Reflection

Introduction

At the end of my Psychiatric Nurse Practitioner (PMHNP) program, I now look to reflect on the course and what I have gained from it at this point in my life and career. I have been an RN for 20 years, and I have a great deal of experience rooted in general medicine, with this being my first foray into psychiatry. The transition into psychiatric nursing has been a very rewarding challenge, and I have learned a great deal throughout the process. With this paper I will reflect on my clinical experiences, the barriers and facilitators that I encountered, my professional development, and my plans for the future.

Standards of Practice

The American Nurses Associations (ANA) Standards of Practice are important guidelines in understanding the responsibilities and duties of Advanced Practice Registered Nurses (APRNs). Three standards that I find particularly important are assessment, diagnosis, and implementation.

Assessment is an essential standard psychiatric nursing, as it involves taking on all the relevant and full data collection to know the patients health status. In my clinical rotations, I learned the importance of a thorough assessment in developing effective treatment plans. For example, during my Clinical Psychiatric Emergency Program (CPEP) experience, I encountered a patient presenting with acute psychosis. A detailed assessment included doing a mental status examination and history taking, both of which were helpful in determining the immediate interventions required.

Accurate diagnosis is an important standard in psychiatric nursing as it guides the treatment process. My rotations taught me the challenge of psychiatric diagnoses and the need for a deep understanding of mental health conditions. At Mind Over Matter outpatient clinic, I dealt with patients presenting with overlapping symptoms of depression and anxiety. Accurate diagnosis required differentiating between these conditions through careful analysis of symptoms and patient history.

Implementation of the treatment plan is where theory meets practice. I learned firsthand that it involves administering treatments and educating patients about health and collaborating with other healthcare professionals to deliver great care. For example, in my CPEP rotation, I was involved in crisis intervention and stabilization, which required quick implementation of treatment plans to manage acute psychiatric episodes.

Reflection on Clinical Experience

Barriers and Facilitators

During my clinical rotations, I encountered some barriers that I initially saw as challenges to my development as a Psychiatric Nurse Practitioner. One of the biggest barriers was my lack of experience with therapeutic modalities. Having spent most of my nursing career in general medicine, transitioning to a psychiatric setting where therapeutic conversations and evidence-based therapies were at the forefront was simply just something I was not used to. I had to basically learn on my feet about engaging patients in meaningful therapeutic dialogue and applying specific therapeutic techniques. Truth be told, it was something of a steep learning curve. I often found myself struggling at first to keep up these conversations effectively, and this definitely took a toll on my confidence. I felt that my initial patient interactions were not top-tier quality for that reason. Over time, however, continuous practice and guidance from experienced practitioners helped me improve in this area.

Another barrier was limited access to electronic health records (EHRs). Efficient documentation and easy access to patient information in my experience are essential for providing high-quality care. However, restricted computer access occasionally blocked my ability to document patient interactions promptly and review important patient history and treatment plans. I felt that this limitation, slight as it may be, sometimes led to delays in decision-making and patient care management, which may have contributed to my stress in an already demanding clinical environment.

Despite these barriers, several facilitators significantly contributed to my learning and professional growth. Foremost...

A study by Fuglsang et al. (2021) emphasized the effectiveness of simulation training in improving clinical skills and confidence among nursing students. Therefore, I believe that using simulation training is also a key step in improving my clinical skills. Simulation training will help me to practice in a safe environment with realistic scenarios, were I can focus on my ability to respond to various psychiatric emergencies and practice therapeutic communication and make assessments.

I also want to make sure I am taking proper self-care, as this is yet another important recommendation of the ANA regarding practice. In fact, Linton and Koonmen (2020) state that that self-care is an ethical principle that nurses need to adhere to. For me, this means making sure I am not overworking myself and that I am taking care to rest so that I can give optimal care when called upon to deliver.

Future Utilization of Degree

Upon graduation and passing the boards, I want to obtain a position in an emergency psychiatric department. I foresee myself working in a fast-paced environment where I can apply my skills in acute psychiatric care. Six months post-graduation, I hope to be well-integrated into my role and able to contribute to patient care while at the same time being able to continue my professional development with ongoing education and clinical practice.

Conclusion

Reflecting on my work in the PMHNP program, I can look back and see all the immense growth and learning that has taken place for me and feel a great deal of appreciation for my mentors. From overcoming initial barriers to developing crucial skills, each experience has helped shape me for my future role as a Psychiatric Nurse Practitioner. With a commitment to continuous learning and professional development, I look forward to contributing to the field of psychiatric…