Document Type: Psychiatric Progress Note
Date of Service/Receive Date: January 17, 2022 13:01 EST
Document Status: Auth (Verified)
Document Title: BT1 Progress Note
Performed by: Waters, Amy – MD,Res,Psychiatry on January 17, 2022 13:05 EST
Verified by: Waters, Amy – MD,Res,Psychiatry on January 17, 2022 13:05 EST
Encounter info: 40020205734, JBHH, Inpatient, 1/14/2022 –
* Final Report *
BT1 Progress Note
JACK_FL
Patient: SOLA, EDUARDO MRN: 5561999 FIN: 40020205734
Age: 28 years Sex: Male DOB: 1/23/1993
Associated Diagnoses: None
Author: Waters, Amy – MD,Res,Psychiatry
Service
performed as a moonlighter
Legal Status: Patient is voluntary and capacitated.
ID:
Patient is a 28 y/o male with no formal pphx who presented to crisis voluntarily brought by family due to worsening mood sx and SI, admitted voluntarily for stabilization.
HPI:
Patient seen during morning rounds, case discussed with treatment team.
Per nursing, no acute events overnight. Pt adherent with meds and vitals, no behavioral issues.
Pt reports last night he was sleepy after taking meds but still had trouble falling asleep, received Ativan 1mg PRN with good benefit. He remains anxious and depressed with SI, but feels safe in the hospital and tolerating meds w/o SE. Agrees to continue titrating.
Target Symptoms:
Quality – mood swings, SI
Severity – severe; danger to self
Context – stress, no past psychiatric tx
Modifying factors – hospitalization, medications, rest
Associated signs & symptoms – as per HPI & MSE
Based on symptoms and behaviors described above :
-There is evidence of symptoms and behavior reflecting impairment, and continued treatment in an Inpatient setting is warranted at this time
-The patient is in continued need of psychiatric hospitalization , no less restrictive alternative is presently available
-Pt continues to meet criteria for inpatient admission to BH Unit
ROS:
Constitutional: denies fever or headache
Cardiac: denies chest pain or palpitations
Pulmonary: denies cough or SOB
GI: denies diarrhea or constipation
GU: denies dysuria or hematuria
MSK: denies myalgias
Neuro: denies tremors or paraesthesias
Vital Signs:
Vitals Signs/Measurements
Temperature Oral: 36.6 DegC Low
Peripheral Pulse Rate: 89 bpm
Respiratory Rate: 18 br/min
Systolic Blood Pressure: 108 mmHg
Diastolic Blood Pressure: 63 mmHg
SpO2: 99 %
Labs:
WBC Count: 9.7 x10(3)/mcL (01/15/22)
RBC Count: 5.79 x10(6)/mcL High (01/15/22)
Hemoglobin: 17.7 g/dL High (01/15/22)
Hematocrit: 52.1 % High (01/15/22)
MCV: 90 fL (01/15/22)
MCH: 30.6 pg (01/15/22)
MCHC: 34 g/dL (01/15/22)
RDW-CV: 11.7 % (01/15/22)
Platelet Count: 307 x10(3)/mcL (01/15/22)
MPV: 10.6 fL (01/15/22)
NRBC%: 0 /100WBC (01/15/22)
NRBC%: 0 /100WBC (01/15/22)
NRBC(Abs): 0 x10(3)/mcL (01/15/22)
NRBC(Abs): 0 x10(3)/mcL (01/15/22)
Neutrophil (%): 73.7 % High (01/15/22)
Lymphocyte (%): 18.7 % (01/15/22)
Monocyte (%): 6 % (01/15/22)
Eosinophil (%): 0.5 % (01/15/22)
Basophil (%): 0.8 % (01/15/22)
Immature Granulocyte (%): 0.3 % (01/15/22)
Absolute Neutrophil: 7.1 x10(3)/mcL High (01/15/22)
Absolute Lymphocyte: 1.8 x10(3)/mcL (01/15/22)
Absolute Monocyte: 0.6 x10(3)/mcL (01/15/22)
Absolute Eosinophil: 0.05 x10(3)/mcL Low (01/15/22)
