Example Journal Entry – Practicum Experience

Example Journal Entry – Practicum Experience Time Log and Journal Template

Example Journal Entry – Practicum Experience

Student Name:

E-mail Address:

Practicum Placement Agency’s Name:

Preceptor’s Name:
Preceptor’s Telephone:
Preceptor’s E-mail Address:

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Example Journal Entry – Practicum Experience

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Time Log

List the objective(s) met and briefly describe the activities you completed during each time period. If you are not on-site for a specific week, enter “Not on site” for that week in the Total Hours for This Time Frame column. Journal entries are due in Weeks 4, 8, and 11; include your Time Log with all hours logged (for current and previous weeks) each time you submit a journal entry.

You are encouraged to complete your practicum hours on a regular schedule, so you will complete the required hours by the END of WEEK 11.

Time Log
Week  Dates Times  Total Hours for This
Time Frame
Activities/Comments Learning Objective(s) Addressed
1 “not on site”
2 6/5/17 8am-5pm 8 Admissions, evaluations, follow-ups, med management, psychotherapy Mini-mental state examination, CAGE and Beck depression inventory was used
6/6/17 8am-5pm 8 Admissions, evaluations, follow-ups, med management, psychotherapy Intake and initial assessments were performed. Mini-mental state examination was administered.

 

Total Hours Completed: 16

 

Journal Entries : Example Journal Entry – Practicum Experience

 

The Client

24-year-old white male self-admitted as an inpatient due to fear of hurting others. Patient is from out of town, currently attending military drills. Patient found out that his significant other he was planning on proposing to has be actively having relations with his step-brother. Patient has a history of fits of rage at a young age that caused hospitalizations of others so he felt it was best he received help before doing harm to others. Patient has no other psychiatric history, no suicidal ideations, not hearing voices or seeing things that are not present, he does not believe others are out to do harm to him. Patient states that no one in his immediate family has history of psychiatric conditions. Patient does report physical and verbal abuse from step-father as a young child. During his teenage years patient was addicted to illicit drugs and alcohol.

Diagnosis

According to the Diagnostic and Statistical Manual of Mental Health Disorders, 5th edition (DSM-5), the patient presents with characteristics of PTSD. The patient exhibits “irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression, reckless or self-destructive behavior, exaggerated startle response, problems with concentration and sleep disturbance lasting since his early teen years” (American Psychiatric Association, 2013).

Patient states he has difficulty trusting others, assures his back is always to a wall, is easily agitated and tends to frequently relay his anger verbally, was once addicted to illicit drugs to cope with the stress in is life, has difficulty concentrating on simple tasks and must keep himself busy at all time, also states he sleeps very little.

 

Legal and Ethical Implications

Special concerns with this patient were voiced because of his current non-active role in the military. The patient came from training drills to seek help for his anger. The military has certain requirements for the patient to be able to safely return to drills. Ethically it is important to ensure the patient’s safety first and assess his intent to do harm to others. In the case of this patient, he was kept for observation for three days before being allowed discharge although the patient was addiment that he just needed a safe place for one night and that he did not feel the need to do harm to himself or others. The case can be made that individuals with military training, combat exposure, and ensuing PTSD may find it even more difficult to engage in an accurate appraisal of danger. Training for combat increases reliance on muscle memory or automatic actions in times of perceived threat, training that was provided initially by the military to help soldiers stay alive. But the physiological sensitivity that results from a chronically disordered pattern of arousal as is found in PTSD can set the stage for a quicksilver reactivity that leads to actions in a civilian setting that have criminal justice implications (Tramontin, 2010).

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental

disorders (5th ed.). Washington, DC: Author.

Tramontin, M. (2010). Exit Wounds: Current Issues Pertaining to Combat-Related PTSD

of Relevance to the Legal System. Developments In Mental Health Law, 29(1), 23-47.

