PRAC 6635 WU Nursing Resolving Ethical and Legal Dilemmas Essay

Critical reflection of your growth and development during your practicum experience in a clinical setting has the benefit of helping you to identify opportunities for improvement in your clinical skills, while also recognizing your strengths and successes. 

Use this Journal to reflect on your clinical strengths and opportunities for improvement, the progress you made, and what insights you will carry forward into your next practicum

TO PREPARE

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 your 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.

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.

Submit your Journal Entry.

Student Notes

25 years old male with past medical history of diabetes and depression, he was diagnosed with Diabetes Mellitus type 1 when he was 2 years old. He is Insulin Dependent and he reports he has not been getting his Insulin because he just want to die. He also reports that he has not been compliant with his psych medications. He has been baker act multiple times. 911 was called and patient was baker acted by police and taken to the nearest hospital.

Student Notes

34 years old male who presents to the clinic as a follow up after being baker acted due to suicidal attempt. Patient has past psychiatric history of MDD, schizoaffective disorder and OCD. Patient ingested 100 baby aspirins. Patient presents with euthymic mode, organized but irregular thought process and anxiety. Patient denies suicidal ideation at this time. TX: Clozapine 100 mgs every morning Depakote 500 mg BID Discontinue Buspar as per patient request.

Student Notes

74 years old male with past psychiatric history of bipolar disorder, insomnia and anxiety who came to the clinic accompanied by his wife. Wife reports patient recently started living in an assisted living facility and the staff reported patient has been aggressive and not compliant with medications. At this time we will continue with current psychotropic regimen and order urinalysis and blood work to rule out any medical condition that can be causing patient’s behavior. Tx: Fluoxetine 40 mg daily Olanzapine 7.5 at bedtime. Ramelteon 8 mg at bedtime Memantine 10 mg daily Ativan 0.5 mg BID Follow up appointment in one week to discuss results and adjust medication is needed.