Assignment: Practicum � Week 9 Journal Entry

An advance directive is a legal document that defines a patient�s wishes for medical care. This document is a way for patients to share their wishes with family members and health care providers when their illness or mental capacity prevents them from making decisions. As an advanced practice nurse who has care discussions with patients and their families, you need to not only be familiar with the process of completing an advance directive, but also understand how this document might impact your role in patient care and treatment.

Journal Entry Part 1

For the first part of your journal entry, reflect on the Five Wishes presented on the Five Wishes website and PDF and complete your Five Wishes. Explain your state�s requirements for advance directives, including whether your Five Wishes can be turned into a formal document. Then, explain how your experience of completing your Five Wishes advance directive will help you guide discussions with patients and their families. Finally, explain how you might apply the Five Wishes advance directives to your nursing practice. Include how this advance directive might benefit patients in decision making for specialized areas of care.

Journal Entry Part 2

For the second part of your journal entry, reflect on geriatric patients from your practicum site with disorders related to specialized areas of care, such as oncology, nephrology, urology, gynecology, and neurology. Describe a case of a frail elder patient who must make decisions related to specialized areas of care. Then, explain potential patient outcomes and include whether treatments would be beneficial and how they would impact the patient�s quality of life. Finally, describe the patient�s wishes in terms of treatments and interventions for the disorder (Was there an advanced directive?) and how the patient might want to spend any remaining time. Include how environmental factors, such as family, caregivers, ethnicity, culture, religion, and/or personal values, might impact decision making for treatments and interventions. If you did not have an opportunity to evaluate a patient with this background during the last 9 weeks, you can select a related case study or reflect on previous clinical experiences.

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