Example Journal Entry – Practicum Experience Time Log and Journal Template

As a future advanced practice nurse, it is important that you can connect your classroom experience to your practicum experience. By applying the concepts, you study in the classroom to clinical settings, you enhance your professional competency. Each week, you complete an Assignment that prompts you to reflect on your practicum experiences and relate them to the material presented in the classroom. This week, you begin documenting your practicum experiences in your Practicum Journal. Example Journal Entry – Practicum Experience

Learning Objectives

Students will:

· Analyze nursing and counseling theories to guide practice in psychotherapy*

· Develop goals and objectives for personal practicum experiences*

· Create timelines for practicum activities*

In preparation for this course’s practicum experience, address the following in your Practicum Journal:

· Review the media Clinical Interview: Intake, Assessment, & Therapeutic Alliance in your Learning Resources.

· Select one nursing theory and one counseling theory to best guide your practice in psychotherapy.

Note: For guidance on nursing and counseling theories, refer to the Wheeler textbook in this week’s Learning Resources.

· Explain why you selected these theories. Support your approach with evidence-based literature.

· Develop at least three goals and at least three objectives for the practicum experience in this course.

· Create a timeline of practicum activities based on your practicum requirements.

Note: Be sure to use the Practicum Journal Template, located in this week’s Learning Resources.

Required Readings: Assignment: Practicum – Week 1 Journal Entry

Wheeler, K. (Eds.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

Chapter 1, “The Nurse Psychotherapist and a Framework for Practice” (pp. 3–52)

Required Media

Sommers-Flanagan, J., & Sommers-Flanagan, R. (2012). Clinical interview: Intake, assessment, & therapeutic alliance [Video file]. Mill Valley, CA: Psychotherapy.net.

PLEASE SEE THE ATTACHED Practicum Journal Template AND JOURNAL SAMPLE (TIME LOG & JOURNAL ENTRIES) FOR WRITING THIS ASSIGNMENT…..ALSO FOR THE TIME LOG AND JOURNAL ENTRIES, JUST MAKE UP A REASONABLE INFORMATION AND CLIENT INFORMATIONAL

Practicum Experience Time Log and Journal Template

Student Name:

E-mail Address:

Practicum Placement Agency’s Name:

Preceptor’s Name:

Preceptor’s Telephone:

Preceptor’s E-mail Address:

(Continued next page)

Time Log

List the objective(s) met and briefly describe the activities you completed during each time period. If you are not on-site for a specific week, enter “Not on site” for that week in the Total Hours for This Time Frame column. Journal entries are due in Weeks 4, 8, and 11; include your Time Log with all hours logged (for current and previous weeks) each time you submit a journal entry.

You are encouraged to complete your practicum hours on a regular schedule, so you will complete the required hours by the END of WEEK 11.

Time Log

Week

Dates

Times

Total Hours for This Time Frame

Activities/Comments

Learning Objective(s) Addressed

Total Hours Completed:

Journal Entries

· Include references immediately following the content.

· Use APA style for your journal entry and references.

Practicum Experience Time Log and Journal Template-Student Name:

E-mail Address:

Practicum Placement

Preceptor’s Name:

Preceptor’s Telephone:

Preceptor’s E-mail Address:

Demographics Information:

The client is 18-year-old black male, living with the parents in Smithfield, NC. He speaks English as his first language and attends high. His family is a middle-class family, with the parents working in white-collar jobs in various different organizations in Raleigh, NC. The client is covered by the health insurance of the parents, in which they are subscribed to Blue Cross Blueshield.

Presenting Problem:

The client described himself as being easily aggravated by small things and has a short temper. The teacher of the client, commented that the client was frequently involved in fights during the school times. The mother of the client also mentioned that the child sometimes refuses to act on her requests, such as doing house chores and constantly bullies her small sister and brother.