Absolute Basophil: 0.08 x10(3)/mcL (01/15/22)
Absolute Immature Granulocyte: 0.03 x10(3)/mcL (01/15/22)
Slide Review: Not Indicated (01/15/22)
TSH: 0.559 mcIU/mL (01/15/22)
Color: Yellow. (01/15/22)
Clarity: Turbid. Abnormal (01/15/22)
Specific Gravity: 1.02 (01/15/22)
Specific Gravity: 1.02 (01/15/22)
Urine pH: 7 (01/15/22)
Urine pH: 7 (01/15/22)
Protein: Negative: (01/15/22)
Glucose: Negative; (01/15/22)
Ketones: Negative: (01/15/22)
Bilirubin: Negative: (01/15/22)
Blood: Negative: (01/15/22)
Urobilinogen: Negative; (01/15/22)
Nitrites: Negative: (01/15/22)
Leukocyte Esterase: Negative: (01/15/22)
Urine Microscopic: Indicated Abnormal (01/15/22)
Urine WBC’s: <1 (01/15/22)
Urine WBC’s: <1 (01/15/22)
Urine RBC’s: 1 /HPF (01/15/22)
Urine RBC’s: 1 /HPF (01/15/22)
Bacteria: 0. (01/15/22)
Bacteria: 0. (01/15/22)
UA Amorph Phos: Present Abnormal (01/15/22)
Triphosphate Crystal: Present Abnormal (01/15/22)
SARS CoV 2 RNA, RT PCR: Negative, (01/15/22)
Cocaine & Metabolites: Not Detected (01/16/22)
Cannabinoid: Presumptive Pos Abnormal (01/16/22)
Benzodiazepine Class: Not Detected (01/16/22)
Opiate Class: Not Detected (01/16/22)
Amphetamine Class: Not Detected (01/16/22)
U Phencyclidine: Not Detected (01/16/22)
U Barbiturate Class: Not Detected (01/16/22)
U Methadone: Not Detected (01/16/22)
POC SARS CoV-2 Antigen: Negative` (01/15/22)
Medication List:
Medications (6) Active
Scheduled: (2)
divalproex 500 mg Tab EC/DR 500 mg 1 tab, ORAL, BID
QUEtiapine IR 200 mg Tab 200 mg 1 tab, ORAL, BEDTIME
Continuous: (0)
PRN: (4)
hydrOXYzine pamoate 50 mg Cap 50 mg 1 cap, ORAL, Q6H
LORazepam 1 mg Tab 1 mg 1 tab, ORAL, BEDTIME
LORazepam 2 mg/mL Inj 1 mL 2 mg 1 mL, IM, Q6H
nicotine 2 mg Loz 2 mg 1 lozenge, TRANSMUCOSAL, Q2H
MSE:
Appearance/Behavior: appears stated age, fair hygiene / calm, cooperative
Orientation: AAOx3
Speech: clear, coherent, normal rate and tone
Eye Contact: good
Motor Activity: no PMR/PMA, no dystonic/tardive movements
Mood/Affect: anxious, depressed / mood congruent
Thought Process: goal directed
Thought content:
– Hallucinations: denies AVH, does not appear RTIS
– Delusions/Preoccupations: none elicited
– SI/HI: denies
Insight/Judgment: limited/limited
Attention/Concentration: fair/fair
Memory: appears grossly intact
Level of risk: High
Justification for continued stay:
– Patient remains symptomatic and in need of further inpatient treatment and stabilization. Patient at risk of re-hospitalization or worsening of psychiatric symptoms in less restrictive environment.
Counseling provided:
– Diagnostic results/impressions and/or recommended studies
– Risks and benefits of treatment options
– Instruction for management/treatment and/or follow-up
– Importance of compliance with chosen treatment options
– Risk Factor Reduction
– Patient Education
– Prognosis
Coordination of care provided with:
– Nursing Staff
– Treatment Team
– Case manager
– Physician/s
Diagnoses
Bipolar disorder, unspecified (F31.9)
Anxiety disorder, unspecified (F41.9)
End of Diagnoses List
Plan
1. Legal Status: patient is voluntary and capacitated.
2. Patient continues to require 24 hour observation, nursing care, and inpatient treatment and cannot be treated in a less restrictive environment.
