Discussion Board 2: Reflective Practice No unread replies. 1 1 reply. BACKGROUND As a PMHNP, your ultimate goal is to provide patients with mental health services in the interest of improvement in their lives. As such, you work strategically to learn, empathize, characterize, assess, judge, diagnose, and determine outcomes for the patient. Much of this is instinctive based on our own experiences, internal bias, and understanding of the human relationship. One way to identify such bias is through reflection. Nursing has four fundamental ways of knowing (Carper, 1978): aesthetic, ethical, empirical, and personal. While these are not exhaustive, they do provide a starting place for which to analyze our decisions. Johns (2017) sought to take this one step further and use these concepts to help define reflection as an essential skill in his Model of Structured Reflection (MSR) “map.” This map is used to drive one’s thinking and reflecting toward the situation and how the individual felt. Reflection is a skill necessary in all walks of life, and when done thoughtfully, can lead to decisions that are improved upon from previous experiences as we learn and grown. It can also help us to achieve caring in a much more substantive way, and alert us to internal bias that may impede our decisions. Review the example below and follow the instructions to complete this assignment. INSTRUCTIONS In this assignment, you are a PMHNP who provides mental health services for patients in a state-funded community setting where the majority of your patients have diagnoses such as bipolar disorder, depression (spectrum of these such as MDD, dysthymia, TRD), bipolar disorder (I and II), anxiety (spectrum of these such as GAD, panic, PTSD, OCD, specific phobia), and substance used disorder. You oftentimes feel as though you are simply a pill pusher and that every patient looks the same, has the same set of circumstances, and has the same complaints. You are concerned that you are simply giving in to patients due to time constraints and your perception of their circumstances. However, you are determined that this is not the way you want to continue to practice. To complete this assignment, review of the work by both Carper (1978) and Johns (Links to an external site.) (2017, p. 36 ), and consider the example above when thinking about one example of a patient you have cared for thus far this semester in order to answer a few questions. In selecting your patient, focus on identifying one with whom you had a significant experience (or perhaps it seemed significant to you) – provide a brief vignette about the patient. What influenced your thinking or feeling at the time of the encounter? Was there any notable or perceived internal or external bias? What knowledge did you gain from the encounter that ultimately resulted in the outcomes it did? What insight have you gained that might alter your response when faced with that situation again? How might you demonstrate caring in a much more beneficial way to the patient and enrich your personal experience? Formulate your answers using the following headers [Patient Selection, Influence, Knowledge Acquisition, Insight (include bias here), Caring] .