History of Present Illness:

The client mainly comes to the clinic, with the parents, with regards to the above problems. The main concerns of his parents, is the behavior of the client while at home, and the various complaints by the teachers and the disciplinary board in the school, about his aggressive behavior. The parents are also concerned about the poor academic performance of their child. The parents of the client, have reported for about over a year, the client has constantly been bullying his siblings, and sometimes even fighting them. The client has also, on several occasions, ignored request from the parents, to wash his clothes or perform other common house chores. The parents admit that even they noticed the behavior as early as when he was aged 7, they initially brushed it off, and though that he would grow out of it, and learn to live in harmony, with the friends or siblings. When he reached adolescence, the parents thought the behavior was largely a characteristic of people reaching this stage of life. As such, the thought that the problem will slowly go away as he matured. Example Journal Entry – Practicum Experience

The report from the school is very similar to the report offered by the parents. At school, the client is describing as being troublesome, with little regards to following orders or school rules. On the other hand, the client has been easily irritable and gets into fights easily. On several occasions, the child has been transferred to other schools, as well as getting suspended, due to the problem of following rules and not heeding to authorities. In one instance, the client has been accused of causing major physical harm to some of his classmates, in one of his fights. The teachers describe that his irritability, make him to have little concentration in class, which further makes him to perform poorly in school work. The poor performance in school is majorly attributed to his behavior, which makes him to have trouble concentrating in class or undertaking any activities, especially those that require the formation of groups, due to the fact that he has trouble forging good relationships with others.

Past Psychiatric History:

From the accounts of the parents, the client does not have incidents, relating to visits to the psychiatrists. Furthermore, the patient has never been hospitalized, due to mental illness or disorders. However, he was taken as outpatient at the age 12, in a psychiatric clinic. In this, the teachers noted how he had difficulties in forging peaceful relationships with other students, as well as disobeying some of the school rules and people in authority. The client was reported to be easily irritable and as such, engage in arguments or fights, with anyone, regardless of the age or authority. On the other, while at home, the client would easily get into fights and quarrels with his siblings, regardless of the issue at hand. Furthermore, the client was noted to result fighting as the only method of resolving conflicts. The parents also noted that the client would at times ignore their calls or requests and orders. His bedroom was highly unorganized, with little attention given to tidiness, which was part of his chores in the house.
At the time the client was brought to the office by the parents, he was evaluated, but there was no official diagnosis given to him or the parents. As a result of this, the provider mainly referred him to undertake a family therapy or psychoeducation. Example Journal Entry – Practicum Experience. The intervention was highly successful as the parents were able to have some little information, on what was the problem with their child. Furthermore, through the family therapy and psychoeducation, it was noted that there was some significant improvement in the behavior of the child, both at school and home, until the current episode, which necessitated the parents to bring him to the clinic.

As a result of the condition, there was really no need for the psychoactive or stimulant medication as some of the pharmacological intervention to the problem facing the client, owing to the main reason that the psychotherapy, mainly seemed to be effective. However, it should be noted that there is no a one-size-fits-all treatment option, for the children as well as the teenagers that suffer from ODD. Despite all this, the most effective treatment plan for the disorder, are mainly tailored towards the behavioral symptoms as well as the needs of the client. It should also be noted that some of the treatment options are majorly determined, based on a number of different things.

These include the age of the client, the nature and severity of the behaviors and whether the client has another mental health condition, which exists at the moment. Due to the nature of the behavior of the child, as it touched on both school and home life, it was largely agreed that he be enrolled in a social skills programs as well as some school based programs. These programs mainly teach the adolescents as well as the children, how to relate positively with other peers and also help them improve they’re on their school studies. Furthermore, the therapy is usually considered to be very successful, especially when done in a natural environment.

Medical History:

At the time of the presentation, the client had no fever. He was weighing 165lbs, with a height of 6 ft. and 3 inches. His BMI index, was thus 21.18. From the BMI, it is seen that the client is healthy, as it falls within the acceptable range of 17.1 to 24.2 for this age, weight and height. The client has no known allergies, to any drugs or food. Furthermore, there is no history of head or head or trauma injuries, which have led to the loss of consciousness. Furthermore, the client has no major physical injuries, except for scars on his face, which are majorly attributed to the fights that he has engaged in, while at school and at home.

