Assignment: Coursework

During the clinical practicum, I successfully achieved the goals I had set for the practicum. For example, I have performed a comprehensive assessment of about 50 patients across the lifespan by the mid of the practicum. When performing a comprehensive assessment, I take the history presenting symptoms, psychiatric, medical, family psychiatric, substance abuse, legal, and social history (Tohmola et al., 2022). In addition, I review systems for all patients, which helps identify pertinent positives and negatives in other body systems. The mental status exam has been fundamental in patient assessments since it helps determine patients’ diagnoses. However, I have encountered some challenges, especially with psychotic patients, since some deny having hallucinations or delusions during the MSE. On the other hand, the relatives claim the patient exhibits them, which becomes difficult to ascertain.

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In addition to performing comprehensive assessments, I have been involved in the ordering and interpreting diagnostic results for these patients. Diagnostic tests are usually fundamental in ruling out medical conditions that share symptoms with psychiatric disorders. I consult my preceptor when ordering a diagnostic test to avoid unnecessary tests, which may increase medical costs (Becker et al., 2020). However, I need to improve my radiology interpreting skills in visualizing and understanding abnormal findings on radiology reports and relating them with the impression made on the radiology reports.

After interpreting the diagnostic results, I work with the preceptor to develop differential diagnoses for each patient and select the primary diagnosis based on the positives and negatives. In addition, I have participated in developing pharmacological and non-pharmacological treatment plans for these patients alongside my preceptor (Tohmola et al., 2022). This has helped me learn about the pharmacotherapy agents used for various conditions. Non-pharmacological treatment mostly includes psychotherapy, and I provide patient and family education.

References

Becker, D., Dechant, L. M., McNamara, L. J., Konick-McMahon, J., Noe, C. A., Thomas, K., &Fabrey, L. J. (2020). Practice Analysis: Adult-Gerontology Acute Care Nurse Practitioner and Clinical Nurse Specialist. American Journal of Critical Care:An Official Publication, American Association of Critical-Care Nurses, 29(2), e19–e30. https://doi.org/10.4037/ajcc2020918

Tohmola, A., Elo, S., Mikkonen, K., Kyngäs, H., Lotvonen, S., &Saarnio, R. (2022). Nursing students’ competence profiles in gerontological nursing-A cross-sectional study. Nursing Open, 9(1), 199–209. https://doi.org/10.1002/nop2.1054