#clinical practice

Disorder 1: Intellectual Developmental Disorder (IDD)

Intellectual Developmental Disorder is a neurodevelopmental condition where a person has:

• limitations in intellectual functioning

(reasoning, learning, problem-solving)

• and limitations in adaptive functioning

(daily life skills, communication, social responsibility)

It begins during childhood, and it’s about support needs, not worth or potential.

📌 what ICD-11 emphasises (important)

This is key and often misunderstood:

ICD-11 does not diagnose based on IQ alone.

Diagnosis focuses on how a person functions in real life, such as:

• communication

• self-care

• social understanding

• independence appropriate to age

📊 how severity is understood

Severity is described as:

mild

moderate

severe

profound

But this is based on adaptive functioning, not a number on a test.

Support ≠ failure.

Support = access.

🧬 common causes & associations

Intellectual Developmental Disorder may be associated with:

•genetic conditions (e.g., Down syndrome, Fragile X)

•prenatal factors (e.g., infections, alcohol exposure)

•Perinatal complications

•metabolic or neurological conditions

•Sometimes, no clear cause is identified — and that’s okay.

🚫 what it is NOT

•not laziness

•not poor parenting

•not a personality flaw

•not a fixed limit on growth

People with IDD learn, feel, form relationships, and develop skills — often differently, not deficiently.

🌱 a gentle reminder

A diagnosis describes support needs, not a person’s value.

Y'all, I'm sitting here with my RN license in hand, and I had to share this because six months ago I was literally crying in my car after bombing another practice test. Like, ugly crying. The kind where you question every life choice that led you to nursing school.

I had tried everything. Flashcards? Check. Question banks? Double check. Review books that cost more than my textbooks? Triple check. But my scores were stuck in this frustrating 60-65% range, and I was starting to panic because my NCLEX date was creeping up fast.

The Problem With How I Was Studying

Here's the thing I finally realized: I was studying nursing like I studied for every other test in college. Memorizing facts, drilling questions, hoping something would stick. But the NCLEX isn't testing if you memorized that normal sodium levels are 135-145 mEq/L (though yes, you should know that). It's testing if you can think like a nurse.

And thinking like a nurse means seeing the whole picture, not just isolated facts.

The Method That Actually Worked

I started what I call "scenario-based learning," and it completely changed my game. Instead of just answering random questions, I began working through complete clinical scenarios from start to finish. Like, really detailed ones where I had to think through:

What's happening with this patient right now?

What could go wrong?

What's my priority?

What would I do first, second, third?

How would I know if my interventions worked?

It was like the difference between learning vocabulary words versus having actual conversations in a foreign language. Suddenly, all those random facts started connecting into actual clinical reasoning.

I found this tool called Case Crafter Pro that generates realistic clinical scenarios using AI, and honestly? Game changer. Instead of the same recycled cases everyone uses, I could practice with fresh scenarios that felt like real patients I might actually encounter.

How I Actually Did It

Step 1: Start with the big picture I'd read through the entire scenario first without looking at any questions. What's the story here? What kind of patient am I dealing with?

Step 2: Think out loud This felt weird at first, but I literally talked through my thought process. "Okay, this patient has chest pain and shortness of breath, they're 65 with a history of hypertension... I'm thinking cardiac, but I need to rule out..."

Step 3: Work through priorities Before jumping to interventions, I'd force myself to identify what's most important right now. ABCs? Safety? Pain? This helped me nail those priority questions that used to trip me up.

Step 4: Follow the whole case Instead of just answering one question and moving on, I'd follow scenarios from admission to discharge when possible. How does this patient's condition change? What complications arise?

The Results

Within three weeks of switching to this method, my practice scores jumped to the high 70s. More importantly, I felt confident. When I sat for my NCLEX, I wasn't just recalling facts—I was actually thinking through each scenario like I'd done hundreds of times in practice.

The computer shut off at 75 questions (hello, anxiety), but I knew I had passed before I even got the official results. That clinical reasoning muscle I'd built up made all the difference.

Why This Works

The NCLEX isn't really testing your textbook knowledge—it's testing your ability to apply that knowledge in real situations. When you practice with complete clinical scenarios instead of isolated questions, you're training your brain to make those connections automatically.

Plus, it makes studying way more interesting. Instead of mindlessly drilling questions, you're solving puzzles and telling stories. It actually feels like preparing to be a nurse, not just preparing for a test.

If you're stuck in that same cycle I was—knowing the material but not seeing the scores you want—try shifting to scenario-based practice. Case Crafter Pro has been incredible for generating the kind of realistic, detailed cases that actually prepare you for both the NCLEX and real nursing practice.

Wednesday recap

I feel like i had a really good night of sleep, even though it werent so many hours and still woke up few times in the middle, it was just enough + my headache vanished

I got just in time to the campus to leave my things at my locker and this time didn't run towards the hospital despite having just 3 minutes to be on time

Today was a pretty relaxed day at the hospital or at least i felt it like that, the professors and the Dr. were bussy evaluating the rest of the rotation. We saw some interesting cases but i worked just with one patient today, they had several head trauma + multiples fractures in craneum, clavicle, ribs + hemopneumothorax + myocardial trauma + ventilator-associated pneumonia

There were many times in which i was left alone to work with the Dr. (little me would be screaming, crying, throwing up at this point) but i think i did just great (i really want to left a good impression of me on her :c ), i noticed important things during the application of the treatment and i tried to point them out