Developmental History:

Developmental Stages: The mother acknowledged that she had some good prenatal, while pregnant with the client. The mother admitted that she always took care of herself and watched her nutrition as well as exercise, while she was pregnant. However, the mother admitted that it was a stressful period, owing to the fact that they were jobless and had little money to support themselves. It should be noted that stress and anxiety, especially in pregnant women, increase the chances and risks of the infants, to develop ADHD and ODD, as well as other complications (Burke & Loeber, 2010). From various literatures, one of the factors that increase the risk of getting ODD is the participation of smoking during pregnancy. However, the mother denied engaging in any substance abuse, during the pregnancy (Sadock, Saddock, & Ruiz, 2015).

Developmental Milestones in Toddlers

The mother stated that the client started walking when he was about 20 months old. Furthermore, in most her visits to the doctors, the client was never diagnosed with having some problems with his cognitive development. The mother stated that he grew up normally, just like his siblings. The mother also acknowledged that the client started uttering words when he was 2-years-old. He also started his toilet training at the age of 3, and before the end of the pre-school period, the client had gained perfect control of his bowel. The cognitive abilities of the client were also well developed during this period.
Substance Use/Abuse History:

Substance 1st use/amount Period of heaviest use/amount Method of use Last/current use/amount
Amphetamines He denied None None None
Bath salts He denied None None None
Benzodiazepines He denied None None None
Caffeine Pa He denied None None None
Crystal Meth He denied None None None
Ecstasy He denied None None None
Energy drinks He denied None None None
Heroin He denied None None None
Marijuana He denied None None None
Methadone He denied None None None
Narcotics He denied None None None
Nicotine He denied None None None
PCP/Acid He denied None None None
Spice He denied None None None
Other (specify) NA None None None

The client denied ever engaging in substance abuse. Furthermore, the parents also admitted that they had never smoked but occasional ingested alcohol.

Psychosocial History:

One of the main things that is very relevant to the clinicians, in planning for the treatment of their clients, is the social and personal history of the client (Sadock, Sadock, & Ruiz, 2015). The client is current in his 12th grade, however, he is not behaving like normal teenagers of his age. The client does not have romantic relationships, but likes to play football. The client is the first born in a family of three. His siblings are twin girls, who are in their 7th grade. The family has never separated, and the client has lived with his parents the entire time.

On the other hand, the client has been suspended and transferred to other schools, due to various disciplinary problems. He has been described as being short-tempered and high-headed, as he rarely follows instructions. He frequently engages in arguments as well as fights with most people that he disagrees with on some issues. The client comes from a middle-class family, which is able to provide most of his necessities.

Family Psychiatric History: Family Genogram

History of Abuse/trauma:
The client has no trauma or abuse history.

Review of System & Assessment
ROS
The Review of the system, is very critical in the coming up with a treatment plan, as it helps to determine the complications that could result from treatment, which can further have negative effects to the client during treatment (Wheeler, 2014). The physical exam on the client was done on August 2018, while his dental care examination was done on June 2018.
Constitution: The client sleeps an average of 8 hours every day, and denies sweating at night.
Eyes: Denies any problems with vision.
Ears: Denies any problems with hearing.
Nose: He denies problems with a sense of smell, unusual nasal congestion, or nose bleeds.
Throat and Mouth: He does not have any part or functionalities of his throat and mouth.
Head and Neck: Denies history of losing consciousness or injury to his head. The head is symmetrical and no bumps on his scalp.
Respiratory: There was no adventitious sound heard. All breath sounds were normal.
Cardiovascular: Denies chest discomfort and tachycardia. S1 and S2 sounds were normal.
Gastrointestinal: He goes to the bathroom every day. He denies problems with his appetite. Although he may not finish his food at a sitting, he eats very well. His gastrointestinal function was unremarkable.
Genitourinary: The individual denies diurnal or nocturnal enuresis. His gastrourinary system was without problem.
Musculoskeletal: The client able to move all extremities with full range of motion.
Psychiatric and Neurologic: The client denies history of mental illness. The client could not recall history of brain injury.

