Assignment: Journal Entry

 

Critical reflection on your growth and development during your practicum experience in a clinical setting helps you identify opportunities for improvement in your clinical skills, while also recognizing your strengths and successes.

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Use this Journal to reflect on your clinical strengths and opportunities for improvement, the progress you made, and what insights you will carry forward into your next practicum. 

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3

Practicum Experience Plan

Your Name

Department of ABC, University of ABC

ABC 101: Course Name

Professor (or Dr.) Firstname Lastname

Date

Practicum Experience Plan

Overview:

Your Practicum experience includes working in a clinical setting that will help you gain the knowledge and skills needed as an advanced practice nurse. In your practicum experience, you will develop a practicum plan that sets forth objectives to frame and guide your practicum experience.

As part of your Practicum Experience Plan, you will not only plan for your learning in your practicum experience but also work through various patient visits with focused notes as well as one (1) journal entry.

Complete each section below.

Part 1: Quarter/Term/Year and Contact Information

Section A

Quarter/Term/Year: 2022

Student Contact Information

Name:

Street Address:

City, State, Zip:

Home Phone:

Work Phone:

Cell Phone:

Fax:

E-mail:

Preceptor Contact Information

Name:

Organization:

Street Address:
City, State, Zip:
Work Phone:
Cell Phone:
Fax:

Professional/Work E-mail:

Part 2: Individualized Practicum Learning Objectives
Refer to the instructions in Week 2 to create individualized practicum learning objectives that meet the requirements for this course. These objectives should be aligned specifically to your Practicum experience. Your objectives should address your self-assessment of the skills found in the “PMHNP Clinical Skills Self-Assessment Form” you completed in Week 1.

As you develop your individualized practicum learning objective, be sure to write them using the SMART format. Use the resources found in Week 2 to guide your development. Once you review your resources, continue and complete the following. Note: Please make sure each of your objectives are connected to your self-assessment. Also, consider that you will need to demonstrate how you are advancing your knowledge in the clinical specialty.

Introduction

In this section, I will discuss my three goals for individualized practicum learning. My objectives will work in tandem with the planned activities to ensure that the smart goals are met effectively. My first goal is to learn more about how to care for people who have mental health issues. My secondary goal is to improve my listening skills and decision-making abilities. And my last goal is to ensure that I use appropriate tone when speaking with inmates who have mental health issues. The objectives and planned activities are outlined below and directly shows how I will undergo my practicum learning.

Objective 1: To improve my listening skills and decision-making abilities

Planned Activities: To work on how to improve listening skills

Mode of Assessment: The mode of assessment for the objective is focused assessment that provides details to specific body system associated with problems of a patient.

PRAC Course Outcome(s) Addressed:

· To get to the near perfect

· To gain more confidence

Objective 2: To acquire more knowledge in my listening skills and ability to make judgment Parreira et al., (2021).

Planned Activities: I will evaluate the areas I need to improve

Mode of Assessment: For this objective, the mode of assessment will be through observation.

PRAC Course Outcome(s) Addressed:

· To gain more knowledge on listening skills

· To adhere to the recommended instructions for women health experts

Objective 3: To make sure I use the right tone when I talk to patients with mental health problems Langegård et al., (2021).

Planned Activities: I will monitor patients under care, conduct interview on the patients to understand their views on the care and develop appropriate care plan based on the information they provide.

Mode of Assessment: The use of observation will used for this objective when making assessment.

PRAC Course Outcome(s) Addressed:

· To gain more knowledge on tone variation

· Evaluate the best use of tone

· Collaborate with my preceptor in evaluating the differences in tones

Conclusion

The above outlined objectives define my practicum learning. Under the objectives, I have the planned activities. The planned activities according to Gold et al., (2021), defines exact activities that will enable one to achieve the set objectives. To achieve the above objectives, I will adhere to the plan and make full use of any and all resources at my disposal in order to define and realize my objectives. I plan to prepare myself for the national certification exam that I need to take by drawing from a variety of relevant resources so that I can feel confident and prepared for it.

