Unit 11-Assignment Journal Reflection on GAD generalized anxiety disorder. 800w. due 7-20-24. 4 references.
Instructions
You will create 5 entries for your Reflective Journal about a patient encounter. In the 5th entry, you will review the previous 4 entries and evaluate your progress in reflective practice over the course of the term.
The purpose of this reflective journal is self-reflection regarding the role in the process of self-reflection as a PMHNP provider. Through reflective practice, the student will evaluate their own emotional health and recognize one’s own feelings as well as one’s ability to monitor and manage those feelings. The point of the exercise is to learn yourself, your triggers, the types of cases you end up getting overly involved with, and those you’d rather refer to someone else. The idea is to be able to personally reflect on your behaviors/thoughts/decisions and how those impact you in the role of PMHNP.
· Discuss the same patient from the previous assignment Unit 11 SOAP notes on GAD generalized anxiety disorder.
1. What impact this had on you in terms of increasing your understanding of the PMHNP role,
2. psychopathology, and the
3. provider-patient relationship.
4. Explore your personal strengths and limitations and their effect on the provider/patient relationship.
5. Include reflection on your therapeutic use of self.
6. Discussion should reflect your specific learning/insight.
7. Identify something specific that you learned from reflecting on this event/interaction and how will you apply that learning in your future practice?
Resource to use
Course Description
This course prepares students to assess, diagnose, and manage mental health care needs across the lifespan. Emphasis will be placed on underlying acute and chronic psychiatric/mental health diagnoses. Clinical opportunities will be utilized for all PMHNP to apply concepts in primary and acute care settings with adults and families.
Program: Graduate Nursing
Resources
Carlat, D. J. (2023). The psychiatric interview (4th ed.). Philadelphia, PA: Wolters Kluwer. ISBN: 9781975212971
American Nurses Association & American Psychiatric Nurse Association. (2015). Psychiatric–mental health nursing: Scope and standards of practice (2nd ed.). Silver Spring, MD: American Nurses Credentialing. ISBN-13: 978-1558105553 ISBN-10: 1558105557
American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Text Revision Dsm-5-tr (5th ed.) (DSM-5). Washington DC: APA Press. ISBN: 978-0890425763
Johnson, K., & Vanderhoef, D. (2016). Psychiatric mental health nurse practitioner review manual (4th ed.). Silver Spring, MD: American Nurses Association. ISBN: 978-1-935213-79-6
Robert Joseph Boland, Verduin, M. L., Ruiz, P., Arya Shah, & Sadock, B. J. (2021). Kaplan and Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (12th ed.). Philadelphia, PA: Lippincott Williams, and Wilkins. 9781975145569
Recommended
Bickley, L. (2016). Bates’ Guide to Physical Examination and History-Taking [VitalSouce bookshelf version]. https://batesvisualguide.com/. Eleventh, North American Edition; Lippincott Williams & Wilkins: ISBN 1609137620
Corey, G. (2016). Theory and practice of counseling and psychotherapy (10th ed.). Boston, MA:Cengage. ISBN: 9781305263727
Heldt, J. P., MD. (2017). Memorable psychopharmacology. Create Space Independent Publishing Platform. ISBN-13: 978-1-535-28034-1
Shea, S. C. (2017). Psychiatric interviewing: The art of understanding (3rd ed.) Elsevier.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press. ISBN 978-1-107-68646-5
Stahl, S. M. (2020). Prescriber’s guide: Stahl’s essential psychopharmacology (7th ed.). Cambridge University Press. ISBN 978-1108926010
**Reflective Journal on Generalized Anxiety Disorder (GAD) Patient Encounter**
—
### Entry 1: Initial Encounter and Impact on Understanding PMHNP Role
During my initial encounter with a patient diagnosed with Generalized Anxiety Disorder (GAD), I felt a significant increase in my understanding of the PMHNP role. The patient, a 34-year-old female, presented with excessive worry about multiple aspects of her life, including work, family, and health. This encounter allowed me to apply my theoretical knowledge to practice, highlighting the importance of thorough assessments, accurate diagnosis, and individualized treatment plans in the PMHNP role (American Psychiatric Association, 2022).