Mental Status Examination:

Appearance: The individual’s appearance matches his age. His dressing was neat and he looks well fed.
Attitude and Behavior: The individual shows cooperation during the interview though he rocks himself in the chair. He also asks for restroom breaks while he was having the interview; he looks directly in the eye of the clinician. He makes eye contact though not sustained during the interview.
Speech: The client is talkative. He talks a lot with normal rate, volume, and tone. Though, he blurts out the answer even before the questions are asked. There was a fast latency of response in his speech. His speech is coherent.

Motor Activity: The client has sat up straight in his chair, and there was no hand tremor, lip smacking or head rocking noted.
Affect and mood: The client reports that his mood was good. And his affect is congruent with mood. His affect too was broad and expansive. He denied suicidal ideations or plan or intention.
Temperament: The client has a short temper, and is easily irritated by various small things.
Perception: He denies hallucination or illusion.
Thought process: The client’s thought process was organized and logical. He frequently answers questions rather too instantaneously.
Thought content: The client denies delusions, and there were no obsessions or preoccupations.
Sensorium and Cognition: He is alert and oriented to person, place, time, and situation.
Memory: His short-term memory is okay and long-term memory intact.
Abstract thought: He was able to explain “an apple a day keeps the doctor away,” he said “if a person undertakes to look out for themselves, through nutrition and exercise, they are capable of keeping most illnesses at bay,” That means abstract thinking was okay.
Intelligence: The client’s knowledge seems normal for his age and educational level.
Insight: His insight was difficult to assess at the moment.
Judgment: His impulsivity greatly affects his sense of judgment.
Physical Assessment and Neurological Examination
Vital Signs: BP: 106/62, HR: 67; R-18, T- 98.2
Pain: The individual rated pain 0/10.
Height/Weight: Ht= 6’ 2”, Wt= 160 pounds
Body mass index percentile was 21.

Neurological exam

Mental status: The client is alert and oriented to person, place, time, and situation. He was very calm and cooperative during the interview.
Assessment of Cranial Nerves:
Olfactory nerve (I): the client could smell vanilla and had intact olfactory nerve, which is CN1.
Optic nerve (II): On the Snellen Chart, the client’s visual acuity was 20/20 which indicated optic nerve was intact.
Oculomotor nerve (III), trochlear nerve (IV), and abducens nerve (VI): the client’s ability to control his eyes movement in every direction both horizontally and vertically portrayed intact CN III, IV and VI. The eye nystagmus was absent.
Trigeminal nerve (V): the client had an intact blink reflex, and he could feel the sense of touch of both sharp and dull with eyes closed. His trigeminal nerve is intact.
Facial nerve (VII): The client’s facial muscles are well innervated as evident by his ability to lift his eyebrows, grimace, and smile.
Acoustic (VIII): It is the cranial nerve employed to listen to sound and hear. He demonstrated ability to hear without any difficulty.
Glossopharyngeal nerve (IX) and Vagus (X) nerve: the cranial nerves IX and X are intact as evident by the client’s ability to verbalize “ah” without any deformities noted in his soft palate. His gag reflex is intact as shown with his ease of swallowing effortlessly.
Spinal accessory nerve (XI): The client demonstrated intact CN XI as evident by his ability to lift his shoulders up against resistance and move his head in all direction within normal range of motion. Hypoglossal nerve (XII): The client’s hypoglossal was within normal functioning as evident by his tongue movement in every direction.

Lab/Diagnostic testing

Test Patient’s Value Normal Range
Urine Opiate Screen negative negative
Urine Buprenorphine negative negative
Urine Oxycodone negative negative
Urine Methadone negative negative
Urine Propoxyphene negative negative
Urine Barbiturates negative negative
Ur Tricyclics negative negative
Phencyclidine Screen negative negative
Urine Amphetamines negative negative
Urine Methamphetamines negative negative
Urine Benzodiazepines negative negative
Urine Cocaine Screen negative negative
Urine Carboxyl THC Screen negative negative

The client tested negative to using the street drugs.

