Reflections on Learning and Clinical Experience in Psychiatric Practicum

Reflections on Learning and Clinical Experience in Psychiatric Practicum

The practicum accorded me an opportunity to bolster my understanding of the areas of psychiatric evaluation, diagnostic reasoning, and psychotherapeutic treatment. Entering the practicum, these areas are formed by learning objectives for the activity. I have improved and am now mostly confident in performing psychiatric evaluations, diagnostic reasoning, and psychotherapeutic treatment. I am, however, new in disease prevention, performing a comprehensive exam, ordering corresponding diagnostics, and discussing the psychopathologies of various mental health illnesses. A thorough history taking and corresponding diagnostics is integral to accurately diagnosing mental health illnesses (Moldawsky, 2020). By equipping myself with this knowledge, I will be able to examine my patients and diagnose them accurately. I am beginning to learn about disease prevention,

The practicum presented several challenging clinical cases. The first challenging case that I encountered was a 49-year-old male presenting with substance use disorder and depression comorbidity. The challenge in this case was the high care demands presented with the comorbidity.  The second case was of a 27-year-old female with severe depressive disorder. She had had multiple failed suicide attempts, prompting his incarceration. In this case, the challenge was the high care demands of the patient prompted by her need for close monitoring. The third case was of a 31-year-old with severe depression. Her condition was not responsive to the conventional antidepressant medications. This presented a challenge as she had to be placed on several concurrent medications.

The clinical experiences widened my perspectives on the suffering people with mental health illnesses experience. Mental health illnesses cause significant disruptions in the social functioning of individuals. It results in lost jobs, deterioration in the quality of life of individuals, and escalations in the cost of care (Høegh et al., 2022). This warrants a holistic approach to managing them.

One of the most valuable resources available at my disposal during the practicum was the DSM-V. Other resources included textbooks on mental health illnesses and journal publications on current advances in mental healthcare. An evidence-based practice I integrated into my normative clinical care role is the collaborative paradigm and the use of science-based clinical evidence in decision-making. The use of the most current evidence in clinical decision-making is crucial in mental healthcare (Connor et al., 2023). Likewise, collaborative paradigms foster shared decision-making, ensuring that the best available therapeutic options are selected for the patients.

I am currently learning different techniques for promoting health and disease prevention across communities. I believe that by expanding my interpersonal and communication skills, I will be able to educate communities on diverse aspects of disease prevention and health promotion (Udoudom et al., 2023). I would do differently in this endeavor to exploit supplementary learning opportunities such as online classes on effective healthcare communication. To manage patient flow and volume, I adequately prepared for the shifts, switched off my phone to minimize disruptions, and carried all utilizable resources.

In my resolve to be an excellent caregiver, I intend to develop my interpersonal and communication skills and transcultural communication capabilities through different learning strategies. I will communicate these efforts to my preceptor through a weekly memo. I feel confident in most areas of my clinical work. However, the clinical work is time-consuming, and I sometimes think I am missing enough time for revision. The formal and informal feedback I received from my preceptor will help enhance my understanding of my weak areas.

References

Connor, L., Dean, J., McNett, M., Tydings, D. M., Shrout, A., Gorsuch, P. F., Hole, A., Moore, L., Brown, R., Melnyk, B. M., & Gallagher‐Ford, L. (2023). Evidence‐based practice improves patient outcomes and healthcare system return on investment: Findings from a scoping review. Worldviews on Evidence-Based Nursing, 20(1), 6–15. https://doi.org/10.1111/wvn.12621

Høegh, M. C., Melle, I., Aminoff, S. R., Olsen, S. H., Lunding, S. H., Ueland, T., & Lagerberg, T. V. (2022). Affective lability and social functioning in severe mental disorders. European Archives of Psychiatry and Clinical Neuroscience, 272(5), 873–885. https://doi.org/10.1007/s00406-022-01380-1

Moldawsky, R. J. (2020). Is the psychiatric history losing its relevance? The Permanente Journal, 24(4). https://doi.org/10.7812/tpp/19.186

Udoudom, U., Igiri, A., George, K., & Aruku, K. J. (2023). Promoting health education through effective communication for development. ALSYSTECH Journal of Education Technology, 2(1), 68–88. https://doi.org/10.58578/alsystech.v2i1.2399

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Refer to the “Advanced Nursing Practice Competencies and Guidelines” found in the Week 1 Learning Resources and consider the quality measures or indicators advanced nursing practice nurses must possess in their specialty of interest.

• 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 and consider the patient activities you have experienced in your practicum experience. 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 three (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 did you have available?
• What evidence-based practice did you use for the patients?
• What new skills are you learning?
• What would you do differently?
• How are you managing patient flow and volume?

Communicating and Feedback

• Reflect on how you might improve your skills and knowledge and how to communicate those efforts to your Preceptor.
• Answer the questions: How am I doing? What is missing?
• Reflect on the formal and informal feedback you received from your Preceptor.

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