Journal Entry Week 11 Assignment
Journal Entry Week 11 Assignment
Journal Entry Week 11 Assignment
Goals and Objectives
During the course period, I have made significant progress towards achieving my goals and objectives. I can conduct psychiatric evaluations and assessments with confidence. I have conducted over five psychiatric examinations within the 11 weeks and communicated to the preceptor regarding every assessment. I have also integrated relevant evidence-based materials towards the successful completion of these assessments. I have acquired the skills necessary to conduct and interpret psychosocial assessments and gather family psychiatric histories. Embracing evidence-based practice has helped improve my clinical judgement and decision-making to ensure patient care quality and safety (Abu-Baker et al., 2021). Additionally, I have equipped myself with the competencies and knowledge to complete diagnosis per DMS-5 criteria for the patients encountered over the 11 weeks. I can rule out a diagnosis by accurately aligning the identified symptoms with the DMS-5 criteria. I can identify differential diagnoses for disease and comprehensively describe why a specific diagnosis was confirmed or refuted. Conclusively, I have achieved most of my course goals and objectives, and I intend to continue usly improve my career readiness.
Challenging Patients
I have encountered multiple patients during the practicum, and most were cooperative, except for two problematic patients and one patient who was reluctant to provide vital information to help with the diagnosis for personal reasons. One of the patients thought I was not good enough to provide appropriate care despite me being the only available nurse to take care of him during a busy shift. I was assigned the patient as my preceptor and other experienced nurses cared for more critical patients. However, the patient felt I was a novice, and it was not respectful and ideal for him to be assigned me. It was detrimental to my confidence significantly, but it is typical in the workplace, particularly for nurse students. I also encountered an aggressive patient who felt we were not quick enough to treat him and threatened to sue us in case something happened to him. The third patient refused to share data needed for a diagnosis for personal reasons. The patient feared that I would judge her on the information she would provide. My preceptor and other experienced providers were resourceful in all three resources, and they helped convince the patients that every provider at the facility is capable of taking care of the patients, which was uplifting. I also adopted insights from the literature on dealing with problematic patients (Tanoubi et al., 2021; Jackson et al., 2021). If I encounter difficult patients in the future, I intend to use the effective communication skills I have acquired to engage the patients and better manage the situation.
Communicating and Feedback
I have grown tremendously over the 11 weeks, and I am a better individual and professional. However, there are areas I still need to improve, particularly patient engagement, considering I had issues communicating with several “difficult” patients. I intend to enhance my patient engagement skills and develop therapeutic relationships. I will improve my communication skills, physical and psychological endurance, critical thinking skills, empathy and compassion, and technology skills for digital engagement to achieve this goal. I intend to seek feedback from my workmates and my preceptor regarding my progress in skills and knowledge development. I will also use performance appraisals to measure goal and objective achievement and overall progress. I will engage in research and evaluation to acquire the competencies needed to improve my practice experience and capacity to care. I will share my goals and objectives for improvement through meetings with my preceptor, which are often informal. I also have a checklist that I share with the preceptor regarding my achievements and performance self-assessments. My preceptor has been integral in my continuous improvement, providing timely and meaningful feedback. Informal feedback is through typical conversations during practice and patient care, which have been effective in improving my on-the-job skills and knowledge. The preceptor provides formal feedback through performance appraisal forms, giving comments about my progress and what areas I need to improve.
References
Abu-Baker, N. N., AbuAlrub, S., Obeidat, R. F., & Assmairan, K. (2021). Evidence-based practice beliefs and implementations: A cross-sectional study among undergraduate nursing students. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-020-00522-x
Jackson, J. L., Kay, C., Scholcoff, C., Becher, D., & O’Malley, P. G. (2021). Capturing the Complexities of “Difficult” Patient Encounters Using a Structural Equation Model. Journal of general internal medicine, 36(2), 549–551. https://doi.org/10.1007/s11606-020-06013-8
Tanoubi, I., Cruz-Panesso, L., & Drolet, P. (2021). The Patient, the Physician, or the Relationship: Who or What Is “Difficult”, Exactly? an Approach for Managing Conflicts between Patients and Physicians. International journal of environmental research and public health, 18(23), 12517. https://doi.org/10.3390/ijerph182312517