Assessment tools:

Differential Diagnoses (Diff. Dx.):
The differential diagnosis must be ruled out for a client to get proper treatment and better outcome of care. So, clinicians must be versatile to the condition that may present as the actual diagnosis but are not (Carlat, 2017). For this case study, the DSM-V has the following differential diagnosis for a client for an eventual diagnosis of ODD.
1. Oppositional Defiant Disorder (ODD). ODD is different from ADHD in that children with ODD are more or resisting order or instruction from higher authority in the form of negativity, defiance, and hostile as against a child with ADHD who action is characterized behaviorally as being inattentive, hyperactive and impulsive. Therefore, since this boy did not present with the symptoms of being hyperactive, inattentive and impulsive, ADHD as a possible diagnosis is eliminated (APA, 2013).

DSM-V Diagnosis:

Oppositional Defiant Disorder

Case Formulation:

In school, teachers have always described the client as being difficult to work with others and cannot join group works effectively. Teachers have also said that he completely disregards and flaunts various school rules. He also ignores orders from authority. At home, the parents claim that he bullies his younger siblings and even beats them up, whenever an adult is absent. Furthermore, the parents claim that the client sometimes disregards the rules or requests.

Treatment Plan:

The client being a 18-year-old, with ODD, will need the cooperation of both the teachers and the parent, as part of the treatment plan. The parents will be enrolled to a family therapy, which will teach them how to manage the behavior of their child. On the other hand, the client will be enrolled in a social skills program that is school based, to ensure that he learns appropriate socialization skills with the teachers. Since the client does not posses’ severe symptoms of the disorder, no medical intervention will be needed.

Medication/medication adjustment:

Medical intervention will not be needed.
Assessment Tools with Rationale:
For the condition, the assessment tool that was used was the Diagnostic Interview Schedule for Children. According to Galanter and Jensen (2009), parts of the questionnaires can be very helpful in determining the extent of the problems caused by ODD. From the assessment, the information from the patient, corroborated with the manual for the questionnaire.
Referrals and Rationale:
The patient will return to the clinic after two weeks, to check on his progress and response to the therapy.

Therapy with Rationale:

Since the problem is prevalent at both school and home, the family and the teachers at school, will be collectively needed to be approached in the therapy options of the client
Legal Issues:
The parents gave consent for the treatment

Patient Education:

The ODD is one of the mental disorders that is commonly diagnosed in the school going children. The disorder mainly occurs to about 2% to 16% of the entire population in U.S. Some of the common symptoms of the disorder include being short tempered, arguing with adults and easily irritable.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Burke, J., & Loeber, R. (2010). Oppositional Defiant Disorder and the Explanation of the Comorbidity Between Behavioral Disorders and Depression. Clinical Psychology: Science And Practice, 17(4), 319-326. doi: 10.1111/j.1468-2850.2010.01223.x
Galanter, C. A. & Jensen, P. S. (2009). DSM-IV-TR-IV-TR casebook and treatment guide for child mental health. Washington, DC: APA
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia: Wolters Kluwer.
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

In preparation for this course’s practicum experience, address the following in your Practicum Journal:

Review the media Clinical Interview: Intake, Assessment,& Therapeutic Alliance in your Learning Resources.
Select one nursing theory and one counseling theory to best guide your practice in psychotherapy.
Note: For guidance on nursing and counseling theories, refer to the Wheeler textbook in this week’s Learning Resources Example Journal Entry – Practicum Experience Time Log and Journal Template.

Explain why you selected these theories. Support your approach with evidence-based literature.
Develop at least three goals and at least three objectives for the practicum experience in this course Example Journal Entry – Practicum Experience Time Log and Journal Template.

Student Name:

E-mail Address:

Practicum Placement Agency’s Name:

Preceptor’s Name:

Preceptor’s Telephone:

Preceptor’s E-mail Address:

Analyze nursing and counseling theories to guide practice in psychotherapy*

Develop goals and objectives for personal practicum experiences*

Create timelines for practicum activities*

 

Nursing and Counseling theories are designed to guide the practices in psychotherapies. Nurse psychotherapist provides biopsychosocial integrative and holistic care. The therapist uses psychotherapy or counseling in resolving behavior problem, feeling, beliefs, relationship problems, and sensations in the body. There several types of counseling used in unique or in combination with others depending on the individual issues of the patient. Example Journal Entry – Practicum Experience Time Log and Journal Template.

