PRAC 6665 WEEK I

Assignment 2: Clinical Skills Self-Assessment

Before embarking on any professional or academic activity, it is important to understand the background, knowledge, and experience you bring to it. You might ask yourself, “What do I already know? What do I need to know? And what do I want to know?” This critical self-reflection is especially important for developing clinical skills such as those for advanced practice nursing.

The PMHNP Clinical Skills List and PMHNP Clinical Skills Self-Assessment Form provided in the Learning Resources can be used to celebrate your progress throughout your practicum and identify skills gaps. The skills list covers all the necessary skills you should demonstrate during your practicum experiences.

For this Assignment (just as you did in PRAC 6645), you assess where you are now in your clinical skill development and make plans for this practicum. Specifically, you will identify strengths and opportunities for improvement regarding the required practicum skills. In this practicum experience, when developing your goals and objectives, be sure to keep assessment and diagnostic reasoning in mind. As you complete your self-assessment this week, you may wish to look back over your self-assessments from prior practicums to reflect on your growth.

To Prepare
Review the clinical skills in the PMHNP Clinical Skills List document. It is recommended that you print out this document to serve as a guide throughout your practicum.
Review the “Developing SMART Goals” resource on how to develop goals and objectives that follow the SMART framework.
Review the resources on nursing competencies and nursing theory, and consider how these inform your practice.
Download the PMHNP Clinical Skills Self-Assessment Form to complete this Assignment.
The Assignment
Use the PMHNP Clinical Skills Self-Assessment Form to complete the following:

Rate yourself according to your confidence level performing the skills identified in the Clinical Skills Self-Assessment Form.
Based on your ratings, summarize your strengths and opportunities for improvement.
Based on your self-assessment and theory of nursing practice, develop three to four (3–4) measurable goals and objectives for this practicum experience. Include them on the designated area of the form.

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Solution

PRAC 6665/6675 Clinical Skills 

Self-Assessment Form

Desired Clinical Skills for Students to Achieve Confident (Can complete independently) Mostly confident (Can complete with supervision) Beginning (Have performed with supervision or needs supervision to feel confident) New (Have never performed or does not apply)
Comprehensive psychiatric evaluation skills in: 
Recognizing clinical signs and symptoms of psychiatric illness across the lifespan

 

     
Differentiating between pathophysiological and psychopathological conditions  

 

   
Performing and interpreting a comprehensive and/or interval history and physical examination (including laboratory and diagnostic studies)  

 

   
Performing and interpreting a mental status examination  

 

   
Performing and interpreting a psychosocial assessment and family psychiatric history    

 

 
Performing and interpreting a functional assessment (activities of daily living, occupational, social, leisure, educational).  

 

   
Diagnostic reasoning skill in:
Developing and prioritizing a differential diagnoses list  

 

   
Formulating diagnoses according to DSM 5 based on assessment data  

 

   
Differentiating between normal/abnormal age-related physiological and psychological symptoms/changes    

 

 
Pharmacotherapeutic skills in:
Selecting appropriate evidence based clinical practice guidelines for medication plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management)    

 

 
Evaluating patient response and modify plan as necessary  

 

   
Documenting (e.g., adverse reaction, the patient response, changes to the plan of care)  

 

   
Psychotherapeutic Treatment Planning:
Recognizes concepts of therapeutic modalitiesacross the lifespan  

 

   
Selecting appropriate evidence based clinical practice guidelines for psychotherapeutic plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management, modality appropriate for situation)  

 

   
Applies age appropriate psychotherapeutic counseling techniques with individuals and/or any caregivers    

 

 
Develop an age appropriate individualized plan of care  

 

   
Provide psychoeducation to individuals and/or any caregivers  

 

   
Promote health and disease prevention techniques  

 

   
Self-assessment skill:
Develop SMART goals for practicum experiences  

 

   
Evaluating outcomes of practicum goals and modify plan as necessary  

 

   
Documenting and reflecting on learning experiences  

 

   
Professional skills:
Maintains professional boundaries and therapeutic relationship with clients and staff

 

     
Collaborate with multi-disciplinary teams to improve clinical practice in mental health settings  

 

   
Identifies ethical and legal dilemmas with possible resolutions  

 

   
Demonstrates non-judgmental practice approach and empathy  

 

   
Practices within scope of practice  

 

   
Selecting and implementing appropriate screening instrument(s), interpreting results, and making recommendations and referrals:
Demonstrates selecting the correct screening instrument appropriate for the clinical situation  

 

   
Implements the screening instrument efficiently and effectively with the clients    

 

 
Interprets results for screening instruments accurately  

 

   
Develops an appropriate plan of care based upon screening instruments response  

 

   
Identifies the need to refer to another specialty provider when applicable  

 

   
Accurately documents recommendations for psychiatric consultations when applicable  

 

   

 

Summary of strengths:

 

I possess a number of strengths that would enable me to perform my roles competency as a psychiatric mental health nurse practitioner. One of the strengths is my knowledge and skills in recognizing the signs and symptoms of psychiatric conditions. Having worked in the psychiatric clinic for some time now, I can confidently differentiate between the symptoms of psychiatric and medical conditions. I can also order appropriate laboratory and diagnostic investigations to guide in the development of accurate diagnoses and treatment plans for the clients. I also have the strength of working effective with other healthcare providers in the provision of patient care. Inter-professional collaboration is a critical tool for optimizing the outcomes of care for psychiatric patients. The collaboration ensures the adoption of highly efficient and effective interventions that would enhance the recovery and coping of patients with psychiatric illnesses. I also have the strength of undertaking and interpreting mental status examination.