3. Patient was educated about reasons for prescribing the below listed medications, their expected benefits as well as potential side effects and relevant risks
4. Medications:
Medications (6) Active
Scheduled: (2)
divalproex 500 mg Tab EC/DR 500 mg 1 tab, ORAL, BID
QUEtiapine IR 200 mg Tab 200 mg 1 tab, ORAL, BEDTIME
Continuous: (0)
PRN: (4)
hydrOXYzine pamoate 50 mg Cap 50 mg 1 cap, ORAL, Q6H
LORazepam 1 mg Tab 1 mg 1 tab, ORAL, BEDTIME
LORazepam 2 mg/mL Inj 1 mL 2 mg 1 mL, IM, Q6H
nicotine 2 mg Loz 2 mg 1 lozenge, TRANSMUCOSAL, Q2H
5. Tobacco Cessation: NRT
6. Nursing Orders: encourage compliance with treatment plan, ADLs, groups
7. Labs/Imaging: reviewed as above
8. Consults: none indicated at this time
9. Court Date: n/a
10. Social Work: evaluation for disposition and follow-up
Clinical oversight provided by Dr. Dreize
Signature Line
Author: Waters, Amy – MD,Res,Psychiatry On: 01/17/2022 13:05 EST
Sent for Review: Dreize, Richard Michael – MD,Attn,Psychiatry
To Prepare
· Review this week’s Learning Resources and consider the insights they provide about assessment and diagnosis. Also review the Kaltura Media Uploader resource in the left-hand navigation of the classroom for help creating your self-recorded Kaltura video.
· Select a patient that you examined during the last 2 weeks who presented with a disorder other than the one present in your selected case for Week 5.
· Conduct a Comprehensive Psychiatric Evaluation on this patient using the template provided in the Learning Resources. There is also a completed exemplar document in the Learning Resources so that you can see an example of the types of information a completed evaluation document should contain. All psychiatric evaluations must be signed, and each page must be initialed by your Preceptor. When you submit your document, you should include the complete Comprehensive Psychiatric Evaluation as a Word document, as well as a PDF/images of each page that is initialed and signed by your Preceptor. You must submit your document using SafeAssign.
Please Note: Electronic signatures are not accepted. If both files are not received by the due date, Faculty will deduct points per the Walden Late Policies.
· Develop a video case presentation, based on your evaluation of this patient, that includes chief complaint; history of present illness; any pertinent past psychiatric, substance use, medical, social, family history; most recent mental status exam; and current psychiatric diagnosis, including differentials that were ruled out.
· Include at least five (5) scholarly resources to support your assessment and diagnostic reasoning.
· Ensure that you have the appropriate lighting and equipment to record the presentation.
NRNP/PRAC6635 Comprehensive Psychiatric Evaluation Exemplar
INSTRUCTIONS ON HOW TO USE EXEMPLAR AND TEMPLATE—READ CAREFULLY
If you are struggling with the format or remembering what to include, follow the Comprehensive Psychiatric Evaluation Template
AND
the Rubric as your guide. It is also helpful to review the rubric in detail in order not to lose points unnecessarily because you missed something required. Below highlights by category are taken directly from the grading rubric for the assignment in Weeks 4–10. After reviewing the full details of the rubric, you can use it as a guide.
In the Subjective section, provide:
· Chief complaint
· History of present illness (HPI)
· Past psychiatric history
· Medication trials and current medications
· Psychotherapy or previous psychiatric diagnosis
· Pertinent substance use, family psychiatric/substance use, social, and medical history
· Allergies
· ROS
· Read rating descriptions to see the grading standards!
In the Objective section, provide:
· Physical exam documentation of systems pertinent to the chief complaint, HPI, and history
· Diagnostic results, including any labs, imaging, or other assessments needed to develop the differential diagnoses.
· Read rating descriptions to see the grading standards!
In the Assessment section, provide:
· Results of the mental status examination,
presented in paragraph form.
· At least three differentials with supporting evidence. List them from top priority to least priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis.
Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case
.
· Read rating descriptions to see the grading standards!
Reflect on this case. Include: Discuss what you learned and what you might do differently. Also include in your reflection a discussion related to legal/ethical considerations (
demonstrate critical thinking beyond confidentiality and consent for treatment
!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
(The comprehensive evaluation is typically the initial new patient evaluation. You will practice writing this type of note in this course. You will be ruling out other mental illnesses so often you will write up what symptoms are present and what symptoms are not present from illnesses to demonstrate you have indeed assessed for all illnesses which could be impacting your patient. For example, anxiety symptoms, depressive symptoms, bipolar symptoms, psychosis symptoms, substance use, etc.)
EXEMPLAR BEGINS HERE
CC (chief complaint): A brief statement identifying why the patient is here. This statement is verbatim of the patient’s own words about why presenting for assessment. For a patient with dementia or other cognitive deficits, this statement can be obtained from a family member.