Cognitive behavioral therapy(CBT) is holistic, creative and individualist. It assists the patient to change the unhealthy behavior that is affecting them by using the following functional assessment known as the stimulus, organism, response, and consequences. The goal of CBT is focusing on the immediate patient problem and how to make changes that will increase their engagement in positive or socially supporting activities.

Sister Callister Roy theory is about understanding person, health, environments, and nursing. Roy views a person as an adaptation system and is interested in promoting their adaptation. A person is a view as a bio-psycho-social being in continuous interaction with a changing environment. A person uses acquired mechanism and innate to adapt which involving individual, family, organizations or communities or society. According to Roy Adaptation model (RAM), health is a predictable dimension of someone life which is characterized by a health-illness continuum.

CBT and RAM are interactionism. The clinician elicits/prompts information from the patient. The patient is involved in decision making and goal settings, narrates the results of the assessment to the presenting symptoms and plan strategies with the help of the patient in improving their adaptation to stimuli. The aim is that the behavior will be focused and lead to adaptation combining with the actual planning and implementation. The presenting symptoms are evaluated based on the patient level of adaptation level. These helps in determining the level of adaptation and assess progress during the therapy progress.

My role as a Psychiatric Mental Health Nurse practitioner is to set and establish goals that are attainable, reasonable and measurable with the patient and act as a guide through the process, assisting with requiring skill training and design suitable experiments with high possibility of success.

My goal is to work with individuals, groups, families, and communities to assess their mental health needs, develop diagnoses based on their presenting symptom and plan, implement and evaluate their care. My intervention will include prevention interventions, health promotion, health maintenance, assessment, evaluation, maintain a therapeutic environment. Provide aid with self-care activities, monitor and administer psychobiological treatment regimens, counseling, and crisis intervention Example Journal Entry – Practicum Experience Time Log and Journal Template.

 Time Log

List the objective(s) met and briefly describe the activities you completed during each time period. If you are not on-site for a specific week, enter “Not on site” for that week in the Total Hours for This Time Frame column. Journal entries are due in Weeks 4, 8, and 11; include your Time Log with all hours logged (for current and previous weeks) each time you submit a journal entry.

You are encouraged to complete your practicum hours on a regular schedule, so you will complete the required hours by the END of WEEK 11.

Time Log
Week  Dates Times  Total Hours for This
Time Frame
Activities/Comments Learning Objective(s) Addressed
1 11/30/17 9A-5:30P 8 Introduction to the unit and staffs. Knowing the dos and don’t on the unit.
1 12/01/17 9A-5:30P 8 Education about different types of therapy. Ethical and legal issues  Knowing the different in therapy and preventing ethical and legal issues

 

Total Hours Completed: 16

 

References

Cherry, K. (2017). What Is Cognitive Behavioral Therapy? Retrieved from:

nacbt.org (n.d.). What is Cognitive-Behavioral Therapy (CBT)? Retrieved from:

nursing-theory.org (n.d.). Roy Adaptation Model. Retrieved from:

http://nursing-theory.org/theories-and-models/roy-adaptation-model.php Example Journal Entry – Practicum Experience Time Log and Journal Template

Practicum Experience Time Log

Explain why you selected these theories (one nursing theory and one counseling theory).

Roy’s Adaptation Theory (nursing theory) and structural family theory (counseling theory) present a good description of my understanding of nursing.