References

Gold, S. B., Green, L. A., & Westfall, J. M. (2021). Heeding the Call for Urgent Primary Care Payment Reform: What Do We Know about How to Get Started? The Journal of the American Board of Family Medicine, 34(2), 424-429.

Kverno, K. S., & Fenton, A. (2021). Specialization within a Specialty: Advanced Practice Psychiatric Nursing Pathways for the Greatest Good. Journal of psychosocial nursing and mental health services, 59(10), 13-18.

Langegård, U., Kiani, K., Nielsen, S. J., & Svensson, P. A. (2021). Nursing students’ experiences of a pedagogical transition from campus learning to distance learning using digital tools. BMC nursing, 20(1), 1-10.

Parreira, P., Santos-Costa, P., Neri, M., Marques, A., Queirós, P., & Salgueiro-Oliveira, A. (2021). Work methods for nursing care delivery. International Journal of Environmental Research and Public Health, 18(4), 2088.

Peterson, B. L., Pittenger, A. L., Kaas, M. J., & Lounsbery, J. L. (2019). Partnering for a sustainable interprofessional psychiatric mental health nurse practitioner education curriculum. Journal of Nursing Education, 58(12), 723-727.

Part 3: Projected Timeline/Schedule

Estimate how many hours you expect to work on your Practicum each week. *Note: All of your hours and activities must be supervised by your Preceptor and completed onsite. Your Preceptor will approve all hours, but your activities will be approved by both your Preceptor and Instructor. Any changes to this plan must be approved.

This timeline is intended as a planning tool; your actual schedule may differ from the projections you are making now.

I intend to complete the 144 or 160 Practicum hours (as applicable) according to the following timeline/schedule. I also understand that I must see at least 80 patients during my practicum experience. I understand that I may not complete my practicum hours sooner than 8 weeks. I understand I may not be in the practicum setting longer than 8 hours per day unless pre-approved by my faculty.

Number of Clinical Hours Projected for Week (hours you are in Practicum Setting at your Field Site)

Number of Weekly Hours for Professional Development (these are not practicum hour)

Number of Weekly Hours for Practicum Coursework (these are not practicum hours)

Week 1

Week 2

Week 3

Week 4

Week 5

Week 6

Week 7

Week 8

Week 9

Week 10

Week 11

Total Hours (must meet the following requirements)

Part 4 – Signatures

Student Signature (electronic): Date:

Practicum Faculty Signature (electronic)**: Date:

** Faculty signature signifies approval of Practicum Experience Plan (PEP)

Submit your Practicum Experience Plan on or before Day 7 of Week 2 for faculty review and approval.

Once approved, you will receive a copy of the PEP for your records. You must share an approved copy with your Preceptor. The Preceptor is not required to sign this form.

PLEASEFOLLOW THE INSTRUCTIONS AS INDICATED BELOW:

1). ZERO (0) PLAGIARISM

2). AT LEAST 5 REFERENCES, NO MORE THAN 5 YEARS (WITHIN 5YRS, OR LESS THAN 5YRS)

3). PLEASE SEE THE ATTACHED RUBRIC DETAILS,

Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Content

Name:

 

PRAC_6675_Week11_Assignment_Rubric

  • Grid View
  • List View
 

Assimilation and Synthesis: Content Reflection

Assimilation and Synthesis: Personal Growth

Written Expression and Formatting

APA

Excellent Good Fair Poor

Points:

Points Range:
45 (45%) – 50 (50%)

Reflection demonstrates a high level of critical thinking in applying and integrating key course concepts and theories from readings, lectures, and/or experiences. Insightful and relevant connections are made through contextual explanations and examples.

Feedback:

Points:

Points Range:
40 (40%) – 44 (44%)

Reflection demonstrates moderate level of critical thinking in applying and integrating key course concepts and theories from readings, lectures, and/or experiences. Connections are made through explanations and/or examples.

Feedback:

Points:

Points Range:
35 (35%) – 39 (39%)

Reflection demonstrates minimal critical thinking in applying and integrating key course concepts and theories from readings, lectures, and/or experiences. Minimal connections are made through explanations and/or examples.