HPI: Begin this section with patient’s initials, age, race, gender, purpose of evaluation, current medication and referral reason. For example:
N.M. is a 34-year-old Asian male presents for psychiatric evaluation for anxiety. He is currently prescribed sertraline which he finds ineffective. His PCP referred him for evaluation and treatment.
Or
P.H., a 16-year-old Hispanic female, presents for psychiatric evaluation for concentration difficulty. She is not currently prescribed psychotropic medications. She is referred by her therapist for medication evaluation and treatment.
Then, this section continues with the symptom analysis for your note. Thorough documentation in this section is essential for patient care, coding, and billing analysis.
Paint a picture of what is wrong with the patient. First what is bringing the patient to your evaluation. Then, include a PSYCHIATRIC REVIEW OF SYMPTOMS. The symptoms onset, duration, frequency, severity, and impact. Your description here will guide your differential diagnoses. You are seeking symptoms that may align with many DSM-5 diagnoses, narrowing to what aligns with diagnostic criteria for mental health and substance use disorders.
Past Psychiatric History: This section documents the patient’s past treatments. Use the mnemonic Go Cha MP.
General Statement: Typically, this is a statement of the patients first treatment experience. For example: The patient entered treatment at the age of 10 with counseling for depression during her parents’ divorce. OR The patient entered treatment for detox at age 26 after abusing alcohol since age 13.
Caregivers are listed if applicable.
Hospitalizations: How many hospitalizations? When and where was last hospitalization? How many detox? How many residential treatments? When and where was last detox/residential treatment? Any history of suicidal or homicidal behaviors? Any history of self-harm behaviors?
Medication trials: What are the previous psychotropic medications the patient has tried and what was their reaction? Effective, Not Effective, Adverse Reaction? Some examples: Haloperidol (dystonic reaction), risperidone (hyperprolactinemia), olanzapine (effective, insurance wouldn’t pay for it)
Psychotherapy or Previous Psychiatric Diagnosis: This section can be completed one of two ways depending on what you want to capture to support the evaluation. First, does the patient know what type? Did they find psychotherapy helpful or not? Why? Second, what are the previous diagnosis for the client noted from previous treatments and other providers. Thirdly, you could document both.
Substance Use History: This section contains any history or current use of caffeine, nicotine, illicit substance (including marijuana), and alcohol. Include the daily amount of use and last known use. Include type of use such as inhales, snorts, IV, etc. Include any histories of withdrawal complications from tremors, Delirium Tremens, or seizures.
Family Psychiatric/Substance Use History: This section contains any family history of psychiatric illness, substance use illnesses, and family suicides. You may choose to use a genogram to depict this information. Be sure to include a reader’s key to your genogram or write up in narrative form.
Social History: This section may be lengthy if completing an evaluation for psychotherapy or shorter if completing an evaluation for psychopharmacology. However, at a minimum, please include:
Where patient was born, who raised the patient
Number of brothers/sisters (what order is the patient within siblings)
Who the patient currently lives with in a home? Are they single, married, divorced, widowed? How many children?
Educational Level
Hobbies:
Work History: currently working/profession, disabled, unemployed, retired?
Legal history: past hx, any current issues?
Trauma history: Any childhood or adult history of trauma?
Violence Hx: Concern or issues about safety (personal, home, community, sexual (current & historical)
Medical History: This section contains any illnesses, surgeries, include any hx of seizures, head injuries.
Current Medications: Include dosage, frequency, length of time used, and reason for use. Also include OTC or homeopathic products.
Allergies: Include medication, food, and environmental allergies separately. Provide a description of what the allergy is (e.g., angioedema, anaphylaxis). This will help determine a true reaction vs. intolerance.
Reproductive Hx: Menstrual history (date of LMP), Pregnant (yes or no), Nursing/lactating (yes or no), contraceptive use (method used), types of intercourse: oral, anal, vaginal, other, any sexual concerns
ROS: Cover all body systems that may help you include or rule out a differential diagnosis. Please note: THIS IS DIFFERENT from a physical examination!
You should list each system as follows: General: Head: EENT: etc. You should list these in bullet format and document the systems in order from head to toe.
Example of Complete ROS:
GENERAL: No weight loss, fever, chills, weakness, or fatigue.
HEENT: Eyes: No visual loss, blurred vision, double vision, or yellow sclerae. Ears, Nose, Throat: No hearing loss, sneezing, congestion, runny nose, or sore throat.
