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.
RESOURCE
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
TO PREPARE
- Refer to the “Population-Focused Nurse Practitioner Competencies” in the Learning Resources, and consider the quality measures or indicators advanced practice nurses must possess in your specialty.
- 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; 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 3 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? How can you apply your growing skillset to be a social change agent within your community?
Communicating and Feedback
- Reflect on how you might improve your skills and knowledge and how to communicate those efforts to your Preceptor.
- Answer these questions: How am I doing? What is missing?
- Reflect on the formal and informal feedback you received from your Preceptor
- CASE 1: 62 years old female with past psych history of anxiety, depression and bipolar disorder who presents to the clinic complaining of depressed mood. Patient reports she recently went for colostomy reversal and the pain is unbearable. She takes Percocet for pain. Patient states she feels hopeless. Denies suicidal ideation. Patient also reports low self esteem due to the big scar she has on her abdomen.
Treatment:
-Refer patient to a psychologist.
-Start Lexapro 10 mg daily.
-Start Zyprexa 5 mg daily. -
CASE 2: 62 years old female with a past psych history of depression, alcohol and cocaine use disorder, and anxiety who presents to the clinic accompanied by her son complaining of hallucinations. Son reports patient has been seeing people in her balcony who are not really there. During the evaluation patient was hyper-verbal with flight of ideas and loose associations. She reports she has really good energy. Patient also reports her last use of alcohol and cocaine was two days ago.
Patient was educated on the importance of stopping substance use.
Treatment:
-Refer patient to rehab facility.
-Continue Buspar 15 mg PO TID.
-Start Lorazepam 0.5 mg BID for anxiety. - Case 3
13-year-old girl presents with intense fear of speaking in class and in group activities. She was referred by her school nurse after several instances where she presents with sweating, trembling, and nausea whenever faced with a situation where she needs to speak in a group or the entire class. She generally avoids situations in which she has to address any group of people and avoids eye contact. Client is diagnosed with social anxiety disorder.
Treatment:
-Start patient on cognitive behavioral therapy (CBT) focused on identifying and regulating negative thought patterns and practicing and improving social skills.