Feedback:

Points:

Points Range:
0 (0%) – 34 (34%)

Reflection lacks critical thinking. Superficial connections are made with key course concepts and resources, and/or assignments.

Feedback:

Points:

Points Range:
27 (27%) – 30 (30%)

Expresses solid evidence of reflection on own work. Demonstrates substantial personal growth and awareness of deeper meaning through inferences, well-developed insights, and significant depth in awareness and challenges. Synthesizes current experience into future implications.

Feedback:

Points:

Points Range:
24 (24%) – 26 (26%)

Expresses moderate evidence of reflection on own work. Demonstrates satisfactory personal growth and awareness through some inferences, insights, and challenges. There is mention of the future implications of student’s current experience.

Feedback:

Points:

Points Range:
21 (21%) – 23 (23%)

Expresses minimal evidence of reflection on own work. Demonstrates less than adequate personal growth and awareness through limited or simplistic inferences made, insights, and/or challenges that are not well developed. There is minimal thought of future implications of student’s current experience.

Feedback:

Points:

Points Range:
0 (0%) – 20 (20%)

Expresses inadequate evidence of reflection on own work. Personal growth and awareness are not evident and/or demonstrate an impersonal experience. Lacks personal insights, challenges, inferences, and/or future implications are overlooked.

Feedback:

Points:

Points Range:
14 (14%) – 15 (15%)

Well written and clearly organized using standard English; characterized by elements of a strong writing style; and basically free from grammar, punctuation, usage, and spelling errors.

Feedback:

Points:

Points Range:
12 (12%) – 13 (13%)

Above average writing style and logically organized using standard English with minor errors in grammar, punctuation, usage, and spelling.

Feedback:

Points:

Points Range:
11 (11%) – 11 (11%)

Average writing style that is sometimes unclear and/or with some errors in grammar, punctuation, usage, and spelling.

Feedback:

Points:

Points Range:
0 (0%) – 10 (10%)

oor writing style lacking in standard English, clarity, language used, and/or contains frequent errors in grammar, punctuation, usage, and spelling. Needs work.

Feedback:

Points:

Points Range:
5 (5%) – 5 (5%)

Contains no APA errors.

Feedback:

Points:

Points Range:
4 (4%) – 4 (4%)

Contains 1–2 APA errors.

Feedback:

Points:

Points Range:
3.5 (3.5%) – 3.5 (3.5%)

Contains 3–5 APA errors.

Feedback:

Points:

Points Range:
0 (0%) – 3 (3%)

Contains more than 5 APA errors.

Feedback:

Show Descriptions

Show Feedback

Assimilation and Synthesis: Content Reflection–

Levels of Achievement:

Excellent
45 (45%) – 50 (50%)

Reflection demonstrates a high level of critical thinking in applying and integrating key course concepts and theories from readings, lectures, and/or experiences. Insightful and relevant connections are made through contextual explanations and examples.

Good
40 (40%) – 44 (44%)

Reflection demonstrates moderate level of critical thinking in applying and integrating key course concepts and theories from readings, lectures, and/or experiences. Connections are made through explanations and/or examples.

Fair
35 (35%) – 39 (39%)

Reflection demonstrates minimal critical thinking in applying and integrating key course concepts and theories from readings, lectures, and/or experiences. Minimal connections are made through explanations and/or examples.

Poor
0 (0%) – 34 (34%)

Reflection lacks critical thinking. Superficial connections are made with key course concepts and resources, and/or assignments.

Feedback:

Assimilation and Synthesis: Personal Growth–

Levels of Achievement:

Excellent
27 (27%) – 30 (30%)

Expresses solid evidence of reflection on own work. Demonstrates substantial personal growth and awareness of deeper meaning through inferences, well-developed insights, and significant depth in awareness and challenges. Synthesizes current experience into future implications.

Good
24 (24%) – 26 (26%)

Expresses moderate evidence of reflection on own work. Demonstrates satisfactory personal growth and awareness through some inferences, insights, and challenges. There is mention of the future implications of student’s current experience.

