Population-Focused Nurse Practitioner Competencies

Order Instructions
• Refer to the “Population-Focused Nurse Practitioner Competencies” found in the Week 1 Learning Resources, and consider the quality measures or indicators advanced nursing practice nurses must possess in your specialty of interest.
• Refer to your Clinical Skills Self-Assessment Form you submitted in Week 1, and consider your strengths and opportunities for improvement.
• Refer to your Patient Log in Meditrek, and consider the patient activities you have experienced in your practicum experience and reflect on your observations and experiences.
JOURNAL ENTRY (450–500 WORDS)
Learning From Experiences
• Revisit the goals and objectives from your Practicum Experience Plan. Explain the degree to which you achieved each during the practicum experience.
• Reflect on the three (3) most challenging patients you encountered during the practicum experience. What was most challenging about each?
• What did you learn from this experience?
• What resources were available?
• What evidence-based practice did you use for the patients?
• What would you do differently?
• How are you managing patient flow and volume?
• How can you apply your growing skillset to be a social change agent within your community?
Communicating and Feedback
• Reflect on how you might improve your skills and knowledge, and communicate those efforts to your Preceptor.
• Answer the questions: How am I doing? What is missing?
• Reflect on the formal and informal feedback you received from your Preceptor.

Reflect on the three (3) most challenging patients you encountered during the practicum experience. What was most challenging about each?
1. JP: CC:” I fought my sister and my mother” HPI:JP is a 13y/o male that presented with report of aggression and property destruction at home. He threatened to fight his sister and mother over $5 that he needed and was denied. Reported that he is using cannabis in the last 2months. Mother stated that his father provided him with cannabis and has been modeling bad behaviors. Has being skipping school, roaming the street at night, not eating at home, coming, and leaving at will. Pt has refused mental and medical care for the past one year and has not taken any prescribed medications. He took Vyvanse last year for ADHD. Pt. denied SI/HI, AH/VH. Past Psychiatric history: History of DMDD, conduct disorder, Cannabis abuse, and ADHD. Inpatient psychiatric hospitalization in July 2018, and August 2022 Medication trail Sertaline 50mg QD, Vyvanse 30mg daily, Abilify 2mg daily, Seroquel 50mg QHS, and Clonidine 0.1 BID. Allergies: NKD/F allergies, no seasonal Allergy. Family Hx: Pt. lives with his mother, 15 y/o brother and 10y/o sister. Mother has depression and anxiety, his father has hx of substance dependency. MSE:AV is alert and orients to person, place, time, and situation. Appeared unkempt and anxious. Eye contact is intermittent, speech is clear and coherent, thought process concrete, mood is impatient and irritable, and affect is labile, and have very poor insight of mental health condition. Plan Order lab: CBC, CMP, Lipid panel, vitamin D level, urine toxicology, HgbA1c, TSH. Start on Seroquel 50mg QHS and titrate Zoloft 50mg QD and Clonidine 0.1mg BID Vvyanse 30mg QD Refer to psychotherapy Follow up in two weeks.
2. WN: CC: “I was Cursing my grandmother” HPI: WN is a 15y/o female that was brought in by her grandmother to be evaluate for increase agitation, irritability, aggressiveness and cursing at her grandmother. Grandmother reported that the verbal aggression has progressed to occasional physical aggression. Pt. has run away from home several times and engaged in risky behaviors like having unprotected sex with multiple people she randomly meet. Will return home intoxicated. Have no regard or respect for her grandmother whom she live with, Destroys things in the house and have no remorse for her behaviors. Her grandmother thinks medication is not working effectively and need her medication reviewed and adjusted. Past Psychiatric History: Diagnosed with autism spectrum, ADHD, DMDD, and conduct disorder. Had two psychiatric hospitalization in 10/2021 and 08/2022. Has had psychotherapy which she was noncompliant in attending. Family Hx: Her mother is deceased, her father not in involved in her life. Live with his grandmother and aunt. Allergy: NKDA, no seasonal allergy. Medication: Clonidine 0.1mg BID, Citalopram 40mg QAM, Perphenazine 4mg BID, Adderall XR 20mg QAM. MSE: WN is alert and oriented x 4, appeared disheveled, appropriately dressed with intermittent eye contact, speech is clear and coherent, normal rate and rhythm, thought process concrete, no delusional thoughts noted, mood is irritable, labile affect, poor insight, denies SI/HI, AH/VH. Labs: CBC, BMP, Lipid panel, urine toxicology, pregnancy test, TSH, HgbA1c, Vitamin D level. Plan: Increase Clonidine to 0.2 QHS and 0.1mg QAM, increase Perphenazine 8mg QHS and 4mg QAM. Adderrall XR 20mg QAM, Citalopram 40mg QAM. Encourages pt. to learn and use coping skills Refer to psychotherapy Follow up in two weeks.
3. JG: CC: “I got physical with staff” HPI: JG is a 18y/o female psychiatric history significant for PTDS and Borderline personality disorder. Pt. live in a group and was brought in to be evaluated after attacking one of the staff memeber for not allowed to bring in a male friend in the apartment. Pt. has a significant trauma history during childhood while living with her biological mother. Removed by CPS from her mother’s care and placed in foster home at age 7, unable to abide by the foster parent’s rule and has been kicked out of multiple foster home for aggression and noncompliant. Currently residing in a group home. Struggling with worsening aggressive behaviors and threw a chair at one of the staff member. Past Psychiatric History: ADHD, PTDS, and Borderline personality disorder. In psychotherapy. Has had multiple psychiatric hospitalizations for aggressive and reckless behaviors. Last hospitalization 5/2022. Social Hx. Pt. completed 12th grade, live with three other female in the group home, work part time in a fast food restaurant, Smokes cigarette but denied drug and alcohol use. Sexual active with two partners, occasional uses condom, not on any birth control, has not been pregnant or have any child. Family Hx: Mother deceased in 2019, had history of bipolar and substance use, father estranged, not involve in her life. Have no siblings. Allergy: NKDA, no seasonal allergy. Medication: Lamotrigine 100mg BID, Guanfacine ER 1mg QAM, Abilify 10mg QAM, MSE: JG is calm and cooperative, alert and oriented x 4, well kempt, appropriately dressed with good eye contact, speech is clear and coherent, normal rate and rhythm, good concentration, thought process organized, no delusion noted, good insight, Denies SI/HI, AH/VH. Endorses sleeping and eating well. Labs: CBC, CMP, Lipid panel, HgA1C, urine toxicology urine pregnancy, Vitamin D level. Plan: Increase Lamotrigine 150mg BID, Guanfacine ER 2mg QAM, Abilify 10mg QAM Continue with psychotherapy, encourages pt. to use coping skills. Will follow up in two weeks.