Roy’s Adaptation Theory

Roy’s Adaptation Theory identifies human beings as holistic adaptation systems that are that are in constant contact with both the internal and external environments. The function of the holistic adaptation system is to preserve the integrity of the body despite influences from environmental stimuli (either external or internal in nature) Example Journal Entry – Practicum Experience Time Log and Journal Template. The body translates and assimilates the environmental stimuli through senses that are present in the nervous system. The information received by the senses is considered as input since it causes a homeostatic imbalance in the endocrine system, fluid, electrolyte and acid-base balance. Once the information is received, a response is channeled through automatic and unconscious routes (Alligood, 2014; Smith & Parker, 2015). The choice of this theory is based on how its views nurses. An interpretation of the theory indicates that the primary function of nurses is to nurture positive adaptation for their patients, to allow for their body’s integrity to be preserved. As such, it can be accepted that holistic adaptation (as presented in the theory) is the progressions and consequences that a body experiences through conscious and unconscious choices as well as awareness to facilitate the integration between the body and environment. This makes it clear that holistic adaptation enables ideal health and wellbeing, high quality of life, and desired dignity in death Example Journal Entry – Practicum Experience Time Log and Journal Template.

Based on my understanding the adaptation theory, humans are bio-psychosocial beings. Any change to their environment, whether internal or external, can result in an imbalance that must be addressed either unconsciously or consciously. The systems appears to center on the caption that health has two aspects in the form of systems and adaptation. A system can be interpreted as the environment that is comprised of many elements to include the individual, family members, social groups, community and society. In contrast, an adaptation is the body’s response to environmental changes that can either be an unconscious or conscious response. The position that nurses play is to influence conscious response by adopting procedures that facilitate the integration between the body and environment. This explains why nursing practices improve health and wellbeing, and enables high quality of life, and desired dignity in death for patients.

Structural Family Theory

The Structural Family Theory is a medical approach that applies psychological frameworks to understand the family dynamics Example Journal Entry – Practicum Experience Time Log and Journal Template. The theory presents the family as a small system unit that operates and lives within larger systems that include organizations, community, and culture. In addition, it concedes that the family is ideally a dynamic system that is subject to change over time even as the family members grow older and interact within themselves and with others. However, the theory also concedes that the ideal is not always the case, whereby there are occasions in which the family is characterized by stuck and neither experiences change nor growth Example Journal Entry – Practicum Experience Time Log and Journal Template. When the family is stuck, one or more of the family members will exhibit signs of either mental or behavioral health issues. In such cases, the Structural Family Theory looks at how the individual family members relate to each other, considering any problems in operation and interaction as a sign of dysfunction. It identifies operations and transactions as the patterns of unconscious interaction between family members, which establish the rules for functioning to include alliances and hierarchy. The theory adds that the problems with operations and interactions are not the cause of the dysfunction, rather they reinforce the symptoms associated with the dysfunction. For instance, an elder sibling that uses power and bullying to intimidate the younger siblings who then become withdrawn and apprehensive is a sign that the whole family is distant and disengaged. The harmful interaction amplifies and supports the problem as a dysfunction. Applying the theory in therapy requires that first a flow chart of unconscious family interactions be developed and described to identify the harmful interactions that cause dysfunction. The harmful interactions are then targeted for reversal (Thompson, 2016). Therefore, the Structural Family Theory is a psychological intervention that entails aiding the family in identifying its strengths and weaknesses with the intention of minimizing the weaknesses while leveraging strengths so as to turn the family into a more productive unit.

Develop at least three goals and at least three objectives for the practicum experience in this course.

Goals

  • Gain practical experience.
  • Enhance confidence in completing tasks.
  • Enhance patients’ confidence in nursing care
  • Example Journal Entry – Practicum Experience Time Log and Journal Template

Objectives

  • Learn about and help plan nursing care
  • Reevaluate nursing practices to reflect current realities.
  • Develop a written nursing care plan.

References

Alligood, M. (2014). Nursing Theorists and their Work (8th ed.). St. Louis: MO: Mosby.

Smith, M. & Parker, M. (2015). Nursing Theories and Nursing Practice (4th ed.). Philadelphia, PA: F. A. Davis Company. Example Journal Entry – Practicum Experience Time Log and Journal Template.

Thompson, R. (2016). Counseling Techniques: Improving relationships with others, ourselves, our families, and our environments (3rd ed.). New York, NY: Routledge. Example Journal Entry – Practicum Experience Time Log and Journal Template Example Journal Entry – Practicum Experience Time Log and Journal Template.

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