Fair
21 (21%) – 23 (23%)

Expresses minimal evidence of reflection on own work. Demonstrates less than adequate personal growth and awareness through limited or simplistic inferences made, insights, and/or challenges that are not well developed. There is minimal thought of future implications of student’s current experience.

Poor
0 (0%) – 20 (20%)

Expresses inadequate evidence of reflection on own work. Personal growth and awareness are not evident and/or demonstrate an impersonal experience. Lacks personal insights, challenges, inferences, and/or future implications are overlooked.

Feedback:

Written Expression and Formatting–

Levels of Achievement:

Excellent
14 (14%) – 15 (15%)

Well written and clearly organized using standard English; characterized by elements of a strong writing style; and basically free from grammar, punctuation, usage, and spelling errors.

Good
12 (12%) – 13 (13%)

Above average writing style and logically organized using standard English with minor errors in grammar, punctuation, usage, and spelling.

Fair
11 (11%) – 11 (11%)

Average writing style that is sometimes unclear and/or with some errors in grammar, punctuation, usage, and spelling.

Poor
0 (0%) – 10 (10%)

oor writing style lacking in standard English, clarity, language used, and/or contains frequent errors in grammar, punctuation, usage, and spelling. Needs work.

Feedback:

APA–

Levels of Achievement:

Excellent
5 (5%) – 5 (5%)

Contains no APA errors.

Good
4 (4%) – 4 (4%)

Contains 1–2 APA errors.

Fair
3.5 (3.5%) – 3.5 (3.5%)

Contains 3–5 APA errors.

Poor
0 (0%) – 3 (3%)

Contains more than 5 APA errors.

Feedback:

Total Points: 100

Name: PRAC_6675_Week11_Assignment_Rubric

Assignment: Journal Entry

Critical reflection on your growth and development during your practicum experience in a clinical setting helps you identify opportunities for improvement in your clinical skills, while also recognizing your strengths and successes.

Use this Journal to reflect on your clinical strengths and opportunities for improvement, the progress you made, and what insights you will carry forward into your next practicum. 

To Prepare

·

Refer to the “Population-Focused Nurse Practitioner Competencies” in the Learning Resources and consider the quality measures or indicators advanced practice nurses must possess in your specialty.

· 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; consider the patient activities you have experienced in your practicum experience and 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 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 were available?

· What evidence-based practice did you use for the patients?

· What would you do differently? 

· How are you managing patient flow and volume?  How can you apply your growing skillset to be a social change agent within your community?

·

Communicating and Feedback

· Reflect on how you might improve your skills and knowledge and how to communicate those efforts to your Preceptor.

· Answer these questions: How am I doing? What is missing? 

· Reflect on the formal and informal feedback you received from your Preceptor. 

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14

ClinicalSkills Self-Assessment

Student’s Name

Institutional Affiliation

Professor’s Name

Course

Date

Clinical Skills Self-Assessment

Everyone possesses some qualities that are referred to as strengths and weaknesses. Both a person’s strengths and limitations can affect the decisions that person makes. As a nursing student, I need to become aware of my strengths and weaknesses. Comparing one’s strengths to one’s weaknesses helps one grow as a person through time, and having solid powers can help someone become more focused. This paper will discuss the three strengths and weaknesses and the three clinical skills that a nursing student would like to have mastered before graduating from the nursing program.

Strengths

My first strength is Communication Skills. Communication skill is the ability to communicate clearly and effectively with coworkers, patients, and families. Even the people who worked under me and in the office while I was a supervisor informed me that I had an excellent capacity to communicate and engage with others. According to Mata et al. (2021), respect, comfort, open communication, and reassuring the patient are the foundations of a healthy connection. This is the first step in developing a positive working relationship with the patient. Instead of offering my thoughts, I made it a point to pay attention to what my patients had to say. By doing so, I can comprehend what my patient is attempting to convey, allowing me to provide an appropriate response. At the beginning of a meeting between a patient and a provider, I like to start by asking open-ended questions. Then at the end, I want to ask “if there are any additional questions or concerns I can answer before I leave the room.” I show respect for them by providing the correct response, which indicates that I am paying attention to the conversation that they are having.