Rubric
PRAC_6665_Week11_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeAssimilation and Synthesis: Content Reflection 50 to >44.0 pts
Excellent
Reflection demonstrates a high level of critical thinking in applying and integrating key course concepts and theories from readings, lectures, and/or experiences. Insightful and relevant connections are made through contextual explanations and examples. 44 to >39.0 pts
Good
Reflection demonstrates moderate level of critical thinking in applying and integrating key course concepts and theories from readings, lectures, and/or experiences. Connections are made through explanations and/or examples. 39 to >34.0 pts
Fair
Reflection demonstrates minimal critical thinking in applying and integrating key course concepts and theories from readings, lectures, and/or experiences. Minimal connections made through explanations and/or examples. 34 to >0 pts
Poor
Reflection lacks critical thinking. Superficial connections are made with key course concepts and resources, and/or assignments.
50 pts
This criterion is linked to a Learning OutcomeAssimilation and Synthesis: Personal Growth 30 to >26.0 pts
Excellent
Expresses solid evidence of reflection on own work. Demonstrates substantial personal growth and awareness of deeper meaning through inferences, well developed insights, and significant depth in awareness and challenges. Synthesizes current experience into future implications. 26 to >23.0 pts
Good
Expresses moderate evidence of reflection on own work. Demonstrates satisfactory personal growth and awareness through some inferences, insights, and challenges. There is mention of the future implications of student’s current experience. 23 to >20.0 pts
Fair
Expresses minimal evidence of reflection on own work. Demonstrates less than adequate personal growth and awareness through limited or simplistic inferences made, insights, and/or challenges that are not well developed. Minimal thought of future implications of student’s current experience. 20 to >0 pts
Poor
Expresses inadequate evidence of reflection on own work. Personal growth and awareness are not evident and/or demonstrate an impersonal experience. Lacks personal insights, challenges, inferences, and/or future implications are overlooked.
30 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting 15 to >13.0 pts
Excellent
Well written and clearly organized using standard English, characterized by elements of a strong writing style and basically free from grammar, punctuation, usage, and spelling errors. 13 to >11.0 pts
Good
Above average writing style and logically organized using standard English with minor errors in grammar, punctuation, usage, and spelling. 11 to >10.0 pts
Fair
Average writing style that is sometimes unclear and/or with some errors in grammar, punctuation, usage, and spelling. 10 to >0 pts
Poor
Poor writing style lacking in standard English, clarity, language used, and/or frequent errors in grammar, punctuation, usage, and spelling. Needs work.
15 pts
This criterion is linked to a Learning OutcomeAPA 5 to >4.0 pts
Excellent
Contains no APA errors. 4 to >3.5 pts
Good
Contains one to two (1–2) APA errors. 3.5 to >3.0 pts
Fair
Contains three to five (3–5) APA errors. 3 to >0 pts
Poor
Contains more than five (>5) APA errors.
5 pts

Collepals.com Plagiarism Free Papers

Are you looking for custom essay writing service or even dissertation writing services? Just request for our write my paper service, and we'll match you with the best essay writer in your subject! With an exceptional team of professional academic experts in a wide range of subjects, we can guarantee you an unrivaled quality of custom-written papers.

Get ZERO PLAGIARISM, HUMAN WRITTEN ESSAYS

Why Hire Collepals.com writers to do your paper?

Quality- We are experienced and have access to ample research materials.

We write plagiarism Free Content

Confidential- We never share or sell your personal information to third parties.

Support-Chat with us today! We are always waiting to answer all your questions.