Paper Example on PMHNP Practicum: Integrating Theory with Professional Practice

Introduction

Clinical practicum is an essential part of any nursing program for undergraduate nurses. The importance of clinical practicum is undeniable as it exposes the undergraduate nursing student to the reality of professional practice. Clinical practicum offers an opportunity for a student to integrate the tacit knowledge learned in class with real-life professional practice. As such, practicum experience is important in producing skilled clinicians. The objective of the PMHNP practicum experience is to allow students to apply theoretical knowledge in different practical aspects of the clinical environment. The expectation of the clinical practicum is to produce a skilled clinician who can independently diagnose and assess clients with psychiatric mental health issues (Weber et al., 2016). Clinical practicum entails working in a convenient location under the guidance of a preceptor. Goals and objectives are set, and upon completion of the practicum experience, an evaluation is done to assess attainment of practicum objectives, gaps in a practicum experience, main points of final evaluation with practicum preceptor, and areas of personal growth and development. Thus, this paper aims to provide a summary report of a clinical practicum experience.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Save 25%

Attainment of Practicum Objectives

The practicum experience is essential in introducing the student to professional practice. Typically, the 8-hour shift system is mainly utilized in psychiatry wards, which is evenly divided into the AM, PM, and NOC shifts. During my practicum, I was assigned the AM shift from 7:30 AM to 4 PM. The practicum experience taught me invaluable lessons on the importance of prioritization and time management. Once the shift starts, the team receives a report on each patient in the psychiatric unit. In psychiatry, the reports detail the 'patient presentation,' which includes details such as the patient's mood, medication compliance, behavior, and comorbidities. Since most psychiatric patients are either held in the hospital for danger to self or others, patient reports are essential to understand their response to treatment and their behavioral presentation. Additionally, it is important to identify patients that require one on one observation. Patients who require keen observation include those that are combative, highly suicidal, or medically compromised. Since these patients are highly unpredictable and can be violent, obtaining this information helps the team to be hyper-vigilant to ensure safety and security during the shift.

Once I received my assignment, I normally checked on my patients. I learned that creating a rapport with the patients is important in discussing any issues they may have. The rest of the shift entails attending to matters that require immediate attention. Such matters include pending admissions, psychiatric emergencies, or patients requiring PRN medications. In the case of incoming admissions, it is important to read about the patient and the reason for admission to organize their paperwork and chart. Performing psychiatric admissions can be tedious depending on the nature of the patient, and thus, it is crucial to be fully organized as a nurse (Llamas, 2018). In the case of no incoming admissions, I took the time to fill outflow sheets, write or update care plans, audit patient charts, and reassess behavioral statuses. Revising the patient charts is crucial to ensure that they are free from error. Additionally, I was required to round on my patients every 15 minutes to check their security and safety. Besides, the check-ups are essential to reassess behavior and psychosomatic symptoms to determine if the effectiveness of treatment. As an aspiring psychiatric nurse, I have learned the importance of active listening as it validates and reaffirms the patient's trust in me as their care provider. Depending on a patient’s presentation, I tried my best to be empathetic while offering the care and support as well as providing them with PRN medications to manage their behavioral and psychotic state. These experiences were crucial in attaining practicum objectives.

Gaps in Practicum Experience

Clinical practicum is crucial in identifying gaps that require to be overcome to be a skilled clinician. My practicum experience highlighted the need to develop health delivery competencies. Going forward, there is a need to focus more on applying nursing, pathophysiology, psychosocial, and genetic health knowledge in assessing and managing patients with psychiatric mental health issues. Besides, as an aspiring psychiatric nurse, there is a need to improve the accuracy of patient diagnoses and the appropriateness of medication. The process of conducting psychiatric diagnosis can be complex and overwhelming as it requires the clinician to possess extensive knowledge of specific psychotic signs and symptoms. Diagnostic accuracy requires a clinician to gather information about the development and duration of the psychotic symptoms. Besides, as a clinician, one is required to understand the preconditions of diagnosis, such as the presence of traumatic events. A significant portion of psychiatric patients tend to have experienced trauma, but trauma-related diagnoses are often overlooked (Posner et al., 2008). Thus to improve diagnostic accuracy, it is crucial to develop assessment skills in reviewing a client’s trauma history. Besides, reviewing a patient’s history will aid in understanding prior diagnoses as a patient's illness may be a continuation of the prior disorder. As such, the importance of a patient’s treatment history is invaluable in enhancing diagnostic accuracy.

