Journal Entry #1 Student Name Walden University PRAC 6552 Date Reflect on the 3 most challenging patient encounters and discuss what was most challenging for each. A patient who hasn't had a Pap or well women exam in over 20 years. This case was challenging as the patient still had her female anatomy and was only 60 years old. This case involved a lot of teaching for the patient to understand the risks she might be facing. She did not think it was dangerous not to have a Pap in over 20 years and thought HPV affected younger generations since there was a vaccine for them. A young patient who has breast cancer. This was a challenging case only because it was so sad. She is only 37 years old with two little kids battling breast cancer. She had to have a double mastectomy, and due to that, her husband left her. The patient had good support from her mother and father and was very positive, and showed a strong commitment in betting this battle. It was challenging not to be overly emotionally invested in her case. My preceptor told me it's ok to be empathic to her case, but there are a lot of these cases, and it can eat you up and burn you out fast if you don't learn to balance it. A patient managing birth control side effects and options. This is just new to me, all the many different options of birth control and the side effects it can have on a patient. This patient was back for the third time to try a new birth control as the others were causes unfavorable side effects. What did you learn from this experience? I have learned you need to educate your patients; it is not all about labs and changing medications. We are still using our nursing background and providing support and education to all our patients. What resources did you have available? My nurse practitioner preceptor will run things with her physician if it is something out of her expertise. I have also used UpToDate and Epocrates apps on my phone. What evidence-based practice did you use for this patient? I used the American Cancer Society guidelines for my patient who did not receive a pap smear in over 20 years. What new skills are you learning? I am learning how to perform Pap smears and breast exams, well women exams, the differences between peri-menopause, menopause, and post-menopause, and ............Continue