Journal Entry 500 words (2 pages)

Learning From Experiences

1 Revisit the goals and objectives from your Practicum Experience Plan. Explain the degree to which you achieved each during the practicum experience.

2 Reflect on the three (3) most challenging patients you encountered during the practicum experience. What was most challenging about each?

3 What did you learn from this experience?

4 What resources were available?

5 What evidence-based practice did you use for the patients?

6 What would you do differently?

7 How are you managing patient flow and volume?

8 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 goals and objectives from past Practicum Experience Plan below: Explain the degree to which you achieved each during the practicum experience.

1. Goal: To acquire excellent skills from onsite preceptor at the end this clinical rotation

a. Objective: To seek for details regarding patient presenting problems

b. Objective: To actively get involve and participate in all patient/clinical activities

c. Objective: To seek for clarification when necessary

2. Goal: To independently perform clinical task by the end of the clinical rotation

a. Objective: Get client assessment done

b. Objective: Initiate and participate in planning

c. Objective: maintain client integrity and document accurately

3. Goal: To independently provide patient education and adequate coping skills by the end of the clinical rotation.

a. Objective: Share skills to help improve coping skills

b. Objective: Encourage and promote self-care and independence

c. Objective: Promote community integration and engage in healthy relationship

4. Goal: To be knowledgeable with treatment recommendation, diagnosis and medication prescriptions by the end of this clinical rotation.

a. Objective: Identity areas of need and make appropriate recommendation/referrals.

b. Objective: Diagnosing effectively using clinical tools

c. Objective: Accurately prescribe medication safely

***My three (3) most challenging clients

Client 1

The client is 35 years old with a history of Bipolar. He Feels his mood stabilizers are not doing enough. He still feels highs and lows. Feels he has high anxiety throughout the day. Anxiety 8/10 most days. Currently of Alprazolam 0.5 mg BID helps with anxiety, Quetiapine 100mg BID, Fluoxetine. Not on any medication for mood. Will start client on Lithium 250 mg BID and clonidine 0.1 mg, increase Alprazolam to 1mg BID. Will see the client in two weeks for a follow-up.

Client 2

The client is 19 years old with a current diagnosis of MDD, GAD, and insomnia, previously diagnosed with ADHD at age 10, was on Vyvanse. The patient reports sadness, loss of interest, guilt, low energy, poor concentration, loss of appetite, passive Si, some excessive worrying, lack of sleep. The client meets the criteria for Depression and GAD. Currently does not have a therapist. The plan is to refer the client to a therapist, start Prozac 10 mg for two weeks then increase to 20mg daily in the morning. Clonidine ER 0.1 mg for sleep at night, obtain baseline labs, start the exercise. Will see the client in two weeks. Medication sent to the pharmacy of choice.

Client 3

The client is 19 years old Hispanic female with history of MDD and GAD, came with mom and dad for follow-up visit. The client reports racing thoughts, lack of sleep, very low energy, appetite has been so poor. She endorsed suicidal ideation stating that she wishes to be dead. Mom and dad confirmed that she has been isolative mostly in bed, not engaging with anyone at home. Got a job and has no interest in starting the job. Mom states client had mentioned severely that she wishes to be dead and that she does not sees herself a living dead. On this encounter, plans had to be made immediately to send patient for a higher level of care. Patient were instructed to send patient to the emergency room for inpatient psychiatric admission. Patient will benefit from group therapy and medication adjustment in inpatient setting. Will call parents in two days to follow up.