How to write a Clinical Journal: Depression and Mood Disorder

How to write a Clinical Journal: Depression and Mood Disorder

As a psychiatric and mental health nurse practitioner, my role includes assessing, diagnosing, and treating the mental health needs of patients.  I tend to involve the patients in therapy (Delaney, 2017). During my practice, I encounter certain barriers that continuously change my emotions, feelings, and behaviors. Sometimes I find myself being compassionate about a certain patient in the healthcare setting. I can remember a scenario that involved a 17-year-old teenager who was raped and had developed posttraumatic stress disorder.  I felt moved by the struggles of the patient.  I become overinvolved and try as much as possible to help the girl. In other scenarios, I felt disappointed in myself if the condition of the patient was not improving.  It normally affects me too much that my colleagues try to reassure me that it is not my fault I have done everything possible to help the patient.  But not even my colleagues’ advice could give me any sought of comfort.  Being overinvolved is something I try to avoid, but on many occasions, after taking history and a complete psychiatric evaluation of a patient from the vulnerable category, I normally feel sorry about them. I am proud that my over-involvement and the feeling of compassion normally pay dividends at times, especially when the patients are discharged after recovery.

My second feeling is frustration. Various things in the healthcare setting trigger my frustrations. Firstly, I am normally frustrated when a patient refuses to take a medication that will clearly improve their condition. I normally feel that maybe my approach is not effective. To make matters worse, you can do nothing in such cases due to the patient’s right to autonomy. Secondly, I am normally frustrated when I come for my shift in the psychiatric and mental health department and find that some patient has missed their treatment or a scheduled diagnostic test was not done. I normally feel so frustrated, and sometimes I try to start arguments with my co-workers without investigating why such duties were not done. On many occasions, I found myself to be on the wrong side. Finally, I am normally frustrated when my shift is almost over, yet most of the duties scheduled for my shift are not done due to being understaffed. One day I was on shift with three other nurses; one of them had a last-minute emergency, and the manager could not recall other nurses since the hospital was attending to victims of an accident along the major highway near the hospital. I was so frustrated. Nothing seemed to be moving in the department. At the end of the shift, I felt so frustrated, possibly due to burnout.

When dealing with psychiatric patients, I tend to be emotionally overinvolved when dealing with certain patients. Over involvement is becoming too concerned with one patient that it impacts your ability to work effectively in the healthcare setting (Bjorge et al., 2019).  The first case that tends to get me overinvolved is when dealing with victims of gender-based violence.  When such patients present, I normally try to live with my colleagues to handle them and conduct psychiatric and mental evaluations. I would come in during the planning of the patient’s treatment.  To help me cope with my emotions and behaviors as a psychiatric and mental health nurse practitioner, there are certain approaches I utilize.  When confronted with any situation with a potential for over-involvement, I normally try to apply simple mindful techniques.  Mindful techniques such as having few slow breaths and relaxing can help reduce stress and assist me in coping with the situation. Secondly, after a challenging or stress full situation, I normally try to do a self-reflection by asking myself several questions like what was I thinking, why did it have to go that way, why did I feel that way, did I overreact, was I able to fully understand the patient or the colleague, and what would I have done differently for a better outcome. Self-reflecting helps me to do better when confronted with such situations in future.  Finally, I try to practice assertive communication.  Assertive communication involves expressing my views in a clear way while also respecting others (Omura et al., 2016). This normally helps me to cope with many challenges involving my colleagues and other interprofessional team members.



Bjørge, H., Kvaal, K., & Ulstein, I. (2019). The effect of psychosocial support on caregivers’ perceived criticism and emotional over-involvement of persons with dementia: an assessor-blinded randomized controlled trial. BMC health services research19(1), 1-9.

Delaney, K. R. (2017). Psychiatric mental health nursing advanced practice workforce: Capacity to address shortages of mental health professionals.

Omura, M., Maguire, J., Levett-Jones, T., & Stone, T. E. (2016). Effectiveness of assertive communication training programs for health professionals and students: a systematic review protocol. JBI Evidence Synthesis14(10), 64-71.

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