Psychiatric mental health nurse practitioners (PMHNP) are essential professionals in the mental health management spectrum. The PMHNP is crucial in assessing, diagnosing, and treating behavioral and mental health illnesses (Gaines, 2020). Through clinical training, PMHNP students learn clinical skills necessary to achieve competency in their roles. The paper highlights the goals and objectives of the practicum experience based on clinical skills self-assessment, personal strengths and weaknesses related to the clinical skills, and a self-reflection of the practicum experience.(Clinical Skills Self Assessment Psychopathology and Diagnostic Reasoning Nursing Paper Example)

PRAC 6635 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 (Clinical Skills Self Assessment Psychopathology and Diagnostic Reasoning Nursing Paper Example)		✔
Performing and interpreting a functional assessment (activities of daily living, occupational, social, leisure, educational).		✔
Diagnostic reasoning skills 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(Clinical Skills Self Assessment Psychopathology and Diagnostic Reasoning Nursing Paper Example)		✔
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(Clinical Skills Self Assessment Psychopathology and Diagnostic Reasoning Nursing Paper Example)		✔
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(Clinical Skills Self Assessment Psychopathology and Diagnostic Reasoning Nursing Paper Example)			✔
Documenting and reflecting on learning experiences			✔
Professional skills:
Maintains professional boundaries and therapeutic relationships with clients and staff		✔
Collaborate with multi-disciplinary teams to improve clinical practice in mental health settings (Clinical Skills Self Assessment Psychopathology and Diagnostic Reasoning Nursing Paper Example)		✔
Identifies ethical and legal dilemmas with possible resolutions			✔
Demonstrates non-judgmental practice approach and empathy		✔
Practices within the 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(Clinical Skills Self Assessment Psychopathology and Diagnostic Reasoning Nursing Paper Example)			✔
Implements the screening instrument efficiently and effectively with the clients			✔
Interprets results for screening instruments accurately			✔
Develops an appropriate plan of care based on screening instruments response		✔
Identifies the need to refer to another specialty provider when applicable(Clinical Skills Self Assessment Psychopathology and Diagnostic Reasoning Nursing Paper Example)		✔
Accurately documents recommendations for psychiatric consultations when applicable	✔

Summary of strengths:

Diagnostic Reasoning: I am confident that I can formulate a diagnosis based on the DSM-5 and develop and prioritize differential diagnoses. Diagnostic Reasoning is crucial in making an accurate and timely decision regarding a patient’s health (Simpking et al., 2017).(Clinical Skills Self Assessment Psychopathology and Diagnostic Reasoning Nursing Paper Example)

Health Promotion: I am confident in applying age-appropriate psychoeducation and counseling to promote and prevent diseases. Psychoeducation is crucial in improving symptoms related to various mental health illnesses (Kramer & Bjorklund, 2021).

Clinical communication: I am confident I can document patient recommendations for appropriate psychiatric referrals. Communication is central to effective nurse-nurse and nurse-patient relationships (Ball et al., 2021).(Clinical Skills Self Assessment Psychopathology and Diagnostic Reasoning Nursing Paper Example)

Opportunities for growth:

· The first opportunity for growth is the appropriate selection of evidence-based clinical practice guidelines for medication planning.(Clinical Skills Self Assessment Psychopathology and Diagnostic Reasoning Nursing Paper Example)

· The second opportunity for growth is the need to develop competency in self-assessment skills, i.e., evaluating the outcomes of practicum goals, documenting and reflecting on learning experiences, and modifying the plan when necessary.

· The third opportunity for growth is the need to master the ethical and legal dilemmas in clinical practice and possible solutions.

· Lastly, I need to master the ability to develop an appropriate plan of care based on the outcome of patient screening.

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

· By the 10^th week of my practicum, I should be competent in selecting and implementing mental health screening instruments and interpreting results independently.(Clinical Skills Self Assessment Psychopathology and Diagnostic Reasoning Nursing Paper Example)

Objective: Consult with my preceptors during the practicum period.

Objective: Use the resources and material available in the clinical setting.

Objective: Review various screening tools and uses across different mental health illnesses.

· By the 10^th week of the practicum, I should be competent in evaluating, documenting, and reflecting on practicum goals and learning outcomes.

Objective: Write down the goals to be achieved during the practicum

Objective: Make daily notes of my practicum experience.

Objective: Make reflections on daily experiences across the clinical setting.

· By the 10^th week of the practicum, I should be competent in identifying ethical and legal dilemmas and mental health and possible resolutions.(Clinical Skills Self Assessment Psychopathology and Diagnostic Reasoning Nursing Paper Example)

Objective: Familiarize with the state’s scope of practices

Objective: Familiarize myself with the hospital’s ethical tenets.

Objective: Consult with my preceptor whenever necessary.

· By the 10^th week of the practicum, I should be competent in selecting and implementing various screening instruments, interpreting the results, recommending, and referring patients.

Objective: Review various screening instruments and relevant clinical situations.

Objective: consult with my preceptor whenever necessary(Clinical Skills Self Assessment Psychopathology and Diagnostic Reasoning Nursing Paper Example)

Objective: Refer to the guidelines before adopting any clinical screening instrument.