SKIN: No rash or itching.
CARDIOVASCULAR: No chest pain, chest pressure, or chest discomfort. No palpitations or edema.
RESPIRATORY: No shortness of breath, cough, or sputum.
GASTROINTESTINAL: No anorexia, nausea, vomiting, or diarrhea. No abdominal pain or blood.
GENITOURINARY: Burning on urination, urgency, hesitancy, odor, odd color
NEUROLOGICAL: No headache, dizziness, syncope, paralysis, ataxia, numbness, or tingling in the extremities. No change in bowel or bladder control.
MUSCULOSKELETAL: No muscle, back pain, joint pain, or stiffness.
HEMATOLOGIC: No anemia, bleeding, or bruising.
LYMPHATICS: No enlarged nodes. No history of splenectomy.
ENDOCRINOLOGIC: No reports of sweating, cold, or heat intolerance. No polyuria or polydipsia.
Physical exam (If applicable and if you have opportunity to perform—document if exam is completed by PCP): From head to toe, include what you see, hear, and feel when doing your physical exam. You only need to examine the systems that are pertinent to the CC, HPI, and History. Do not use “WNL” or “normal.” You must describe what you see. Always document in head-to-toe format i.e., General: Head: EENT: etc.
Diagnostic results: Include any labs, X-rays, or other diagnostics that are needed to develop the differential diagnoses (support with evidenced and guidelines).
A
ssessment
Mental Status Examination: For the purposes of your courses, this section must be presented in paragraph form and not use of a checklist! This section you will describe the patient’s appearance, attitude, behavior, mood and affect, speech, thought processes, thought content, perceptions (hallucinations, pseudohallucinations, illusions, etc.)., cognition, insight, judgment, and SI/HI. See an example below. You will modify to include the specifics for your patient on the above elements—DO NOT just copy the example. You may use a preceptor’s way of organizing the information if the MSE is in paragraph form.
He is an 8-year-old African American male who looks his stated age. He is cooperative with examiner. He is neatly groomed and clean, dressed appropriately. There is no evidence of any abnormal motor activity. His speech is clear, coherent, normal in volume and tone. His thought process is goal directed and logical. There is no evidence of looseness of association or flight of ideas. His mood is euthymic, and his affect appropriate to his mood. He was smiling at times in an appropriate manner. He denies any auditory or visual hallucinations. There is no evidence of any delusional thinking. He denies any current suicidal or homicidal ideation. Cognitively, he is alert and oriented. His recent and remote memory is intact. His concentration is good. His insight is good.
Differential Diagnoses: You must have at least three differentials with supporting evidence. Explain what rules each differential in or out and justify your primary diagnosis selection. You will use supporting evidence from the literature to support your rationale. Include pertinent positives and pertinent negatives for the specific patient case.
Also included in this section is the reflection. Reflect on this case and discuss whether or not you agree with your preceptor’s assessment and diagnostic impression of the patient and why or why not. What did you learn from this case? What would you do differently?
Also include in your reflection a discussion related to legal/ethical considerations (demonstrating critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
References (move to begin on next page)
You are required to include at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines which relate to this case to support your diagnostics and differentials diagnoses. Be sure to use correct APA 7th edition formatting.
© 2021 Walden University Page 1 of 3
Running head: PRACTICUM EXPERIENCE PLAN 5
Week 2 Practicum Experience plan
Monica Castelao
Walden University
PRAC 6635: Clinical Skills Self – Assessment in Psychiatric Mental Health Nurse Practitioner
Practicum
Dr. Leonardo
12/21/ 2021
Practicum Experience Plan
Overview:
Your Practicum experience includes working in a clinical setting that will help you gain the knowledge and skills needed as an advanced practice nurse. In your practicum experience, you will develop a practicum plan that sets forth objectives to frame and guide your practicum experience.
As part of your Practicum Experience Plan, you will not only plan for your learning in your practicum experience but also work through various patient visits with focused notes as well as one (1) journal entry.
Complete each section below.
