Clinical Journal 4/22/16
Today I was with the Nurse Practitioner for the first half of the day. There were two new admissions that I was able to observe. The first admission was a full assessment, and the second admission was a shortened assessment because one had been done one at the previous center he was at. It was nice to watch the full head-to-toe assessment and be able to recognize the assessment techniques she was doing and understand what she was looking for. I wasn’t able to watch the third admission of the day, but I was able to read her chart. I found her chart very interesting and I wish I had been able to interact with her. It stated in her chart that she wanted to murder her school counselor, but she also wanted to do a school shooting so that she would get the death penalty. This was shocking to me and so sad that she thought that way. She also had auditory hallucinations, and I wish I could have been able to see her and see if she was still having the hallucinations. After the new admissions, we went to the cafeteria and sat with some of the students. The student I sat and talked with told me that he had been away from his parents for 5 years, and they hardly contact him. I thought that was extremely sad, and feel that it probably doesn’t help him to not have his family active in his life. After lunch we had our own lunch and post conference, and then went to group therapy. I got to watch group therapy with the older girls. This was my first time being with the girls at the treatment center. In group therapy it was “positivity Friday”, and they talked the whole time about different positive things they have observed each other do throughout the week. I really liked this idea, and I thought that the girls did a really good job at being therapeutic and communicating with each other.
The day was very positive and was a good day to end clinicals. During the admissions I was thinking that the NP did a good job as keeping boundaries while doing the assessment. I think that is important because the assessment does include a bit of physical contact, and with some of these children you have to be careful. I think she did a really good job. I learned how to do a shortened assessment, which I thought was very helpful to watch as well. In group therapy I thought that the therapist did a good job at engaging and including everyone. Some of the girls pointed out that sometimes he pushes them too much, but in retrospect they appreciate how much he pushes them because it always helps them. He was very open to the comments and stated that they are always welcome to share comments like that with him and he will make appropriate changes. I thought this was important and showed that he had a good, trusting relationship with all of the girls.
Today has taught me the importance of maintaining a healthy trusting relationship with clients. This is important in all situations with all patients no matter where I am working. I realize that it is important to build a relationship with the patient and let them know that I am there for them and that I can be someone they trust.
In the future I will be aware of how I speak and interact with my patients. I will make sure I am building effecting therapeutic relationships.
Today I recognized the RN role when I was able to observe the nurse practitioner and see how she does the full head-to-toe assessment.