Clinical Journal 5024

This is an exciting time for me as we end this educational course, it is time to bring all of our

experiences together and start the foundation for our future practice. On my first day of clinical, I

had a pediatric patient that presented a new opportunity and experience. I am very concerned

about this particular patient. A 15-year-old presented to the clinic for what was scheduled as a

well visit that quickly turned into more. This child presented with his step-mother and overall the

physical went well; however, there was an immediate change in the patient’s demeanor that

clearly identified the psychological issues this patient possessed. My preceptor expresses this

was not a normal occurrence in the clinical setting. Although, it was a sad occurrence for the

patient and clinical staff it was truly a learning experience for me. I was also able to bring some

knowledge to this situation that proved to be helpful to some of the clinic staff as well as provide

guidance in my future practice. Due to this experience, I will incorporate this learning experience

into my practice by ensuring that all staff are well educated on the process to follow in the event

we have a psychiatric patient in the facility. All staff will have easy access to crucial phone

numbers, such as the local police department, and crisis center. My staff will also fell

empowered to call 911 when necessary or in the event they feel anyone is in danger.

1. What goal did you meet this week that you and your preceptor discussed?

This is the first week of a new semester. Thank God for the journey thus far. I am

precepting with the same preceptor that I had last semester, she and I were working on

me becoming more proficient with the electronic medical record. I documented with

minimal support today and fell as if a goal was met as I had retained knowledge gained

from last semester.

2 What areas does your preceptor feel that you need to work on for next week?

Next week the goal is for me is to become more familiar with the final stages of the

documentation process. Also, the goal is for me to become familiar with psychiatric

services in our area.

3 What did you do this week that made you feel you gained confidence in a particular

area of patient care? We had a pediatric patient present to the clinic for a well visit that

transitioned to a sick visit. This patient expressed suicidal ideations during his visit. The

staff at the clinic was not certain of the proper process, and I was. Therefore, I had the

opportunity to teach them.

4 Reflect on a challenging clinical situation or a situation where you did not feel

confident in a particular area of patient care. This particular patient was a flight risk,

and he did elope, 911 was called, the city police responded although they detained him

they refused to stay with the patient and facilitate a safe environment. This made me feel

less confident as well as the clinical staff. Our goal was to provide a safe environment for

the patient and others that was on campus the officer made us feel as if we were out of

line asking for his assistance.

5 How did you handle the situation? My preceptor and I explained to the officer the

condition of this patient was out of his control and he needed in-patient medical treatment

which we were in the process of facilitating. The practice manager contacted his superior
 and a second officer was dispatched to the clinic. The second officer was caring and

compassionate he was able to deescalate the patient while providing a safe environment.

6 What have you done or will you do to make you feel more prepared for this same

situation in the future? I will make myself aware of psych services that are available to

the community and review pediatric psychiatric disorders. I will also incorporate this

learning experience in my future practice.

7 Reflect on some areas of learning while in the clinical area that will benefit you the

most in your own practice. The greatest benefit for me from this situation is learning it

is okay to call for assistance when things are not going as they should as well as feeling

comfortable in reporting officials when they do not provide necessary services. Prior to

this, I would not have thought about reporting a police officer; however, it was necessary

for the greater good of this patient.

8 What course objective did you address this week? By preforming an individual risk

assessment to identify the health maintenance and health promotion needs of individuals

and families across the life span and implementing indicated interventions. I feel this was

met by performing a history and physical that led to the psychological findings of

potential self-harm as the patient expressed the desire to do self-harm if given the

opportunity to do so. This patient obviously has previous issues; the step-mother

appeared to be in denial of the severity of the situation. Through the knowledge gained
 from King University’s Family Nurse Practitioner program, I was able to apply this

knowledge and facilitate proper care for this particular patient.

9 Describe how you integrated one of the SON’s Professional Pillars during your

clinical experience this week. Commitment is King University’s Professional Pillar of

Commitment I integrated this week in my clinical experience. I feel I will be more

prepared to serve not only my patients that present with psychiatric issues but will also be

better prepared to serve my future staff to maintain a safe environment and meet the acute

needs of my patients. I will also be committed to providing services necessary to

facilitate the educational needs of parents and or caregivers of pediatric patients with a

disease process they are not familiar with and provide them with available community

support services and groups.