The appropriateness of a treatment plan is linked with the accuracy of diagnosis. During my practicum experience, I realized the need and importance of selecting the appropriate medication and treatment plan. Selecting an effective treatment plan requires a thorough understanding of a patient's current symptoms, previous diagnoses, trauma history, and prior treatment experiences (American Psychiatric Association, 2015). The details of a treatment plan will be different depending on the patient's needs and preferences, but it should generally consist of elements that address the psychiatric diagnoses. Recommended treatment plans need to be feasible so as to optimize the patient's outcomes. It is important to assess a patient’s treatment history as it provides useful information on the feasibility and benefits of specific interventions as well as providing the likely adverse consequences of similar treatment. Moreover, decisions concerning therapeutic benefits should be shaped by evidence-based psychotherapy administered for an adequate duration. In case there is treatment resistance, it is crucial to assess possible contributors and tweak the treatment plan in order to enhance the patient's outcomes.

Main Points of Final Evaluation with Practicum Preceptor

The clinical practicum experience was a crucial exercise as it provided insightful self-evaluation. Therefore, in my final evaluation with the practicum preceptor, I would like to discuss more on performing clinical assessments. Generally, a psychiatric assessment involves interviewing the patient. During my practicum, I realized I had difficulties conducting interviews with patients, and I resorted to seeking assistance from my practicum preceptor. The specific approach to conducting a direct interview depends on multiple factors such as patient’s communication, level of patient’s cooperation, the severity of the illness, and the patient's ability to remember historical details. I realized that my questions were a bit insensitive in some circumstances as they caused significant distress on the patient, especially on traumatic experiences. Thus, in my final evaluation, I would like my practicum preceptor to guide me on asking sensitive questions and when and if they are necessary. Moreover, I realized being insensitive can negatively impact the patient's ability to establish trust during the therapeutic relationship.

An insightful self-examination is an important aspect of the practicum experience. As previously mentioned, interviewing was my main area of weakness during my clinical practicum. However, other factors, such as a patient's vocabulary, intellectual disability, age, and cultural background, may influence how they interpret questions during interviews (American Psychiatric Association, 2015). These factors highlight the need for a clinician to develop additional sensitivity during interviews. A skilled clinician should possess the ability to recognize impairments in hearing or cognition as these conditions call for a more detailed assessment. Besides, a skilled interviewer should be flexible in order to frame questions in a clear manner to enhance the patient's understanding. However, direct interviewing may not yield the desired outcomes for patients with dementia or severe psychosis. As such, in my final evaluation, I would like to discuss with my practicum preceptor ways of corroborating information obtained through direct questioning. During my practicum, I realized that collateral information is necessary in order to enhance diagnosis accuracy. The different ways of obtaining additional information may include retrieving prior medical records and using electronic prescription databases. Additionally, communicating with family members can help in cases where the patient needs assistance due to impaired neurocognitive functioning or erratic behavior. Though liaising with family members raises questions of confidentiality, I would like my practicum preceptor to elaborate more on how to maintain confidentiality during a patient’s assessment.

Personal Growth and Development

Personal growth and development are crucial in becoming a skilled mental health nurse. As a psychiatric clinician, communication skills and personality are essential components needed to enhance success in mental health nursing. One is required to think on their feet and stay calm even in the most of challenging circumstances. As such, developing basic skills such as problem-solving, good judgment, interpersonal communication, psychosocial, observation, and offering advice can be of invaluable importance to a psychiatric nurse. These skills are useful traits of any clinician as they are used on a daily basis. The expectations and additional responsibilities of a psychiatric nurse demands a unique set of personal attributes and skills to enhance accurate assessment and improve patient outcomes. A crucial element of personal growth and development entails building mental and emotional endurance. To become a successful psychiatric nurse, one needs to possess both physical and psychological endurance. Physical endurance is necessary as the job demands long hours to attend to patients. Besides, developing mental endurance is essential as psychiatric patients can be violent, unpredictable, and erratic.

Personality is an important aspect in advancing in the PMHNP role. A crucial element of personality is religion, and thus the Christian worldview can have various implications in the delivery of psychiatric care. In general, nursing offers an ideal platform to incorporate Christian perspectives in professional practice. Also, Christian worldviews can help to model care delivery and mentoring in the nursing profession. As nurses, our profession calls us to demonstrate love and compassion to those around us. By encouraging a suffering patient or fellow co-workers, it is a way to share the Christian message of love and compassion. The nursing curriculum emphasizes on providing holistic care to patients but is less focused on offering spiritual care (White, 2017). It can be overwhelming to espouse the Ch...