Reflective journal on Nursing

Introduction

The presented reflective journal effectively emphasizes 4 clinical experience and themes in the context of implementing advanced nursing practice level in the healthcare settings. Advanced nursing practice assists the professional nurses to mitigate complex healthcare situations through proactive decision-making, skills, expertise, and training. The advanced nursing practice extends wide applications in the public health sector. Advanced nursing practice implications in ethics, global health, cultural competence, health communication, health policy management, environmental health, epidemiology, biostatistics, systemic thinking, leadership, and interdisciplinary teamwork dynamically modify nursing care perspectives in the healthcare environment (Zanetti, 2015). The following clinical objectives require systematic accomplishment for the establishment and enhancement of advanced nursing practice in the healthcare setting.  

1. The accomplishment of patients' educational requirements. 
2. Establishment of an appropriate nurse-patient ratio while minimizing work stress/load of the treating nurses through effective leadership strategies. 
3. Promotion of interdisciplinary healthcare interventions.
4. Mitigation of communication challenges in the healthcare setting.
5. Resolution of ethical dilemmas and complex clinical/healthcare issues.
6. Improvement in the health, wellness, and healthcare education of patients' family members/caretakers. 

Description

I experienced a range of healthcare challenges and complications during my clinical placement in the mental health hospital. I acquired the opportunity to visit the bed-bound mentally ill patients who were left alone in the mental healthcare wards/units and failed to accomplish their individualized requirements under the sustained impact of restraints. I requested the concerned mental health nurses to address the self-sufficiency needs of these patients. However, they refused to do so while emphasizing the requirement of restraints to reduce the risk of patient injuries. I found various mentally ill patients who experienced mobility challenges and exhibited health deterioration under the impact of pressure ulcers, wounds, and nosocomial infection. The clinical nurse asked me to provide basic health care to these patients while explaining the healthcare challenges in the absence of interdisciplinary coordination. I could barely track the visits of clinical specialists and follow-up treatment/interactive sessions for the psychologically ill patients in the mental healthcare facility. The entire facility worked like a mental asylum with the core objective of isolating the mentally challenged patients across an unfriendly environment. The absence of rehabilitative efforts, conflicts between the healthcare team members, and zero discount for patients' family members included some of the significant findings that I effectively tracked, observed, and recorded during my clinical practice in the concerned mental health facility. Forceful administration of treatment interventions created a state of panic for the mentally ill patients as well as the healthcare staff almost on a routine basis. Serious injuries during ADL (activities of daily living) facilitation and their inappropriate clinical management substantially deteriorated patients' quality of life and their wellness outcomes in the mental healthcare facility.         

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