My primary responsibility was to conduct a comprehensive psychiatric evaluation, which involved gathering a detailed history, conducting a mental status examination (MSE), and considering differential diagnoses. This process emphasized the complexity of the PMHNP role, requiring both clinical skills and empathy to build a therapeutic alliance with the patient. It underscored the importance of listening to the patient’s concerns and validating their experiences, which are critical components in fostering trust and engagement in treatment.
### Entry 2: Understanding Psychopathology
This patient encounter deepened my understanding of the psychopathology of GAD. I learned to recognize the hallmark symptoms of GAD, such as pervasive worry, restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbances (American Psychiatric Association, 2022). It was essential to differentiate these symptoms from other anxiety disorders and mood disorders, which often present with overlapping features.
Through this experience, I also gained insight into the potential etiologies of GAD, including genetic predispositions, neurobiological factors, and environmental stressors. This holistic understanding of psychopathology is crucial for developing effective treatment plans that address both the symptoms and underlying causes of the disorder (Carlat, 2023). Additionally, it highlighted the importance of considering comorbid conditions, such as depression, which frequently coexist with GAD and complicate the clinical picture.
### Entry 3: Provider-Patient Relationship
The provider-patient relationship was a focal point of this encounter. Establishing a therapeutic relationship based on trust and empathy was vital for effective treatment. I observed that active listening, maintaining eye contact, and providing a non-judgmental space encouraged the patient to open up about her worries and fears. This approach facilitated a more accurate and comprehensive understanding of her condition.
Building this relationship also involved educating the patient about GAD, its symptoms, and treatment options. By involving the patient in the decision-making process, I was able to empower her and enhance her adherence to the treatment plan. This experience reaffirmed the importance of patient-centered care and the need to view patients as active partners in their mental health journey (Johnson & Vanderhoef, 2016).
### Entry 4: Personal Strengths and Limitations
Reflecting on this encounter, I identified several personal strengths and limitations that impacted the provider-patient relationship. One of my strengths was my ability to empathize with the patient, which helped in building a rapport and gaining her trust. My thorough knowledge of GAD and its treatment options also enabled me to provide comprehensive care.
However, I also recognized some limitations. At times, I found myself feeling overwhelmed by the patient’s extensive worries, which could potentially affect my clinical judgment. Additionally, I realized that I need to improve my skills in managing my own emotional responses during patient encounters. This self-awareness is crucial for preventing burnout and maintaining professional boundaries (American Nurses Association & American Psychiatric Nurses Association, 2015).
### Entry 5: Therapeutic Use of Self and Future Application
Reflecting on my therapeutic use of self, I realized the importance of self-awareness and self-regulation in clinical practice. Being mindful of my own emotional state and its impact on the patient encounter allowed me to provide better care. I learned to use empathy and active listening as therapeutic tools while maintaining professional boundaries.
One specific learning from this reflection is the need to continuously develop coping strategies to manage my emotional responses. This will help me remain composed and effective in my role as a PMHNP. Moving forward, I plan to incorporate regular self-reflection and mindfulness practices into my routine to enhance my emotional resilience and professional competence.
In conclusion, this reflective practice has been instrumental in enhancing my understanding of the PMHNP role, psychopathology, and the provider-patient relationship. It has also helped me identify my strengths and areas for improvement, which I will continue to work on in my future practice. Through this process, I aim to provide compassionate, evidence-based care to my patients, while also ensuring my own emotional well-being.
### References
American Nurses Association & American Psychiatric Nurses Association. (2015). *Psychiatric–mental health nursing: Scope and standards of practice* (2nd ed.). American Nurses Credentialing Center.
American Psychiatric Association. (2022). *Diagnostic and Statistical Manual of Mental Disorders, Text Revision DSM-5-TR* (5th ed.). American Psychiatric Publishing.
Carlat, D. J. (2023). *The psychiatric interview* (4th ed.). Wolters Kluwer.
Johnson, K., & Vanderhoef, D. (2016). *Psychiatric mental health nurse practitioner review manual* (4th ed.). American Nurses Association.
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