Journal Entry (600-700 words)
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 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 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.
My first goal was to develop advanced mental status examination skills by the end of the practicum. I was able to examine many patients with conditions that varied in range from psychotic illnesses, mood disorders to substance abuse disorders and got to understand the interrelation of these conditions. I was able to formulate diagnosis and institute management on patients that I encountered and most of them were able to recover from their conditions.
The second goal was to develop skills to formulate psychiatric diagnosis independently by the end of the practicum which is achieved successfully as I was able to see many patients, and performed a mental status examination on each of them with focus on the nature of their conditions, the possible etiology, and how it could be managed to ensure the patient leads a better quality life. I was able to order for laboratory tests for samples of patients some of whom were ill due to substance use that is usually detected in the body e.g. marijuana, alcohol. I performed physical examination of patients to ascertain their physical well-being and was able to figure out the extent of the illness on the physical well-being of patients and formulate differentials from these findings. Furthermore, I was able to apply advanced assessment skills and made differentials for conditions with overlapping symptoms.
Screening for psychiatric conditions requires that one knows what tests to do and what to look for in a patient while taking history which I was able to master as I performed many advanced techniques on patients, made appropriate diagnosis and managed them to satisfaction. I was able to learn how to communicate with mentally ill patients despite the fact that they are mentally ill and assessed them to determine what was ailing them. I was able to utilize psychiatric screening instruments like Depression anxiety Stress scale (DASS), Hamilton Anxiety Rating Scale and Generalized Anxiety Disorder Screener (GAD-7) in making
The three most challenging experiences I had with patients are a violent patient, a patient who could not talk at all and one who was convinced he was being persecuted by his family and being confined unreasonably. The violent patient gave me a hard time as he had to be restrained during the history taking, but he later calmed down after being given a mood stabilizer. A patient who had difficulty expressing himself verbally was also a challenge as we had to communicate via signs at times. It was a bit of a challenge because I am not well-versed in sign language and certain signs could be misinterpreted. The last patient was determined to leave the facility as he was having a familial conflict and was convinced they were punishing him. He was unwilling to be interviewed, and I had to befriend him promising to help him be freed.