Clinical Journal Reflection

Clinical Journal Reflection: You will create 5 entries for your Reflective Journal about a patient encounter. In the 5th entry…

Clinical Journal Reflection

• Reflective Journal Instructions

You will create 5 entries for your Reflective Journal about a patient encounter. In the 5th entry, you will review the previous 4 entries and evaluate your progress in reflective practice over the course of the term.  Each journal should be a minimum of 250 words. 

The purpose of this reflective journal is self-reflection regarding the role in the process of self-reflection as a PMHNP provider. Through reflective practice, the student will evaluate their own emotional health and recognize one’s own feelings as well as one’s ability to monitor and manage those feelings. The point of the exercise is to learn yourself, your triggers, the types of cases you end up getting overly involved with, and those you’d rather refer to someone else. The idea is to be able to personally reflect on your behaviors/thoughts/decisions and how those impact you in the role of PMHNP. 

Introduction address the following items:  

·         Describe your past experience in mental health or with someone with mental illness. 

·         What are the reasons you have chosen to work with this population?  

·         Discuss any concerns you have regarding this specific clinical course and population Adult/Geriatric. 

·         Identify personal and academic/professional goals for the clinical course and population Adult/Geriatric.  

Clinical Journal Reflection
As a PMHNP, I was involved in patient confrontation when the patient involved (an elderly female patient diagnosed with generalized anxiety disorder and manic depressive disorder). She was under our in-patient general surgical team following a head injury arising from a fall after she fell off a one-story house. During our ward round, she was told she was fit for discharge but was subject to a social services report recommending the installation of banisters in her house and at least have someone close to check on her. However, the patient was adamant that she did not have the money to install the banisters and could not let her family know about the fall. I felt frustrated and thought the lady would not understand why I could be of help to her in the matter of the social services report. On reflection, I also feel I could have taken some time and not rushed through my explanation.

Becoming a PMHNP is a fantastic choice because it is bound to accord me a chance to improve the elderly population’s mental health after giving their prime life to the service of the society they live in. The incidence and prevalence of chronic illness and comorbidities increase with advancing age, thus increasing the acuity of care among the elderly (Woo et al., 2017). The patient’s socio-economic status only serves to compound the challenging issues a psychiatric nurse practitioner has to grapple with, considering that mentally ill patients are already a vulnerable population requiring special legal and mental health rights to be upheld.
My personal and academic/professional goals for taking a course in the adult/geriatric population merge easily. They include offering care for patients with acute and chronic illnesses, competently facilitating discharge planning, and offering palliative care to those in need of it. The PMHNP’s goals are to provide comprehensive care that incorporates the adult/geriatric patients’ needs at the physical, social, emotional, cultural, and psychological levels.
A good or bad patient encounter triggers a succession of stages beginning with the situation (precisely what, where, and who), the PMHNP’s emotional state, making sense of the situational encounter, and critical analysis and development of insight arising from the situation. Having solid reasons for selecting PMHNP as a nursing specialty will give one the necessary job satisfaction and motivation, but having personal and professional overcome these challenges.

References
Koshy, K., Limb, C., Gundogan, B., Whitehurst, K., & Jafree, D. J. (2017). Reflective practice in health care and how to reflect effectively. International journal of surgery. Oncology, 2(6), e20.
Woo, B. F. Y., Lee, J. X. Y., & Tam, W. W. S. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Human resources for health, 15(1), 1-22.