JOURNAL ENTRY

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Week 11: Journal Entry

Name:

Institution:

Course:

Date:

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Week 11: Journal Entry

Goals and Objectives

This week I evaluated my goals and objectives from week one to see how well I met

them during my practicum. My first goal for this practicum was to design an optimal treatment

plan for my patients based on their clinical presentations. After documenting each patient

encounter on the Meditrek, I used the DSM-5 to confirm that the diagnosis matched the patient's

symptoms by comparing them to the diagnostic criteria. The second objective I set for myself in

the first week was to be able to evaluate the client's response to prescribed medications and

modify treatment based on clinical presentations of the patient. When adding newly prescribed

medication to a client's regimen, my preceptors instructed me on which clinical signs and

symptoms to observe.

Challenging Clients

One challenging client was a 16-year-old guy with a major depression condition (MDD).

The problem did not lie with the client but rather with his mother. His appointments were either

cancelled, or his parent did not respond to her phone on the days of his scheduled appointments.

The parent's noncompliance made it difficult to treat the client due to a lack of communication

adequately. A 30-year-old man with opioid use disorder and bipolar disorder also presented a

unique set of difficulties. The client would show up for his session after having used

methamphetamines and would be uncooperative in his behavior. The third patient was a 36-year-

old woman who was also extremely agitated during her visit, and she was prone to losing her

train of thought regularly. She was frequently easily distracted and jumped from issue to issue,

which resulted in her not always answering correctly.

Experience

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My challenging practicum clients provided me with a great deal of insight. It is tough to

treat youngsters whose parents miss appointments. I realized that managing clients under the

influence of drugs is difficult since they cannot think clearly and cannot fully appreciate your

ideas. To properly manage your time when getting information from these clients, you must keep

focused and track.

Available Resources

It is possible to make follow-up phone calls to noncompliant clients if they are persistent.

Therapy and other clinicians, as well as staff from the facility, may be included in these groups,

who can perform safety checks on patients to ensure their well-being and safety.

Evidence-Based Practice Methods

The mother of the adolescent diagnosed with MDD was advised to seek psychotherapy,

but she failed to follow her son's therapist visits. Thus he missed his treatment appointments as

well. There is substantial evidence that inpatient or group therapy can help people struggling

with addiction.

Managing Client Flow and Volume

Improving patient flow and volume can be hard when client appointments run late. It is

occasionally important to divert the client back to the original issue to prevent falling behind

schedule. Documenting the evaluation or follow-up visit data while evaluating the client helps

eliminate documentation gaps and ensures that the information received is not lost or forgotten.

Improving knowledge and skills

Using my new abilities, I can help improve community mental health and wellness. As a

PMHNP, I hope to work with local practitioners and therapists to help persons with psychiatric

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issues. I also want to educate the community on psychiatric problems by offering leaflets and

pamphlets to help people understand mental illness and treatment alternatives.

How am I doing? What is missing?

Though I am doing well, I wish I had performed at a higher level. The critical

requirement is to operate effectively in a psychotherapy unit with diverse knowledge and

experience.

Preceptor’s feedback reflection

Compassion, per the preceptor, is critical and can affect the patient care provided.

However, my willingness to help patients will enable me to succeed in the field.

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