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Running Head: SELF-EVALUATION OF LOGS 1

SELF-EVALUATION OF LOGS 2

Self-Evaluation of Logs.

Students Name:

Professors Name:

Date.

Week one.

I was privileged to work with other group therapy members at Queens General Outpatient Clinic, which offered a wide range of medical services for both inpatient and outpatient who sought medical attention from the said facility. Working along with other group members, I got a chance to co-leader group therapy as it was part of my course requirement (EveryNurse, 2019). Since I have received proper training on how the various procedure for therapeutic services are provided with respect to the immediate and long-term needs of the patients, I was able to facilitate several services to help the clinic facility achieve its goals, particularly those that were directly related to group therapeutic services.

It is worth mentioning that, as co-leader of group therapy, my objectives of the week were to ensure that the team I worked with collaborated and worked towards the mission and vision of the Queens General Outpatient Clinic, the second objective as co-leader of the group therapy was to ensure that we target specific problems present by various patients suffering psychiatric challenges within the community and any of the patient that visited our clinic. Besides that, I had objectives to amass experiences as I worked collaboratively with my preceptor to identify my learning needs and concerns to help me meet the anticipated clinical experience. Finally, my objectives were to improve social skills by helping patients suffering from various forms of psychiatric challenges be able to deal with a wide range of issues they face, such as increased levels of anger, lack of interest in their lives, loneliness, poor relationships, low esteem among many other issues.

A good percentage of my objectives were met, and I was able to achieve them through strictly adhering to my schedules and strongly following the clinical objectives as my guide. Secondly, a good relationship with my preceptor enabled me to interact with him more when I faced a few challenges. I got guidance, which facilitated every aspect of my practice, which saw me succeed in many of my objectives.

As a nurse practitioner, I devoted myself to offer professional assistance to a wide range of patient in all the clinical settings that I worked in. as required by the nursing field ethical standards and practices, I remained committed throughout the training session and used clinical guidelines and objectives to execute my duties promptly as required by NP profession as well as according to the expectations of the course outcomes so as to ensure that all areas of practice are met competently and professionally.

While attending to various groups and individual patients at a mental health practice in Californian was able to offer professional services by seeking to get more details about the patients who arrived at the clinic via in-depth interview to collect more details on the present and past medical history about the said patient which was to help form a rapport for the further medical examination for effective clinical and treatment plan to be deployed. I used semi-structured questions, which facilitated me to collect adequate and comprehensive clinical data that could guide in providing personalized and patient-centred services that effectively met their needs.

Perhaps with my preceptor's assistance and guidance, I was able to make appropriate adjustment for the 26-year-old woman who had visited our clinic with her husband alongside their two-year-old son. Due to her inability to speak English, the preceptor guided me on how best to avoid full assessment, which could have taken longer due to cultural diversity and its related challenges. Her husband played a critical role in translating for effective assessment to be achieved. Perhaps, after I did an alternative assessment as guided, I noted from the patient's past medical story she narrated that she had been experiencing several incidences of mood imbalances where at many times she felt depressed, which were often accompanied with progressive panic attacks, and it was clear that until then the patient was under different medication where she used to take Zoloft 50mg as prescribed by her primary care. The patient admitted that in her teenage life, she attempted to cut her wrist using a knife.

I was able to diagnose the patient with mental distress. She agreed to take sertraline alongside the use of psychotherapy to help reduce the mental distress that had caused her neglect and lose even the interest in taking care of her child. It is good to mention that the strategy I deployed when interviewing, assessing and diagnosing the patient help reduce the risks of treatment avoidance as the patient had had mental illness for a long time.

Week two.

While I was working in south Oak’s hospital every Thursday as my clinical rotation and a requirement for my course, I was able to collaboratively work with Mr Prato, who was my instructor, to provide programs that aimed at helping children and adolescent, both inpatient and outpatients are able to manage various challenges associated with mental illness. I did this by offering or conducting psychoeducation for parents alongside offering behavioural support, rehabilitation services, and perhaps facilitating therapeutic services. With the adequate exposure and experiences I had acquired, I effectively assessed a 13-year-old male who had been admitted to developing suicidal ideation accompanied by aggressive activities and frustrations.

The 13-year-old male patient was caught by his mother attempting to harm himself by using a dust cleaner. Prior to the worsening of the patient conditions, the mother reported that the son had developed stealing her money only to purchase 80 dollars of Amazon gift certificates. PT report indicated that the patient had increased levels of sad feelings; he experienced several occasions of anger and the inability to handle or control his frustrations effectively. During the interview with his mother, I noted that the patient increased and uncontrolled levels of anger have been making him high, thus developing a frequent urge to fight, and these effects have extended to the punching of the wall and continuous destruction of the property at any moments his moods swings towards annoyance. Perhaps the patients have been frequently reported with high levels of physical aggression where he extends the aggressiveness to his fellows, particularly when playing with his friends.

During the patient’s evaluation and assessment exercise, I noted that the boy had not been able to sleep well for the last two days, although there was no clear indication whether the patient had been having challenges to do with hypomanic episodes in his initial stages of life. However, the mother reported that the boy has been facing challenges of behavioural disturbances since he was at the age of three. The report indicated that the boy used to fight teachers by biting them and running away from school without permission. When his moods were disturbed, he always becomes impulsive with and could not control himself and often acted without hesitating nor thinking.

With recommendations on the use of Zoloft for mood disturbances, depression and anxiety helped reduce the suicidal ideation and perhaps managed mood disorders that possibly affected the patient's normal life.

Week three.

During week three, a 39-year-old male sought medication attention due to an increased level of worries and all along, the patient has been experiencing many challenges, some of which are related to stressful episodes and considerably longer night without sleep. The client’s worries were attributed to his occupation, where he had been given an opportunity to install pipes in one of the nearby healthcare facilities. When I asked him, what could be the primary cause of emerging worries, he explained that he only felt that the worst things might happen sooner or later with regard to the work he had done.

His medical history and past life did not indicate mental distress or any sort of psychiatric challenge that could prompt the increased worries he is currently experiencing. Upon interviewing him, I noted that hears fears were attached to either the belief that he could have overcharged his client when he was called to install pipes, and if that could not be the case, he thought that there was the possibility he had given incorrect change when cash payment was made. Given that I have been exposed to several scenarios and perhaps mingled with many psychiatric patients, I used my knowledge to assess the level of worries and what might be triggering such fears, yet he has been doing well.

I asked my client to vividly describe how he felt and whether he had been experiencing any anxiety or mood disorders over the past few days. I further asked home to describe how the current situation of increased worries might have impacted his daily life and his life in general. From the description, he provided I was able to deduce that the patient had been experiencing high levels of anxiety, which he was unable to describe, and he needed help to remedy the situation. Since I had several options for treatment, I found it wise to consult my preceptor, and after the deep discussion on the presented symptoms and medical challenges of the client, I was advised to use Generalized Anxiety Disorder 7-item after which I recommended to the patient to attend a talk therapy session as part of his treatment to help him overcome the uncontrolled challenge anxiety and abnormal worries.