NUR6640 Example Practicum Journal

NUR6640 Example Practicum Journal

 

Student Name:

E-mail Address:

Practicum Placement Agency’s Name:  A Healthy Mind

Preceptor’s Name: , PMHNP-BC

Preceptor’s Telephone: 28-201-9795

Preceptor’s E-mail Address:

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Time Log
Week	Dates	Times	Total Hours for This Time Frame	Activities/Comments	Learning Objective(s) Addressed
1	2/28/20	0800-1800	10	Office Orientation/ Psychiatric Evaluations, Medication Management Strategy Techniques	Medication Management
1	2/29/20	0800-1800	10	Individual psychotherapy sessions, medication refills, psychiatric evaluations.	Experience with patients of diverse demographics, Manage all patient types, utilize text and psychopharmaceutical resources to aid in directing patient care.
2	3/5/20	0800-1800	10	Psychotherapy Sessions	Experiences with patients of diverse demographics. Utilize text and psycho pharmaceutical resources to aid in directing patient care.
3	3/12/20	0800-1800	10	Psychiatric Evaluation, Individual Psychotherapy	Experience with patients of diverse demographics, Manage all patient types, utilize text and psychopharmaceutical resources to aid in directing patient care.
3	3/13/20	0800-1800	10	Medication Management, Individual Psychotherapy	Experiences with patients of diverse demographics. Utilize text and psycho pharmaceutical resources to aid in directing patient care.
4	3/16/20	0800-1800	10	Individual Psychotherapy	Proficiency in psychotherapy Manage all patient types
4	3/20/20	0800-1800	10	Individual Psychotherapy	Proficiency in psychotherapy Manage all patient types
5	03/26/20	0800-1800	10	Individual Psychotherapy	Proficiency in psychotherapy Manage all patient types

 

Total Hours Completed:

 

NUR6640 Example Practicum Journal

Journal Entries

 

Week 1

Nursing Theory:

Modelling and Role Modelling

The Modeling and Role Modeling Theory was developed by Helen Erickson, Evelyn M. Tomlin, and Mary Anne P. Swain. It was first published in 1983 in their book Modeling and Role Modeling: A Theory and Paradigm for Nursing. The theory enables nurses to care for and nurture each patient with an awareness of and respect for the individual patient’s uniqueness. This exemplifies theory-based clinical practice that focuses on the patient’s needs (Nursing Theory, 2020).  As an Advanced Practice Registered Nurse (APRN) being a role model will be key to setting examples for clients as they face difficult challenges in their lives.

 

Counselling Theory:

Cognitive Therapy Theory

Cognitive therapy emphasizes what people think rather than what they do.  Cognitive therapists believe that it’s dysfunctional thinking that leads to dysfunctional emotions or behaviors. By changing their thoughts, people can change how they feel and what they do.  Major figures in cognitive therapy include Albert Ellis and Aaron Beck (American Psychological Association, 2020).  The way clients view themselves, the world in which they live, and how to function within society is key to their long-term success.  Cognitive Therapy Theory helps clients redirect their thought processes to find healthy ways to think, affording them the possibility of moving forward in a positive direction with improved coping mechanisms related to their thought processes.

 

Goals:

1. Proficiency in psychotherapy
2. Manage all patient types
3. Become proficient med management practitioner

Objectives:

1. Perform independent individual psychotherapeutic sessions.
2. Seek experiences with patients of diverse demographics.
3. Utilize text and psycho pharmaceutical resources to aid in directing patient care.

1. References
2. American Psychological Association (2020). Different Approaches to Psychotherapy.  Retrieved
3. from:  https://www.apa.org/topics/therapy/psychotherapy-approaches
4. Nursing Theory (2020), Modelling and Role Modelling Theory, Retrieved from:  https://nursing
5. theory.org/theories-and-models/erickson-modeling-and-role-modeling-theory.php

Week 2

Patient:  Richard

Low socioeconomic status, lives with roommate, unemployed, 52 yo male, father to 2 year old son, recently in relationship with his step daughter, past meth, marijuana, and heroin use disorder.  Ongoing AA, counselling, and random UAs, no SI, HI, SMI, and no Audio/Visual hallucination (AVH), CBT for Panic Disorder. 3 heart attacks, defibrillator placed.  NUR6640 Example Practicum Journal

 

Meds: Valium 5mg 1 tab TID PRN

 

Diagnosis:

F15.21 other stimulants dependence (in remission)

F41.1 Generalized Anxiety Disorder

 

Legal/ ethical: Open CPS Case due to substance abuse.

 

Studies find that disconfirmation of patients’ role expectations in group therapy were associated with weaker therapeutic alliance highlights the importance of discussing psychotherapy expectations at an early stage in treatment. Expectations characterized by defensiveness predicted worse retention in psychotherapy, which indicates that the PEX‐S can be helpful in detecting patients at risk for dropout. Practitioner points in targeting a patient’s role expectancies prior to treatment, possible discrepancies between patient and therapist are made visible and possible to examine. Clarifying the patient’s role expectations and the therapist’s rationale might be a first step towards establishing a strong working alliance. Surveying the patient’s defensiveness tendencies at the beginning of therapy offers a chance to discuss possible fears and other obstacles concerning therapy (Frankl, M., Philips, B., & Wennberg, P., 2014).

When counseling parents with suspected child abuse, studies have found that curative interventions with interventions focusing on improving parenting skills and providing social and/or emotional support to be effective in preventing or reducing child maltreatment (Van der Put, C., Assink, M., Gubbels, J., & Boekhout van Solinge, N., 2018).