Part 1: Quarter/Term/Year and Contact Information
Section A
Quarter/Term/Year: Winter 2021
Student Contact Information
Name: Monica Castelao
Street Address: 1365 West 41 Street
City, State, Zip Hialeah, Fl 33012
Home Phone: N/A
Work Phone: N/A
Cell Phone: 954589 8392
Fax:
N/A
E-mail: casmonica841@gmail.com
Preceptor Contact Information
Name: Marlon Medina
Organization: Private
Street Address: 3430 NW 97 Street
Miami, Florida 33147
Work Phone: 786-597-746 Cell Phone:
Fax:
Professional email: medinamarlon72@yahoo.com
Part 2: Individualized Practicum Learning Objectives
Refer to the instructions in Week 2 to create individualized practicum learning objectives that meet the requirements for this course. These objectives should be aligned specifically to your Practicum experience. Your objectives should address your self-assessment of the skills found in the “PMHNP Clinical Skills Self-Assessment Form” you completed in Week 1.
As you develop your individualized practicum learning objective, be sure to write them using the SMART format. Use the resources found in Week 2 to guide your development. Once you review your resources, continue and complete the following. Note: Please make sure each of your objectives are connected to your self-assessment. Also, consider that you will need to demonstrate how you are advancing your knowledge in the clinical specialty.
Objective 1: To improve my assessment technique on mental status of patients.
Planned Activities: To assess not less than 90 mentally disabled patients within the practicum period to improve my knowledge on the effective assessment techniques for such patients.
Mode of Assessment: The mode of assessment for the objective is focused assessment that provides details to specific body system associated with problems of a patient.
PRAC Course Outcome(s) Addressed:
· To identify professional boundaries in the workplace and acknowledge the required therapeutic relationship with patients.
· To interpret mental status of an individual based on an assessment performed.
Objective 2: To identify appropriate practices that guides medication plan for patients in the clinical setting.
Planned Activities: I will consult other clinician on the appropriate evidence-based practices that are supposed to be implemented in a workplace and also search and evaluate the available practices and implement the chosen practices.
Mode of Assessment: The mode of assessment for this objective is through an observation of what evidence-based practices are applied and how they are used and utilize the DSMV
PRAC Course Outcome(s) Addressed:
· Develop a list of appropriate evidence-based practices
· Incorporate DSM V in clinical care
· Use evidence-based practices in improving care
Objective 3: To accurately evaluate the response of a patient towards care provided and use the information to make decision on how to modify the care.
Planned Activities: I will monitor patients under care, conduct interview on the patients to understand their views on the care and develop appropriate care plan based on the information
Mode of Assessment: The assessment mode for this objective is through observation and use of DSM V and other resources provided
PRAC Course Outcome(s) Addressed:
· Develop plans that improves patients’ care
· Analyze the patients views to come up with adequate information of care programs
· Accurate modify care for specific patients.
Part 3: Projected Timeline/Schedule
Estimate how many hours you expect to work on your Practicum each week. *Note: All of your hours and activities must be supervised by your Preceptor and completed onsite. Your Preceptor will approve all hours, but your activities will be approved by both your Preceptor and Instructor. Any changes to this plan must be approved.
This timeline is intended as a planning tool; your actual schedule may differ from the projections you are making now.
I intend to complete the 144 or 160 Practicum hours (as applicable) according to the following timeline/schedule. I also understand that I must see at least 80 patients during my practicum experience. I understand that I may not complete my practicum hours sooner than 8 weeks. I understand I may not be in the practicum setting longer than 8 hours per day unless pre- approved by my faculty.
Number of Clinical Hours Projected for Week
Number of Weekly Hours for Professional Development
Number of Weekly Hours for Practicum Coursework
Week 1
9
8
4
Week 2
24
8
4
Week 3
24
8
5
Week 4
24
5
5
Week 5
12
5
5
Week 6
11
5
5
Week 7
10
5
5
Week 8
10
5
5
Week 9
20
5
5
Week 10
20
8
5
Week 11
20
8
5
Total Hours (must meet the following requirements)
160 Hours
Part 4 – Signatures
Student Signature (electronic): monica castelao Date: 12/23/21
Practicum Faculty Signature (electronic) **: Date:
** Faculty signature signifies approval of Practicum Experience Plan (PEP)
Submit your Practicum Experience Plan on or before Day 7 of Week 2 for faculty review and approval.
Once approved, you will receive a copy of the PEP for your records. You must share an approved copy with your Preceptor. The Preceptor is not required to sign this form.
References
Early, B. P., & Grady, M. D. (2017). Embracing the contribution of both behavioral and cognitive theories to cognitive behavioral therapy: Maximizing the richness. Clinical Social Work Journal, 45(1), 39-48.a
Erickson, M. E. (2017). Modeling and role-modeling. Nursing Theorists and Their Work-E- Book, 398.
