Practicum Week 10 Journal Entry

Practicum Week 10 Journal Entry

Week 10 Journal Entry
Reflect on your overall practicum experience in this course. Then, address the following in your Practicum Journal:
• Explain whether your therapeutic theory has changed as a result of your practicum experiences. Recall the theories you selected in Week 1.
• Explain how you integrated the therapeutic approaches from this course in your clinical practice. Include how this helped you achieve the goals and objectives you developed in Week 1.
• Explain how you might impact social change through your work with clients who have mental health issues. Practicum Week 10 Journal Entry.
• Support your approach with evidence-based literature.


Week 10 journal entry

  • Explain whether your therapeutic theory has changed as a result of your practicum experiences. Recall the theories you selected in Week 1.

My therapeutic theory prior to the practicum experience was Peplau’s Theory, and this has not changed although. I feel that the theory stresses on the identity of nurses as carers, sentiments I concur with since I understand that nursing is concerned with caring as a central function when considering that patients receiving palliative care and who have had their medical intervention for a cure withdrawn would still require nursing care in the form of comfort. Still, the theory has some shortcomings that should be addressed to improve its functionality, especially in today’s nursing practice environment. Peplau’s theory was first developed by Hildegard Peplau in 1952 and has been revised twice in 1991 and 1997. Practicum Week 10 Journal Entry. It is a middle-range theory that acknowledges that nursing care can be improved through incorporating concepts from patient’s experiences. It notes that the relationship between nurses and patients has an influence on the overall experience of patients, holding to the notion that nursing care should be focused on patients’ perceptions and needs (Hagerty et al., 2017).

The central tenet of Peplau’s theory is that nurses’ core function is to aid patients who are facing difficulty and require care. The implication is that nursing personnel are therapeutic agents who have a contract with patients that allows them to have close interactions. As such, it is prudent to have a good interpersonal relationship between patients and nurses. The theory does not mention implications for interaction time, however, longer interactions are encouraged since they allow the relationship to mature at a faster rate while shorter interactions would cause the relationship to mature at a slower rate. To be more precise, the current form of the theory presents a concern about limited contact time between nursing personnel and patients. Another concern is that theory does not make allowances for information technology solutions. In fact, there is a need to revise the theory to allow for adoption of information technology solution, especially the self-guiding applications that use routine processes to improve the quality of interaction between patients and nursing personnel. Practicum Week 10 Journal Entry. Addressing the two concerns ensures that the theory keeps abreast with the reality of social transformations as it pertains to the 21st century, particularly in the face of social changes that include social media and the internet. These information technologies (such as online resource centers and smartphone applications) are acting as automated substitutes for routine nursing activities. The proposed revision should assign a supervisory role to nursing personnel, allowing them to intervene when clarification is needed (Peterson & Bredow, 2017). As such, my therapeutic theory remains the same although I would recommend that it be revised. Practicum Week 10 Journal Entry.

  • Explain how you integrated the therapeutic approaches from this course in your clinical practice. Include how this helped you achieve the goals and objectives you developed in Week 1.

The therapeutic approaches presented in my eclectic education were integrated into my clinical practice. In this case, my initial objective was to provide care through taking on a passive connotation of supporting or maintaining the patients’ current health position. However, I reviewed my objective during actual practice and realized that I need to be more proactive to make meaningful change. My new objective changed to not only achieving comfort (from support and maintenance) for my patients as a major nursing function, but also looking at comfort as simply the beginning in a structured process and not the end in itself. Currently, I view nursing as being concerned with providing care, a dynamic process whose main objective is the patients’ health. This is reflected in my ability as a nurse to improve the patients’ capacity for self-determination, self-esteem and self-care. Through reviewing the therapeutic approaches, I now understand that nursing is a dynamic process that is not simply concerned with supporting other medical interventions (such as the efforts of physicians), but has the potential for influencing the achievement of health for patients. This is particularly so when it is considered that nurses have traditional been concerned with caring functions while physicians have traditionally been concerned with curative functions (Finkelman, 2016).

In addition, I understand that therapeutic approaches applied in nursing should be ‘non-purist’. For this approaches to be effective, they must focus on highlighting the need for an effective helping relationship that is independent of theoretical orientation. The fundamental form of the helping relationship between nursing personnel and patients should be focused on integrating different theoretical orientations. This new mentality (‘non-purist’ approach) allows me to adopt appropriate patient-need-driven intervention that are not constrained by theoretical dogma. Besides that, the approach allows me to be an empowered, collaborative and perceptive nurse, allowing me to interactively work with the patients to teach, assess and understand the changes to the patient’s body that constitutes the illness. This should occur in both the inpatient and outpatient care settings, offering advice, help and professional support (Catalano, 2015) Practicum Week 10 Journal Entry.

During the process of integrating therapeutic approaches, I noticed that my interactions and relationship with the patients presented a tough challenge with regards to emotional stability and physical boundaries of the relationship. Still, my priorities should be guided by the understanding that therapeutic nursing is targeted at ill health and its meaning as perceived by patients and interpreted through medical literature, while encouraging a nurse-patient relationship that is creative rather than passive. Overall, every professional action that I undertake as a nurse should be reflective and intuitive, while encompassing therapeutic dimensions in nursing (Catalano, 2015).

  • Explain how you might impact social change through your work with clients who have mental health issues.

As a nurse, my work with patients who have mental health issues could impact social change. In fact, I have been actively engaged in eliminating health inequalities and achieving equity. This occurred through focusing on the importance of humility in acknowledging that cultural diversity exists and no single culture should smoother another culture. In addition, I consider trust as a foundation of my relationship with other stakeholders in the care environment (such as patients, family members and other medical personnel). Also, I have an awareness of myself and others in my professional environment. Practicum Week 10 Journal Entry. These qualities have allowed me to recognize and understand the effect of social health determinants on population outcomes, to include the physical and social environments, socio-economic status, behavioral and biologic response, and access to care. I understand that social determinants of health, inequality and poverty adversely affect health outcomes, mortality and morbidity. As a nurse, I am well positioned to assess patients and communities, advocate for care equality and justice, and partner with other stakeholders to address mental health issues as social change issues (Finkelman, 2016).




Catalano, J. (2015). Nursing now! today’s issues, tomorrow’s trends. (7th ed.). Philadelphia, PA: FA Davis Company.

Finkelman, A. (2016). Leadership and management for nurses: core competencies for quality care (3rd ed.). London: Pearson Education. Practicum Week 10 Journal Entry.

Hagerty, T., Samuels, W., Norcini-Pala, A. & Gigliotti, E. (2017). Peplau’s theory of interpersonal relations: an alternate factor structure for patient experience data? Nurs Sci Q., 30(2), 160-167. doi: 10.1177/0894318417693286

Peterson, S. J. & Bredow, T. S. (2017). Middle range theories: application to nursing research (4th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. Practicum Week 10 Journal Entry.

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