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.
In 450–500 words, 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.
Difficult pt that came in for medication refill and Spravato treatment in the office last week. She was very impulsive; she couldn’t sit still at all. She left her treatment room and she barged into the Dr. office, she said she wanted 3 months supplies for her Adderall. She was educated that she needs to come in for a monthly appt that she won’t be able to give 3 months supplies because Adderall is a stimulants and she needs to be monitored. She was walked out of the room by a nurse practitioner because she almost attacked Dr. She is currently taking Adderall 15 mg once daily and Adderall 20 mg once daily.
Background:
Pt is a 36 yr Asian female GAD; MDD; Borderline personality disorder; ADHD unspecify who presents for follow up assessment. Background: Suicidal thoughts 2008, ADHD (2013), MDD; GAD (2022). TMS did not help, but Spravato helped, made her happier, less cry, felt stronger. She wants to repeat the treatment.
Another encounter was a black American guy that came in for initial assessment. He said he has been bullied all his life, he said he is depressed, he has anxiety and can’t go out, and said he stays at home all day. He was prescribed Prozac 10 mg but pt refused he said he wanted Xanax, and that was the only medication that works for him. He said he takes his sister Xanax sometimes. Pt was asked if he takes any pain medication or if he was seeing other doctors. Pt denied. My doctor checked the PDMP database to track his prescriptions record and we found out pt has been seeing a lot of doctors and he was also taking some narcotics. Pt said he was shot few weeks ago at some random place and he was prescribed pain medication. Educated the patient that we can’t order Xanax at this time. He was frustrated and he worked outside of his office. He said I will go somewhere else.
Third encounter you can write something on PTSD scenario.