My second strength is the documentation. According to Svavarsdottir & Gisladottir (2019), maintaining charts promptly is a vital task in nursing. One of my most remarkable abilities is creating multiple papers at the same time. During my initial stint as a nurse, I spent significant time documenting activities similar to those I perform today. Even while we may believe that we have excellent memories, the truth is that after a particularly hectic day, we frequently fail to recall many of the events that took place.

My third strength is Professionalism. The characteristics of Professionalism include the ability to collectively express Professionalism, the ability to receive constructive critique constructively, respect for the worth of time, and the ability to dress and speak appropriately. Whenever I have a clinical conversation with my management, I make it a point to tell my manager to correct me whenever I err in any way. One of my superiors responded that I have a strong drive to learn in an interested, considerate, always open to advise, and always want to expand his own space approach.

Weaknesses

My first weakness is the differential diagnosis. According to Rofiqi et al. (2019), accurate diagnosis is achieved by collecting subjective and objective data and through focused assessment and comprehensive patient history. Having said that, there are times when I fail to recognize a different diagnosis. At one point, my boss suggested that I think about the possibility of having a condition that could be life-threatening. The recognition of patterns and indications is one method that can be utilized to address this condition.

My second weakness is Medication Prescribing. My most significant concern is that a paediatrician will mistakenly take the wrong medication. I did not want to go an excessive distance, nor did I want to be treated poorly. My plan to become a skilled nurse is to collaborate with my supervising physician anytime I have second thoughts about prescription medication; use evidence-based research; carry meds in a pocket next to me; use currently; and download other helpful apps, such as Epocrates.

My third and last weakness is the Scope of Services. As family nurse practitioner students, we are encouraged to decline the services outside of our legal scope of practice. However, in the real world, the situation is a little different. I am one of those who do not dare to say no to the supervising physician or the management team. As a nurse practitioner student, I have often witnessed nurse practitioners going out of their legal scope of practice because of the pressure of administration. How do we deal with that type of situation? As a nurse practitioner, if I feel trapped in a particular case, I feel like it is out of my scope of practice. I would gather the courage to say no or tell the administration to provide me with enough orientation to do specific tasks, go to an alternative physician for consultation, and ensure that my competencies and experiences are enough to handle specific services or cases.

Possible goals and objectives for this practicum experience

My first goal is to develop competencies in suturing. Under this goal, my first objective is to be exposed to suturing during my clinical rotations; however, I still feel that I need to work on known tying techniques. I have mentioned to my preceptor that I would like to get some hands-on if we get a patient who would require suturing. My third objective is to gain more confidence and get near-perfect; I have been using the tissue model to master the suturing skill.

My second goal is to develop competencies in cervical dilation. When I visited the source of the problem at the clinic, I conducted a significant number of tests on the vaginal area. IT IS THE MOST CHALLENGING PART OF MY JOB when I have to examine pregnant women’s cervix for dilation. My current physician is incredibly knowledgeable. As a result, she has given me permission to open a cervix that is already present. My provider and I always sought the patient’s consent before treating pregnant patients whenever they came into the clinic. In addition, I intend to adhere to the recommended instructions for women’s health experts, which provide a more in-depth demonstration of how to locate cervical dilatation. According to Zhao et al. (2020), practice makes perfect. I am resolute that before I finish my clinical course, I will have reached the level of expertise required to be considered a professional in this ability.

My third and last goal is to differentiate between skin conditions. According to Hudson et al. (2020), for a freshly qualified nurse, dealing with thinning skin can be an extremely stressful and perplexing experience. It may be difficult to distinguish the skin’s condition based solely on its appearance; therefore, it is essential to consider the entire clinical presentation to help make an accurate diagnosis. This may include assessing the formation of rashes, location, and other associated symptoms.

References

Hudson, M. P., Thompson, A. R., & Emerson, L. M. (2020). Compassion-focused self-help for psychological distress associated with skin conditions: a randomized feasibility trial. Psychology & Health, 35(9), 1095-1114.