Self-Reflection

At the start of the practicum, I listed three goals to achieve by the end of the practicum experience. These goals were related to my areas of weakness as identified by the clinical self-assessment form. The first goal was to be competent in selecting and implementing mental health screening instruments and interpreting results. The second goal was to be competent in evaluating, documenting, and reflecting on practicum goals and learning outcomes. The third goal was to be competent in identifying ethical and legal dilemmas and mental health and possible resolutions. The fourth goal was to be competent in selecting and implementing various screening instruments, interpreting the results, and recommending and referring patients. All four goals were crucial since they determine my competency as a PMHNP and deliver quality and safe care.(Clinical Skills Self Assessment Psychopathology and Diagnostic Reasoning Nursing Paper Example)

To this end, I can confidently select and implement mental health screening instruments and interpret results. This goal was achieved through consistent consultation with my preceptor, using resources and material available in the clinical setting, and reviewing screening tools for various mental health illnesses. Similarly, I can confidently evaluate, document, and reflect on my practicum goals and learning outcomes. I achieved this goal by noting the goals to be achieved, recording daily experiences, and reflecting upon them. Furthermore, I can confidently identify the legal and ethical dilemmas in mental health and provide resolutions. I achieved this goal by familiarizing myself with the state’s scope of practice, the hospital’s ethical tenets, and consultation with my preceptor. Lastly, I can confidently select and implement various screening instruments and recommend and refer patients. I achieved this goal by reviewing multiple screening tools, consulting my preceptor, and referring to guidelines before adopting any screening instrument.(Clinical Skills Self Assessment Psychopathology and Diagnostic Reasoning Nursing Paper Example)

A problematic encounter during the practicum involved a 35-year-old Hispanic male with a history of pathological drinking and substance abuse. The patient was violent and resistant to every psychiatric intervention. In the end, the facility obtained a restraint order for the patient. Restraint is typically recommended for aggressive and violent mental health patients presently assessed to be at risk of harm to themselves and others (Ye et al., 2019). The other encounter involved a West African immigrant, a female aged 26 with a history of anxiety and depression due to intimate partner violence. The patient had not sought treatment in a long time since intimate partner violence is normal in her background, and she only came to the hospital following police intervention. Cultural affiliations determine how patients behave towards seeking treatment and coping with health outcomes (Gopalkrishnan, 2018).(Clinical Skills Self Assessment Psychopathology and Diagnostic Reasoning Nursing Paper Example)

Through the practicum, I have learned that mental health illnesses have a broad spectrum. The concept of the mental health continuum implicates how different people perceive mental health across various cultures (Peter et al., 2021). Clinical assessment is central to determining various mental health conditions’ causes and underlying determinants. A PMHNP is critical in assessing, diagnosing, and treating mental health conditions. Besides, I learned that ethical dilemma is a common aspect of mental health nursing. However, it is critical to understand the moral obligations in given jurisdictions and legal requirements when making decisions in conflicting situations. Evidence-based practice is vital in making clinical decisions and achieving positive patient health outcomes. Therefore, competency in various clinical skills is necessary to provide quality and safe mental health care services.(Clinical Skills Self Assessment Psychopathology and Diagnostic Reasoning Nursing Paper Example)

In conclusion, I had a crucial practicum as far as my career is concerned. I have benefited mainly from communication and feedback from my peers, licensed colleagues, and my preceptor. Ideally, communication and feedback are critical in pointing out areas that need improvement and how to improve them. Having achieved my practicum goals, I believe I still need to review all the skills learned, including screening tools, evidence-based practice, clinical documentation, and ethical and legal issues. I look forward to fostering formal and informal relationships with my peers, licensed PMHNP, mentors, and preceptors to continue learning and improving my clinical skills as a PMHNP student nurse.(Clinical Skills Self Assessment Psychopathology and Diagnostic Reasoning Nursing Paper Example)

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2021). Seidel’s Guide to Physical Examination-E-Book: An Interprofessional Approach. Elsevier Health Sciences.

Gopalkrishnan, N. (2018). Cultural diversity and mental health: Considerations for policy and practice. Frontiers in public health, 6, 179. https://doi.org/10.3389%2Ffpubh.2018.00179

Kramer, A., & Bjorklund, P. (2021). Implementation and evaluation of a psychoeducation program in an outpatient mental health center. Perspectives in Psychiatric Care, 57(1), 219-224. https://doi.org/10.1111/ppc.12552

Peter, L. J., Schindler, S., Sander, C., Schmidt, S., Muehlan, H., McLaren, T., … & Schomerus, G. (2021). Continuum beliefs and mental illness stigma: a systematic review and meta-analysis of correlation and intervention studies. Psychological medicine, 1-11. https://doi.org/10.1017%2FS0033291721000854

Simpkin, A. L., Vyas, J. M., & Armstrong, K. A. (2017). Diagnostic Reasoning: an endangered competency in internal medicine training. Annals of Internal Medicine, 167(7), 507-508. https://doi.org/10.7326/M17-0163

Ye, J., Wang, C., Xiao, A., Xia, Z., Yu, L., Lin, J., … & Zhang, Y. (2019). Physical restraint in mental health nursing: A concept analysis. International journal of nursing sciences, 6(3), 343-348. https://doi.org/10.1016%2Fj.ijnss.2019.04.002

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Clinical Skills Self Assessment Psychopathology and Diagnostic Reasoning