I successfully met the goals and objectives I had set for the practicum experience. For instance, I met the objective of conducting comprehensive patient assessments for at least patients weekly. I also attained the objective of developing at least three differential diagnoses for each patient I assessed based on the DSM-V guidelines. I also met the goal of collaborating with my preceptor in developing treatment plans for patients with psychiatric diagnoses

I successfully met the goals and objectives I had set for the practicum experience. For instance, I met the objective of conducting comprehensive patient assessments for at least patients weekly. I also attained the objective of developing at least three differential diagnoses for each patient I assessed based on the DSM-V guidelines. I also met the goal of collaborating with my preceptor in developing treatment plans for patients with psychiatric diagnoses

I successfully met the goals and objectives I had set for the practicum experience. For instance, I met the objective of conducting comprehensive patient assessments for at least patients weekly. I also attained the objective of developing at least three differential diagnoses for each patient I assessed based on the DSM-V guidelines. I also met the goal of collaborating with my preceptor in developing treatment plans for patients with psychiatric diagnoses

I successfully met the goals and objectives I had set for the practicum experience. For instance, I met the objective of conducting comprehensive patient assessments for at least patients weekly. I also attained the objective of developing at least three differential diagnoses for each patient I assessed based on the DSM-V guidelines. I also met the goal of collaborating with my preceptor in developing treatment plans for patients with psychiatric diagnoses.

One of the most challenging cases was of a 18-year-old female with Bulimia nervosa, who was unwilling to change her dietary behaviors despite undergoing a series of psychotherapy sessions. The second most challenging case was a 34-year-old male with schizophrenia characterized by paranoid delusions. He was ever suspicious of the therapist and at times became aggressive. The third challenging case was a 46-year-old man with Multiple personality disorder. The patient was challenging to manage since each personality was complicated by difficult behavior patterns and interpersonal relationships.

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From the practicum experience, I have learned that mental health providers can avoid liability by responding to patients appropriately and adhering to the clinical guidelines and standards of care (Hartley et al., 2020). Besides, I have gained insight into the PMHNP’s role in educating patients about their mental health issues and behaviors, following up on patients, and evaluating care (APA, 2013). The resources available during the practicum include psychiatric treatment protocols, drug handbooks, psychotherapy protocols, and the DSM-V handbook. The resources have been valuable in diagnosing and developing treatment plans for patients with mental health disorders.

The EBP practices we used for challenging patient cases include psychotherapy modalities like cognitive behavioral therapy (CBT) and Interpersonal psychotherapy (IPT) for bulimia nervosa. CBT was also useful for the paranoid schizophrenia case alongside social skills training (Locher et al., 2019). CBT, dialectical behavioral therapy, and psychodynamic psychotherapy were used in the patient with Multiple personality disorder. If I were to assess these patients again, I would involve the patients’ families in obtaining history and psychotherapy.

The clinic has a high patient volume and flow as many mental health cases are referred to the facility. We are managing the high patient flow by using technology to schedule clients’ appointments. The facility has also adopted Telemedicine to provide online consultations, thus minimizing the number of patients visiting the clinic. I can apply my growing skillset by educating people in the community about mental health to change their attitudes and the social stigma on mental health.

Communicating and Feedback

I can improve my knowledge and skills in mental health by practicing more in history taking, MSE, developing treatment plans, and providing different psychotherapy modalities.  The preceptor has greatly helped me in acquiring the needed clinical skills through her constant guidance. Nonetheless, I have noted an area of improvement, particularly in interprofessional collaboration. The preceptor has commended my progress during the practicum and has mentioned that I have significantly shown improvement in my clinical knowledge and skills.

References

American Psychiatric Nurses Association. (2013). Population-focused nurse practitioner competencies. https://www.apna.org/files/Councils/Population-Focused-NP-Competencies-2013.pdf

Hartley, S., Raphael, J., Lovell, K., & Berry, K. (2020). Effective nurse-patient relationships in mental health care: A systematic review of interventions to improve the therapeutic alliance. International journal of nursing studies, 102, 103490. https://doi.org/10.1016/j.ijnurstu.2019.103490

Locher, C., Meier, S., & Gaab, J. (2019). Psychotherapy: A World of Meanings. Frontiers in Psychology, 10, 460. https://doi.org/10.3389/fpsyg.2019.00460