References

Frankl, M., Philips, B., & Wennberg, P. (2014). Psychotherapy role expectations and

experiences—Discrepancy and therapeutic alliance among patients with substance use disorders. Psychology and Psychotherapy: Theory, Research and Practice, 87(4), 411–424. https://doi-org.ezp.waldenulibrary.org/10.1111/papt.12021

Van der Put, C., Assink, M., Gubbels, J., & Boekhout van Solinge, N. (2018). Identifying

Effective Components of Child Maltreatment Interventions: A Meta-analysis. Clinical Child And Family Psychology Review, 21(2), 171–202. https://doi-org.ezp.waldenulibrary.org/10.1007/s10567-017-0250-5

Week 3

Part 1: Comprehensive Client Family Assessment

 

Patient: Caleb

 

• Demographic information:  147.4 lbs, BMI 27, 23 year old male

 

• Presenting problem:  Initial Psych Eval

 

• History of present illness: See Psychiatric History.

 

• Past psychiatric history:  Celexa 20mg Daily for depression (off and on since diagnosis).  He reports feeling hopelessness, helplessness, worthlessness, feelings of low motivation and feelings of hating to live, suicidal ideations without a plan, Paranoia, He worries about the future and his insurance covering his future treatment needs. Denies taking any meds for anxiety.  Pt. states he takes Ativan for nausea.NUR6640 Example Practicum Journal

 

• Medical history:  Lymphodemnia, Triple Lumen PICC line, Iliostomy, Interocutaneous Fistula, Near Sited Vision, Sterile, Acute Leukemia (April 2012), Introanal fistula secondary to colectomy, past tracheostomy for long term vent needs secondary to chronic condition and medically induced coma (2012), Cancer is in remission, Type II Insulin Dependent Diabetic, Long Acting insulin in TPN with sliding scale, nephrostomy tubes, Graft Vs Host Disease, Sees Physicians for photophores at Mayo in Scottsdale for his care now every other week to have his blood spun and have a special procedure, pt. will send his medication list (multiple meds), gets 7 hours of sleep a night.

 

• Substance use history:  Denies cigarette use, illicit drug, or alcohol use.

 

• Developmental history:  High School Degree, Met all Milestones, Degree in Business Writing.

 

• Family psychiatric history:  Maternal Grandmother:  Depression/Anxiety, Paternal Grandfather:  None., Denies family suicide history.

 

• Psychosocial history: Born and raised in BHC, played in orchestra and sang in competitive choir in high school, sophomore year of college he was diagnosed with Leukemia, Supportive friends from choir.

 

• History of abuse/trauma:  None

 

• Review of systems:  Wears glasses, Breathing on room air, Moves all Extremities, BP: 143/87, HR:99, RR: 24 bpm, PERRLA

 

• Physical assessment:  Pt. appears calm, pleasant, cooperative.

 

• Mental status exam:  AOX4

 

• Differential diagnosis:  Acute Lymphoblastic Leukemia (remission), Chronic Pain, Graft Versus Host Disease (unspecified), Type II Insulin Dependent Diabetes, Percutaneous Nephrostomy, Generalized Anxiety.

 

• Case formulation:  Case Management and Counselling.

 

• Treatment plan: Plan to have pt. look into further government assistance, plan to review patient’s meds, plan to possibly change meds. NUR6640 Example Practicum Journal

 

Part 2: Family Genogram

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

• Include references immediately following the content.
• Use APA style for your journal entry and references.

 

 

Practicum Journal Entries

Each week, you will complete practicum-related assignments. It is highly recommended that you review the practicum assignments for Weeks 2–10 before Day 7 of Week 1. This will give you time to connect with your preceptor so that you can fulfill the requirements of each practicum assignment.

Due Day 7 of Week 4:

• Week 1:You will select one nursing theory and one counseling theory to best guide your practice in psychotherapy. You will explain why you selected these theories and support your approach with evidence-based literature. You also will develop at least three goals and at least three objectives for the practicum experience in this course.
• Week 2:You will write about a client you observed or counseled. (Assignment to be submitted by Day 7 of Week 4.)

• Week 3: You will complete a Comprehensive Client Assessment. (Assignment to be submitted by Day 7 of Week 4.)

Due Day 7 of Week 7: NUR6640 Example Practicum Journal

• Week 4:You will write about a client you observed or counseled and explain whether cognitive behavioral therapy would be effective with this client. (Assignment to be submitted by Day 7 of Week 4 .)

Due Day 7 of Week 7:

• Week 5:You will write about a client you observed or counseled that suffers from a disorder related to trauma. (Assignment to be submitted by Day 7 of Week 7.)
• Week 6:You will write about a client you observed or counseled and explain whether motivational interviewing would be effective with this client. (Assignment to be submitted by Day 7 of Week 7.)

Due Day 7 of Week 10:

• Week 7:You will write a progress note and privileged psychotherapy note for the client you assessed in Week 3 for the Comprehensive Client Assessment. (Assignment to be submitted by Day 7 of Week 7.)

Due Day 7 of Week 10:

• Week 8:You will write about a client you observed or counseled and explain whether existential-humanistic therapy would be effective with this client. You will also reflect on your clinical supervision experiences. (Assignment to be submitted by Day 7 of Week 10.)
• Week 9:You will write about a child or adolescent client you observed or counseled. (Assignment to be submitted by Day 7 of Week 10.)
• Week 10:You will write a reflection on your practicum experiences. (Assignment to be submitted by Day 7 of Week 10.)

Comprehensive Client Assessments, Progress Notes, and Client Termination Summary

Due Day 7 of Week 4:

• Week 10:You will write a Client Termination Summary for a client who is ready to complete therapy. (Assignment to be submitted by Day 7 of Week 10.) NUR6640 Example Practicum Journal