Mental status examination provides an accurate picture of the health needs and problems of clients. The examination guides the evaluation of the effectiveness of the adopted treatment interventions. I believe that my competency in undertaking mental status examination and interpreting its findings will contribute to my success in the practicum experience. I also have the strength of selecting effective screening tests for psychiatric patients. I can also interpret the screening results to guide the development of the desired treatment plans for the patients. The strength will enable me ensure effective care delivery for the patients suffering from mental health problems. The last strength that I possess as a psychiatric mental health nurse practitioner is being able to maintain professional boundaries and therapeutic relationship with my patients. Nurses have the obligation of ensuring professionalism in their practice. They ensure the protection of the patient rights as well as therapeutic relationship for the realization of optimum outcomes of patient care (Morgan & Townsend, 2019). Therefore, I will leverage on the above strengths to achieve my desired competencies in the practicum experience.

 

 Opportunities for growth:

An area of opportunities for growth that I need to explore during the practicum experience is developing my competencies in the implementation of screening test results in psychiatric practice. Despite being knowledgeable on the different screenings for psychiatric patients, I have the weakness of ensuring the effective implementation of the screening results. I have to work closely with my preceptor as well as other healthcare providers in the practicum experience to ensure that I develop the desired competencies in this area of practice. The other area of growth that I need to explore during the practicum experience is the use of age appropriate psychotherapeutic techniques in patient care.

Different psychotherapies exist for use in patients presenting with psychiatric conditions. The therapies also vary based on the age of the patients under consideration. I have inadequate knowledge and skills on the use of the different types of psychotherapies for the wide range of patient age groups in psychiatric practice. As a result, I have to ensure that I develop the desired competencies in the use of psychotherapy to ensure that I provide high quality, safe and efficient care to psychiatric patients in my practice. The other area of growth that I will need to explore during the practicum experience is the assessment of effectiveness of care given to psychiatric patients. Evaluation of treatment in psychiatry is important in informing if the adopted interventions have been effective or not ((Hercelinskyj & Alexander, 2019). It informs the revisions that are made to ensure optimum outcomes in patient care. I feel that I have not mastered the knowledge and skills needed in the evaluation of psychiatric treatments. Consequently, I would wish to enhance my competencies in this area during my practicum experience.

 

 Now, writethree to four (3–4)possible goals and objectives for this practicum experience. Ensure that they follow the SMARTStrategy, as described in the Learning Resources.

1.       Goal: Develop competencies in the implementation of screening results of psychiatric conditions by the end of the practicum experience.

a.       Objective: interpret at least ten psychiatric screening results on a weekly basis during the practicum experience.

b.      Objective: Develop at least ten treatment plans based on screening results for psychiatric patients during the practicum experience.

c.       Objective: Collaborate with my preceptor and other healthcare providers in the practicum site in interpreting and implementing treatment plans for psychiatric patients during the practicum experience.

 

2.       Goal: Develop competencies on the use of different psychotherapeutic treatments in psychiatric patients of various age groups by the end of the practicum experience

a.       Objective: Learn about the different psychotherapeutic modalities used for psychiatric patients in the practicum site by the end of the first month of the experience.

b.      Objective: To implement the use of different psychotherapeutic modalities in treating patients of various age groups during the practicum experience.

c.       Objective: Collaborate with my preceptor and other healthcare providers in the use of different psychotherapeutic modalities in managing psychiatric conditions during the practicum experience.

 

3.       Goal: Develop competencies in the assessment of psychiatric treatments by the end of the practicum experience

a.       Objective: Evaluate the treatment plans for at least 10 patients on a weekly basis during the practicum experience. 

b.      Objective: Implement evidence-based interventions of evaluating psychiatric treatments during my practicum experience.

c.       Objective: Collaborate with my preceptor and other healthcare providers in evaluating psychiatric treatments during the practicum experience.

 

  References

Hercelinskyj, G. (Julie), & Alexander, L. (2019).Mental Health Nursing: Applying Theory to Practice.Cengage AU.

Morgan, K. I., & Townsend, M. C. (2019).Essentials of Psychiatric Mental Health Nursing: Concepts of Care in Evidence-Based Practice. F. A. Davis Company.

Morgan, K. I., & Townsend, M. C. (2020).Pocket Guide to Psychiatric Nursing. F.A. Davis.

 

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