One weird? unfortunate? thing that happened today ( i don't even know how to classify it 😭) was that while i was helping to movilizate one of the patient's arms i accidentally placed my hand on an open wound, i didn't know it was there, no one told me and i noticed just because it started leaking in my hand it was an experience to say the least 😀

Not gonna lie i panicked internally a little and was like Dr? their hand.. it is weat ... is there a wound? and she was like yep, then again, is .. is it open? yep (no thank you for the warning)

As today was the last day of our rotation in the hospital (💔) one of the professors gifted us stickers :c and then once out we took a group pic in front of the hospital

As i said before, this last months at hospital made me realice that this field is one of my favorites to develop my career into, i hope that if this is for me, in a future i have the opportunity to work again in a place like this 🙂‍↕️✨

And i don't think i can stress this enough but please please guys, always take care of your body, try to maintain a healthy life style, this is a really important factor to reduce the risk of complications and the time of stance in the ICU in case one day (that i hope never never never comes) you have to be derivated to this special care unit

I did so much more after practice today, but i think this already turned long enough

Thank you so much for taking the time to read all of this rambling

👣 12.1 k

“In particular, we’re really excited to see the range of manuscripts that can come in, the range of clinical practice that’s found across Europe and further abroad as well.”

From clinical practice to peer review, the new editors of European Heart Journal – Case Reports describe how their roles will help shape the younger group of clinicians and researchers in the field of cardiology.

And yet, somehow, that’s the first thing people expect.

Over the past five years, I’ve been asked to “read someone’s mind” more times than I can count. Sometimes it comes from curiosity. Sometimes from genuine innocence. Sometimes it’s framed like a challenge— go on, tell me what I’m thinking. And almost every time I say, “I can’t,” there’s that brief pause. That look. A quiet disappointment, as if I’ve failed to live up to something they were certain I could do.

It’s not their fault entirely. Psychology has been romanticized into something it is not. Movies, shows, even casual conversations have shaped this idea that psychology is a shortcut into people’s minds— that with enough training, you can decode someone instantly, extract truths, or reveal secrets just by looking at them.

But psychology doesn’t work like that.

Psychology is a science. And like any science, it is slow, structured, and grounded in evidence. It relies on observation, data, patterns, and context. It does not rely on intuition alone, and it certainly does not operate through telepathy.

When we study psychology, we are not learning how to “read” people in a mystical sense. We are learning how to understand behaviour. We look at patterns, how someone responds to situations, how their thoughts influence their actions, how past experiences shape present functioning. Even then, what we form are interpretations, not instant truths.

There is no moment where you look into someone’s eyes and suddenly “know everything about them.”

At best, psychology trains you to notice. To observe more carefully. To pick up on subtle cues, tone, posture, inconsistencies, but even these are not conclusions. They are hypotheses. They need time, context, and often direct conversation to make sense.

One of the most common questions I get is:

“Can you tell something about me?”

It sounds reasonable. Almost harmless.

But if you pause for a moment, you’ll notice something deeper. People are rarely asking for an observation. They are asking for recognition. They want to hear something that aligns with how they already see themselves. They want validation, not analysis.

And without context, without interaction, without understanding their background, anything I say would not be psychology, it would be guesswork.

Psychology does not function in fragments. It cannot build meaning out of a single glance, a single message, or a single interaction. It requires patterns over time. It requires history. It requires context.

For example, two people may appear quiet in a social setting. One may be anxious, overwhelmed by internal fear. The other may simply be reserved, comfortable in silence. The behaviour looks the same. The meaning is entirely different. Without understanding the underlying process, any assumption would be inaccurate.

This is what psychology actually teaches us, to question surface-level interpretations.

It teaches us that behaviour is layered. That thoughts, emotions, environment, and past experiences interact in complex ways. That childhood experiences, attachment styles, and social conditioning can quietly shape who we become. That what you see is rarely the whole story.

And none of this happens instantly.

Another layer to this misconception appears in digital spaces. People often ask, “read my mind” or “tell me about me” through a screen. But psychology depends on observation, facial expressions, tone, behaviour, interaction patterns. Without these, there is no data. It becomes an empty exercise.

You cannot analyse what you cannot observe.

That said, the curiosity itself is not a problem. In fact, it is one of the most human things. Wanting to be understood. Wanting to understand others. Wanting someone to look at you and know you.

Psychology does not take that desire away. It simply reframes it.

It replaces the fantasy of instant understanding with the reality of careful, evidence-based insight. It shows that understanding a person is not about decoding them in seconds, but about paying attention over time. About asking the right questions. About listening, not assuming.

So no, I don’t read minds.

But I do study behaviour. I try to understand patterns. I learn how people think, feel, and respond. And in doing so, I’ve realized something far more important than mind reading:

People are not puzzles to be solved in a moment.

They are processes to be understood over time.

Sleep–Wake Disorders in ICD-11 are defined by persistent disturbances in sleep quantity, quality, timing, or regulation that cause clinically significant distress or functional impairment.

Importantly, ICD-11 classifies sleep–wake disorders in a separate chapter to reduce the artificial separation between “mental” and “physical” conditions. Sleep disturbance may occur as:

• A primary disorder (e.g., Insomnia Disorder)

• Secondary to another mental disorder (e.g., depression, bipolar disorder)

• Associated with medical or neurological conditions

Accurate diagnosis requires evaluating:

• Duration and persistence

• Adequate opportunity for sleep

• Daytime impairment

• Differential diagnosis

Sleep is a regulatory system — not just a behaviour.

Understanding classification improves assessment.

Assessment improves intervention.

Continuing the ICD-11 Sleep–Wake Series:

Next — Insomnia