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Journal Entry 2

Student Name

Institution

Date
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Despite being an entrant that required considerable supervision in certain aspects, such as

recognizing symptoms of psychiatric diseases, recognizing clinical signs, and sometimes

differentiating psychopathology and pathophysiology in patients, I admit that I gained

considerable experience and developed my professional capabilities during my period as a

practitioner. Undoubtedly, I improved in building up confidence and proficiency in diagnosing

psychiatric illnesses, implementing treatment plans, and administering the treatments, as Esteves

et al. (2019) establish. Additionally, I improved my skills at delivering a mental status

examination, which are some of the skills I believe are needed by beginners and professionals

alike. Although the practice helped me acquire these skills, I will still need to reinforce them

through constant practice and allocating the time required to master the practice.

Nevertheless, the challenges were ubiquitous during my practicum nursing practice. One

of the most challenging areas was difficult communication, especially when handling adolescent

groups of patients. However, I dedicated my time and resources to getting these groups to open

up and share their issues to make the diagnostic process more straightforward; most resorted to

maintaining silence, which made communication difficult. Occasionally, this group of patients

initiated conversations by themselves after being allowed some space and time to think, which

helped me cope with this group of patients. Even so, their behavior made it difficult to work

forward with them.

Moreover, I had challenges setting boundaries at the beginning of my practicum, but I

later adapted after spending more time practicing and learning more about clear goal-setting

from the outset. In one instance, I handled client J.M in her late teens, who was a victim of

sexual trauma. In our twice-a-week sessions, her extremely violent experiences made me

emotional each time she narrated them, and I could sometimes become emotional, causing me to
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sob uncontrollably in front of the patient. Occasionally, I could misunderstand the client, owing

to the differences in our cultures and ages (Arguvanli, 2016): this caused the client to resort to

aggression and personal attacks whenever I questioned her experiences that I found unbelievable.

In setting boundaries, I learnt the importance of setting expectations from an early. Additionally,

I learnt that walking away from the patient is sometimes necessary to reinstate the set boundaries

and expectations. With time, I learned to make a list of my boundaries and implement clarity in

my priorities, which helped me cope with this difficulty.

The resources at my disposal ranged from my preceptor, who was always available and

ready to help or even intervene whenever such help was required to my library books, research

articles, and resources in the counseling office, which helped me cope with the challenges. It

became clear that continuous learning and self-education, as well as sharing with peers and

colleagues that are more experienced without breaching patient confidentiality, are some of the

tools that come in handy during nursing practice (Ahmadi et al., 2020). By the end of my

practicum, I had learnt through experience that treating, speaking to, and interacting with

adolescents must be done differently from adults. My preceptor shared the same sentiments when

I intimated with him about the tension and challenges I encountered with adolescents during my

clinical. During my practice, the importance of being grounded in evidence-based practice,

which Ahmadi et al. (2020) claim is crucial for effective interventions, also became apparent.

Other minor challenges, such as difficulty in ending or beginning a counseling session,

were also improved during my nursing practice because I noted that they could be solved by

reviewing a patient’s files and charts before a session is crucial for a successful outcome. Even

so, I need to better my knowledge and competence in the field of personality disorders. The
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clinical practice enabled me to experience the importance of interacting with other staff during

practice.
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Reference

Ahmadi, S., Abdi, A., Nazarianpirdosti, M., Rajati, F., Rahmati, M., & Abdi, A.

(2020). Challenges of Clinical Nursing Training through Internship Approach:

A Qualitative Study. Journal of Multidisciplinary Healthcare, Volume 13, 891-

900. https://doi.org/10.2147/jmdh.s258112

Arguvanli, S. (2016). Views of Final Year Nursing Students about Internship in

Mental Health and Psychiatric Nursing. Journal of Psychiatric Nursing.

https://doi.org/10.5505/phd.2016.33042

Esteves, L., Cunha, I., Bohomol, E., & Santos, M. (2019). Clinical supervision and

preceptorship/tutorship: contributions to the Supervised Curricular Internship in

Nursing Education. Revista Brasileira De Enfermagem, 72(6), 1730-1735.

https://doi.org/10.1590/0034-7167-2018-0785