Practicum Journal Entry: Analyzing an Ethical Decision

In your role as a Psychiatric and Mental Health Nurse Practitioner (PMHNP), you will encounter several situations that will require your ability to make sound judgments and practice decisions for the safety and well-being of individuals, families, and communities. There may not be a clear-cut answer of how to address the issue, but your ethical decision making must be based on evidenced-based practice and what is good, right, and beneficial for patients. You will encounter patients who do not hold your values, but you must remain professional and unbiased in the care you provide to all patients regardless of their socio-demographic and ethnic/racial background. You must be prepared to critically analyze ethical situations and develop an appropriate plan of action. For this Assignment, you review the literature and discover the various ethical dilemmas PMHNPs encounter and how these issues are typically addressed in your state.

Assignment

To prepare:

· Review literature for moral/ethical issues encountered by a Psychiatric and

Mental Health Nurse Practitioner (PMHNP).

· Select one of the articles you found that was published within the last 5 years to

use as a focus for this assignment.

Write a 2-page paper in which you do the following:

· Summarize the moral/ethical issue in the article (no more than 1 paragraph).

· Describe the moral and ethical dilemmas surrounding the issue.

· Analyze the ethical issue and compare them to the state health laws and

regulations in your state.

· Outline the process of ethical decision making you would use to address this

ethical dilemma.

Note: Be sure to use the Practicum Journal Template attached in this assignment.

Also, the Sample Practicum Journal attached is just a sample.

· Include references immediately following the content.

· Use APA style for your journal entry and references.

Learning Resources

Required Readings

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 5, “Examination and Diagnosis of the Psychiatric Patient” (pp. 192–289)

Chapter 31, “Child Psychiatry” (pp. 1082–1107)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

“Introduction”

“Use of the Manual”

“Cultural Formulation”

Kaplan, C. (2017). Ethical dilemmas. Advanced Healthcare Network. Retrieved from http://nurse-practitioners-and-physician-assistants.advanceweb.com/Article/Ethical-Dilemmas-2.aspx

Pumariega, A. J., Rothe, E., Mian, A., Carlisle, L., Toppelberg, C., Harris, T., . . . Smith, J. (2013). Practice parameter for cultural competence in child and adolescent psychiatric practice. Journal of the American Academy of Child & Adolescent Psychiatry, 52(10), 1101–1115. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00479-6/pdf

American Academy of Child & Adolescent Psychiatry (AACAP). (2012a). Practice parameter for psychodynamic psychotherapy with children. Journal of the

American Academy of Child & Adolescent Psychiatry, 51(5), 541–557. Retrieved from http://www.jaacap.com/article/S0890-8567(12)00141-4/pdf

American Psychological Association. (2017). Code of Ethics. Retrieved from http://www.apa.org/ethics/code/

Optional Resources

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 1, “Neural Sciences” (pp. 1–92)

Chapter 31.2, “Assessment, Examination, and Psychological testing” (pp. 1107–1118)

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell.
Running Head: PRACTICUM EXPERIENCE TIME LOG AND JOURNAL TEMPLATE
PRACTICUM EXPERIENCE TIME LOG AND JOURNAL TEMPLATE
Student Name:

E-mail Address:

Practicum Placement Agency’s Name:

Preceptor’s Name:

Preceptor’s Telephone:

Preceptor’s E-mail Address:

Time Log

Week

Dates

Times

Total Hours for This Time Frame

Activities/Comments

Learning Objective(s) Addressed

4

3/7/2017

6am-6pm

12hrs

Admissions, evaluations, follow-ups, medications management

DSM-5 of mental disorder was utilized, Motivational Enhancement Therapy (MET) was used, Contingency Management (CM) & Cognitive Behavioral Therapy

8

14/9/2017

10am-6pm

8hrs

evaluations medications management.

DSM-5 of mental disorder was utilized, Motivational Enhancement Therapy (MET) was used, Contingency Management (CM) & Cognitive Behavioral Therapy for the seasonal affective disorder

11

23/10/2017

10am-5pm

7hrs

evaluations medications management, Discharge instructions

DSM-5 of mental disorder was utilized, Motivational Enhancement Therapy (MET) was used, Contingency Management (CM) & Cognitive Behavioral Therapy for the seasonal affective disorder

Total Hours Completed: 27

The client

The client in this practicum was a 28-year old male. She arrived at the clinic with a concern about his inability to concentrate on his job, having disrupted sleep, withdrawal from social activities, unusual fatigue associated with loss of energy, reduced appetite, unusual sadness and high affinity for irritability. In some cases, he experiences hallucinations and delusions. During the short preliminary stages of examination, the patient appeared weak and needed serious help. He retorted that the condition has molested his independent decision making and economic engagements. He complains he no longer go to job as he gets irritated so quickly at his boss.

Diagnosis

The diagnosis commenced with identification and respect for the dignity of the client. DSM-5 played a significant role as it highlighted the standards to be used in addressing mental problems (Fisher, 2016).

Effectivity of motivational, contingency and cognitive therapy.

The client indicated that he really wanted to concentrate on his job, besides feeling wasted by this seasonally swinging moods. The American Psychiatric Association provides that the attitude of the client determines the effectivity of this therapy. Wheeler also proposes the approach as a sedative to helping patients anticipating change in given directions. Such therapies involve the influence of family and the personal attributes that agitate the phenomenon (2015).

Contingency management therapy highlights the influence of environment and family as a factor of the disorder. Issues of financial liberty will help solve the problem. The cognitive therapy, however, champions proper health habits as an aid to the healing process.

Legal and ethical implications.

Fisher provides that ethics promotes development of proper records of the client. All parties must equally have an established relationship in order to be effective (2016). Confidentiality and privacy should be upheld according to APA recommendations. Professional ethics and standards enables compliance with the established statutes.

Reference

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

American Psychological Association. DOI: 10.1037/12345-010

Chapter 10 “Humanistic Existential and Solution- Focused Approaches to Psychotherapy’ (Review pp. 369-406)

Fisher, M. A. (2016). The ethical ABCs of conditional confidentiality. In Confidentiality limits in psychotherapy: Ethics checklists for mental health professionals (pp. 13–25). Washington, DC: American Psychological Association. DOI: 10.1037/14860-002

Nagy, T.F. (2011). Ethics in psychotherapy. In Essential ethics for psychologists: A primer for understanding and mastering core issues, pp. 185-198. Washington D.C.

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