-5-TR

contains a complete and detailed explanation of the influence of racism and prejudice on mental

illness diagnosis and manifestation and how to overcome them (“Facts About DSM-5-TR,”

2022). Clinically and scientifically, the handbook aids in defining and classifying mental

illnesses, allowing for more accurate diagnosis, treatment, and investigation (“Facts About DSM-

5-TR,” 2022). Finally, it gives me a common language to engage with patients and develop

consistent and trustworthy diagnoses, which is essential to my career advancement (“Facts About

DSM-5-TR,” 2022).

This study source was downloaded by 100000853131049 from CourseHero.com on 11-10-2023 12:34:49 GMT -06:00

https://www.coursehero.com/file/164116055/Week-11-Journal-JKdocx/

Communicating and Feedback

Reflect on how you might improve your skills and knowledge, and communicate those

efforts to your Preceptor

As a medical professional, I must have the capacity to master a wide range of skills and

knowledge, including technical mastery, theoretical understanding, caring intention, and ethical

considerations. I have to do a lot of clinical skill evaluations based on a clinical reasoning

process before, during, and after clinical skill training. In a medical admissions unit, I would

have to participate in multiple substantial instances of clinical reasoning (“Clinical Trials

Informed Consent: An Educational Intervention to Improve Nurses’ Knowledge and

Communications Skills,” 2018). I must make judgments and the best alternatives using this

information. I should discuss any concerns with my preceptor before making a diagnosis and

thus offering the best treatment option.

Answer the questions: How am I doing? What is missing?

Overall, I am doing well as a medical provider. However, it became clear that I need

more training and experience when dealing with adolescents and abusive patients. My

knowledge of drug prescription has also improved significantly.

Reflect on the formal and informal feedback you received from your Preceptor.

Even though I received brief feedback from the preceptor, the feedback was clear,

objective, succinct, and up to a point.

This study source was downloaded by 100000853131049 from CourseHero.com on 11-10-2023 12:34:49 GMT -06:00

https://www.coursehero.com/file/164116055/Week-11-Journal-JKdocx/

References

Clinical Trials Informed Consent: An Educational Intervention to Improve Nurses’ Knowledge

and Communications Skills. (2018). Clinical Journal of Oncology Nursing.

https://doi.org/10.1188/18.cjon.e152-e158

Facts About DSM-5-TR. (2022). Psychiatric News, 57(3).

https://doi.org/10.1176/appi.pn.2022.03.3.28

Greenhalgh, T., Fisman, D., Cane, D. J., Oliver, M., & Macintyre, C. R. (2022). Adapt or die:

how the pandemic made the shift from EBM to EBM+ more urgent. BMJ Evidence-

Based Medicine, bmjebm-2022. https://doi.org/10.1136/bmjebm-2022-111952

Imtiaz, N., & McLaughlin, J. (2022). Reducing the Pressure on Mental Health Team by

Improving Post-Discharge Follow-Up of Self-Harm or Suicidal Patients in Primary Care.

BJPsych Open, 8(S1), S99. https://doi.org/10.1192/bjo.2022.307

Naltrexone. (2018). Reactions Weekly, 1684(1), 185. https://doi.org/10.1007/s40278-018-40797-

Nandita, G., Shivalingesh, K., Swati, S., Resham, I., & Satyaki, V. (2020). Evaluation of

pharmacological and non–pharmacological methods of smoking cessation; A Review.

Journal of Addiction Medicine and Therapeutic Science, 6(1), 045–051.

https://doi.org/10.17352/2455-3484.000037

Stupazzoni, M. (2022). Marie-Ève Thérenty, Convergences: “Vernon Subutex” et “La Comédie

humaine.” Studi Francesi, 196 (LXVI | I), 184.

https://doi.org/10.4000/studifrancesi.48824

Vahdat, S. (2018). IDENTIFYING AND PRIORITIZING FACTORS EFFECTIVE ON

HOSPITAL SERVICES QUALITY FROM THE PATIENT ATTENDANTS VIEW

This study source was downloaded by 100000853131049 from CourseHero.com on 11-10-2023 12:34:49 GMT -06:00

https://www.coursehero.com/file/164116055/Week-11-Journal-JKdocx/

USING FUZZY AHP TECHNIQUE IN 2017. Universal Journal of Pharmaceutical

Research, 3(2), 21–28. https://doi.org/10.22270/ujpr.v3i2.135

This study source was downloaded by 100000853131049 from CourseHero.com on 11-10-2023 12:34:49 GMT -06:00

https://www.coursehero.com/file/164116055/Week-11-Journal-JKdocx/
Powered by TCPDF (www.tcpdf.org)

https://www.coursehero.com/file/164116055/Week-11-Journal-JKdocx/

http://www.tcpdf.org

Order a similar assignment, and have writers from our team of experts write it for you, guaranteeing you an A

Share:

Categories:

Health