Critical Reflection- Navigating Growth and Success in Clinical Practicum

The practicum is giving me further insights into the role of nurses in the comprehensive management of mental health disorders. So far, the practicum has considerably enhanced my ability to work with other caregivers in collaborative care. I am continuously learning to communicate better, engage other caregivers more, and consult whenever necessary. I am also better knowledgeable about various screening tools and am now confident when selecting and implementing various screening tools. My experience during the practicum has also enhanced my confidence in performing psychiatric evaluations on clients with mental health illnesses.

In as much as I have enjoyed the practice, it has not been short of challenges. Some of the clinical complexities encountered have widened my perspective on the nursing role in mental healthcare and put my ability to handle these complexities to task. The first challenging case encountered is of a patient seeking psychotherapy as a result of childhood trauma sustained after being sexually harassed by a close relative. This presentation has challenged my emotional competence in handling such situations. Another challenging case was of a patient seeking psychotherapy and medication management for increased anxiety and severe depression accustomed to seeing his wife die. This case also questioned my emotional competence in handling such cases. The third challenging case was of a patient seeking psychotherapy to gain positive coping skills due to his auditory hallucination.

The cases encountered were quite insightful. The first and second cases widened my perspective on how emotionally engaging some patient presentations may be. They gave me insight into the need to maintain emotional competency when managing clients with mental health disorders. As Harvey et al. (2019) report, emotional competence is an ethical obligation for nurses in mental healthcare. These cases also expanded my knowledge of various psychopathological disorders and their presentations and how healthcare resources can be engaged to the benefit of the patients. As evident in the case presented, the decision to initiate psychotherapeutic and pharmacotherapeutic interventions adjunctively often depends on symptom severity. Leichsenring et al. (2022) note that pharmacological and nonpharmacological interventions are often used adjunctively in severe cases of mental health disorders for fast alleviation of symptoms and the circumvention of the potential for harm.

Several hospital resources were at my disposal during the practicum. These included the hospital library, which had many medical books and published its weekly medical-oriented newsletter. The human resources at the hospital were perhaps the most valuable resource. All caregivers involved in the collaborative care for patients with mental health illnesses were open to sharing their knowledge and welcomed related questions. Accordingly, I learned a lot from them. An evidence-based practice I used was collaborative care. Collaborative care is the gold standard for the comprehensive management of chronic illnesses (Ee et al., 2020). I was able to work with other caregivers to manage various patients. Moving forward, I intend to not only rely on the library and my peers to learn but also utilize online resources such as online videos. This will further widen my perspective of psychiatric nursing.

So far, I have been managing patient workflow and volume by prioritizing care based on the client’s care acuity. Patients with many care needs are given more time to use this approach. I intend to utilize my growing skillset to educate my community on common mental health illnesses. As an advocate for social change, I believe this move will help expand communities’ knowledge of these illnesses.

Moving forward, I can utilize diverse reading materials to better my clinical skills. This will be communicated to my preceptor via email. So far, I am doing good and enjoying the practicum. I am also in a comfortable position and not missing much. I, however, intend to push myself more to optimize my learning during the practicum. The formal and informal feedback I have received from my preceptor has impacted my practice positively.

 References

Ee, C., Lake, J., Firth, J., Hargraves, F., de Manincor, M., Meade, T., Marx, W., & Sarris, J. (2020). An integrative, collaborative care model for people with mental illness and physical comorbidities. International Journal of Mental Health Systems, 14(1). https://doi.org/10.1186/s13033-020-00410-6