Mata, Á. N. D. S., de Azevedo, K. P. M., Braga, L. P., de Medeiros, G. C. B. S., de Oliveira Segundo, V. H., Bezerra, I. N. M., … & Piuvezam, G. (2021). Training in communication skills for self-efficacy of health professionals: a systematic review. Human resources for health, 19(1), 1-9.

Rofiqi, E., Nuritasari, R. T., & Wiliyanarti, P. F. (2019). Factors affecting the organizational commitment of nurses in comprehensive health services: A systematic review. Jurnal Ners, 14(3), 195-198.

Svavarsdottir, E. K., & Gisladottir, M. (2019). How do family strengths‐oriented therapeutic conversations (FAM‐SOTC) advance psychiatric nursing practice?. Journal of Nursing Scholarship, 51(2), 214-224.

Zhao, B., Lv, M., Dong, T., Chen, Y., Xi, F., Lv, W., & Luo, Q. (2020). Transverse parallel compression suture: a new suturing method for successful treating pernicious placenta previa during cesarean section. Archives of gynaecology and obstetrics, 301(2), 465-472.

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-TR 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 modalities across 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:

My strengths includes communication, documentation, and professionalism. Having worked in the psychiatric clinic for some time now, I can confidently differentiate communicate, ensure proper documentation of records, and I can practice professionalism. My communication skills enables me to comprehend what it is that my patient is attempting to convey, allowing me to provide an appropriate response. At the beginning of a meeting between a patient and a provider, I like to start by asking open-ended questions, and then at the end, I like to ask “if there are any additional questions or concerns I can answer before I leave the room.” I show respect for them by providing the correct response, which indicates that I am paying attention to the conversation that they are having. One of my greatest abilities is also being able to create multiple papers at the same time. During my initial stint as a nurse, I spent a significant amount of time documenting activities similar to those I perform today. Even while we may believe that we have excellent memories, the truth is that after a particularly hectic day, we frequently fail to recall many of the events that took place. Lastly is professionalism, Whenever I have a clinical conversation with my management, I make it a point to tell my manager to correct me whenever I err in any way. One of my superiors actually provided me with the response that I have a strong drive to learn in an inquisitive, considerate, always open to advice, and always want to expand his own space approach.

Opportunities for growth:

An area of opportunities for growth that I need to explore during the practicum experience includes Differential Diagnosis, Medication Prescribing, and Scope of Services. Accurate diagnosis is achieved by the collection of data, both subjective and objective, as well as through focused assessment and a comprehensive patient history. Having said that, there are times when I fail to recognize a different diagnosis. At one point, my boss suggested that I think about the possibility of having a condition that could be life-threatening. The recognition of patterns and indications is one method that can be utilized in order to address this condition. On medication prescribing, My greatest concern is that a pediatrician will mistakenly take the wrong medication. I did not want to have to go an excessive distance, nor did I want to be treated poorly. My plan to become a skilled nurse is to collaborate with my supervising physician anytime I have second thoughts about prescription medication; use evidence-based research; carry meds in a pocket next to me; use current; and download other helpful apps, such as epocrates. Lastly on the scope of services, As a family nurse practitioner student, we are encourage to decline the services that are outside of our legal scope of practice. However, in real world the situation is little different. I am one of those people who do not have the courage to say no to the supervising physician or to the management team. As a nurse practitioner student, many times I have witnessed nurse practitioner going out of their legal scope of practice because of the administration pressure.

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

1. Goal: Develop competencies in suturing

a. Objective: To work on known tying techniques

b. Objective: To gain more confidence

c. Objective: Get to the near perfect

2. Goal: Develop competencies in Cervical Dilation

a. Objective: Evaluate the source of the problem at the clinic

b. Objective: Gain more knowledge on cervical dilation

c. Objective: To adhere to the recommended instructions for women health experts

3. Goal: How to differentiate between skin conditions

a. Objective: To gain more knowledge on skin

b. Objective: Evaluate the treatment plans for skin

c. Objective: Collaborate with my preceptor in evaluating the difference between skin conditions.

Signature:

Date:

Course/Section:

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