How to write a nursing essay on clinical Journal Reflection as a psychiatric Nurse Practitioner

My expectations of being a Psychiatric Mental Health Nurse Practitioner (PMHNP) were different from my experience in clinical settings. Clinical mental healthcare provision deals with the mental illness and the associated conditions that affect one’s mental health, like drug use and socioeconomic status. Even though I felt confident going into practice, I worked with a diverse base of patients, which enabled me to gain the skills and knowledge required to become a competent PMHNP. My experience as a PMHNP has built my patience over the years and enabled me to become a better listener, allowing me to scrutinize situations for accurate assessment. Active listening and respecting the patient’s diverse cultures and views are critical to delivering culturally sensitive mental health interventions to enhance patient outcomes. This paper details my clinical journal reflection as a psychiatric nurse practitioner, including the inpatient hold in my facility and the potential biases towards patients expressing suicidal statements.

In my years of practice as a PMHNP, the most challenging cases for me were the ones in which the patient was suicidal/homicidal. At the beginning of my practice, I was unsure of my ability to handle such cases but with the support of my colleagues; I gained confidence in myself. The California state policy on mental health focuses on community program groups in which patients have personalized treatment plans according to their mental health needs. Forced hospitalization of mental health patients is called civil commitment and only occurs under particular circumstances for a limited time (Substance Abuse and Mental Health Services Administration, 2019). The commitment period is limited to reinstating the individual’s health and ability to undertake a beneficial medical intervention. Individuals eligible for civil commitment are the patients that need a physically secure 24-hour intervention that is not provided in community programs (California, 2022). Moreover, a court investigation is required to prove that these individuals are suicidal or homicidal or deteriorated and can no longer cater to their basic needs because of the mental illness. The guidelines for civil commitment in California are outlined in the Lanterman-Petris-Short Act, which necessitates a judicial review and that the individual designated for civil commitment must have consecutively shown signs of being a danger to themselves or others.

The potential biases against a patient making suicidal statements often exist subconsciously and are only revealed when the nurse practitioner interacts with the client. These potential biases include ethnic and racial prejudices that negatively affect the quality of care. Marginalized populations such as homeless persons, incarcerated persons, and people of color suffer the most due to implicit bias in mental health care. I might be biased against a homeless person expressing suicidal statements by assuming that their mental health issues arise from homelessness and thus focus intervention on housing placement which might be ineffective. I might feel unsafe around an incarcerated person accused of violent crimes and thus refer the case to my colleagues. I have not yet dealt with patients making suicidal statements, but if I encountered one, I would refer them to my colleagues due to my limited experience with suicidal patients.

In conclusion, being a PMHNP has equipped with the necessary skills and knowledge required to become a competent healthcare provider. The most important skills are active listening and understanding diverse cultural beliefs to provide a personalized care for enhanced patient outcomes. However, I need to work with more patients expressing suicidal statements to build my confidence and become an inclusive PMHNP.

References

California, S. of. (2022). Civil commitments. Organization Title. Retrieved July 6, 2022, from https://www.dsh.ca.gov/Treatment/Civil_Commitments.html

Merino, Y., Adams, L., & Hall, W. J. (2018). Implicit bias and mental health professionals: Priorities and directions for research.

Substance Abuse and Mental Health Services Administration: Civil Commitment and the Mental Health Care Continuum: Historical Trends and Principles for Law and Practice. Rockville, MD: Office of the Chief Medical Officer, Substance Abuse and Mental Health Services Administration, 2019

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