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Assignment: Journal Entry
Critical reflection on your growth and development during your practicum experience in a clinical setting helps you identify opportunities for improvement in your clinical skills, while also recognizing your strengths and successes.
Use this Journal to reflect on your clinical strengths and opportunities for improvement, the progress you made, and what insights you will carry forward into your next practicum.
· Refer to the “Population-Focused Nurse Practitioner Competencies” found in the Week 1 Learning Resources and consider the quality measures or indicators advanced nursing practice nurses must possess in your 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 and 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 most challenging patients you encountered during the practicum experience. What was most challenging about each?
· What did you learn from this experience?
· What resources were available?
· What evidence-based practice did you use for the patients?
· 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.
PMHNP PRAC 6645 Clinical Skills
Desired Clinical Skills for Students to Achieve
Confident (Can complete independently)
Mostly confident (Can complete with supervision)
Beginning (Have performed with supervision or need supervision to feel confident)
New (Have never performed or does not apply)
Comprehensive psychiatric evaluation skills in:
Recognizing clinical signs and symptoms of psychiatric illnessacross the lifespan
Differentiating between pathophysiological and psychopathological conditions
Performing and interpreting a comprehensive and/or interval history and physical examination (including laboratory and diagnostic studies)
Performing and interpreting a mental status examination
Performing and interpreting a psychosocial assessment and family psychiatric history
Performing and interpreting a functional assessment (activities of daily living, occupational, social, leisure, educational).
Diagnostic reasoning skill in:
Developing and prioritizing a differential diagnoses list
Formulating diagnoses according to DSM 5 based on assessment data
Differentiating between normal/abnormal age-related physiological and psychological symptoms/changes
Pharmacotherapeutic skills in:
Selecting appropriate evidence based clinical practice guidelines for medication plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management)
Evaluating patient response and modify plan as necessary
Documenting (e.g., adverse reaction, the patient response, changes to the plan of care)
Psychotherapeutic Treatment Planning:
Recognizes concepts of therapeutic modalities across the lifespan
Selecting appropriate evidence based clinical practice guidelines for psychotherapeutic plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management, modality appropriate for situation)
Applies age appropriate psychotherapeutic counseling techniques with individuals, families, and/or groups
Develop an age appropriate individualized plan of care
Provide psychoeducation to individuals, family, and/or groups
Promote health and disease prevention techniques
Develop SMART goals for practicum experiences
Evaluating outcomes of practicum goals and modify plan as necessary
Documenting and reflecting on learning experiences
Maintains professional boundaries and therapeutic relationship with clients and staff
Collaborate with multi-disciplinary teams to improve clinical practice in mental health settings
Identifies ethical and legal dilemmas with possible resolutions
Demonstrates non-judgmental practice approach and empathy
Practices within scope of practice
Selecting and implementing appropriate screening instrument(s), interpreting results, and making recommendations and referrals:
Demonstrates selecting the correct screening instrument appropriate for the clinical situation
Implements the screening instrument efficiently and effectively with the clients
Interprets results for screening instruments accurately
Develops an appropriate plan of care based upon screening instruments response
Identifies the need to refer to another specialty provider when applicable
Accurately documents recommendations for psychiatric consultations when applicable
Summary of strengths:
My foremost strength is professionalism. I definitely fathom my responsibility and I recognize how to uphold limitations with patients and colleagues. In my daily life I make it a practice not to judgment regardless of their situation. It is not hard to apply this habit in my professional practice.
Opportunities for growth:
My greatest opportunity for progress this quarter will be working with groups and families. This will be a new area in this semester. It will be remarkable how to traverse group and family dynamics while commerce with specific traits and interests.
Now, write three to four (3–4) possible goals and objectives for this practicum experience. Ensure that they follow the SMART Strategy, as described in the Learning Resources.
1. Goal: I want to perform mental status exams on at various patients by the end of this practicum rotation.
a. Objective: Comprehensive psychiatric evaluation skill
b. Objective: Diagnostic Reasoning Skills
c. Objective: Professional Skills
2. Goal: I want to correctly identify clinical signs and symptoms to the corresponding mental illness for each patient that I see this quarter, as evidenced by acknowledging of practicum instructor.
a. Objective: Comprehensive psychiatric evaluation
b. Objective: Diagnostic Reasoning
c. Objective: Shadow and participate in patient care
3. Goal: Will complete 160 hours of clinical hours for this course as required.
a. Objective: Arrive at the clinical site on time and well prepared.
b. Objective: Enter patient information on Meditrek.
c. Objective: Complete time log and patient information on a timely manner during practicum experience.
Course/Section: NURS 6645 PRAC
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