ORIENTATION PHASE
Biographic data;
Name: IED
Date of birth: March 23rd, 1954
Age: 55yrs
Gender: Male
Status: Married
Educational attainment: Law
Religion: catholic
Setting;
Place: Pavilion 21, dinning hall
Date and time: January 9th,2009. 3pm-11pm
Description of patient;
My client is an adult male, dressed in blue shirt and shorts. He has a neat appearance. Yellow
skin colour and gray hair he is also well behaved and cooperative with good eye contact, good
body posture and body language. His vocabulary is fluent. My client has a confident and pride in
himself.
He is aware of his surroundings but is not acquainted to reality. He has inner creativity
which he shows when conversing, but is bound to fantasy. He smiles but when asked about his
condition and family his facial appearance changes (sad). When interacting with him he showed
interest .he thinks he is now better and ready to be united with his family. He often changes topic
and prefers discussing more on his inner creative thoughts.
Description of environment;
The environment is well kept with beautifications (trees) around and quiet and conducive for the
patients. It has boundaries that separate the patients from the health professionals.
Objectives;
• Introduction and acknowledging the client
• Establishing rapport with the client
• Using therapeutic means of communication to discuss clients problems
• Organizing the socializing activities of the day
1. News paper reading
2. Mind games
3. Bibilo theraphy
4. Music and art theraphy
• Starting activities as scheduled and finishing on time
• Making sure the socialization was successful and beneficial
• Submission of the requirements for the day
NUSRE-PATIENT INTERACTION
NURSE PATIENT INTERPERTATION AND
ANALYSIS
Verbalize; Verbalize; Interpretation;
“Good afternoon. I am a “yes go on” The interaction with my client
student nurse from FEU. I was therapeutic in that it made
will be your student nurse him express his inner feelings
for today for the 4days in towards his environment and
this hospital, i am here to the people around him. In my
help you with your health interaction with him he
problems. showed concerns and mood
changes from happy to sad
I will ask you some
when asked about his
questions it will take 20-
condition and his family
30mins, will that be okay
which shows that he is
with you?”
emotionally alert. I noticed
“I am fine thank you” that defense mechanism’s
were used such as
“how are you today?” “ Ignacio Eriberto Y
rationalization, projection,
Dimaano jnr. But you can
“can you state your full denial)
call me mang jun, i was
name, your date of birth,
born in march 23rd 1954 My client has confidence and
your religion and and i graduated from the pride in himself.
educational attainment?” school of law”
His body language; posture,
proper eye contact are
appropriate. He has
“ how long have you been “ I have been here for up
accelerated speech. He
in this institution?” to 7years”
understands what is been
asked and replies accordingly
but at the same time shifts
“how do you find your “ I get along with the
from one topic to another. He
surrounding and do you people here, i am the
sounds like an intelligent man
get along with the people president here. I have a
but seems to have inner
here” high rank here. But i am
creativity which is over
not violent
shadowing his thoughts and
I was in pavilion 1in Feb. not realistic to his goals in life
2002. Where i wash plates due to what he thinks is true,
and measure rice. It was he blames people for his
there i got scabies because present situation, for putting
i slept on the floor. It was him in the institution against
the people who collided his own will.
against me that put me
His facts of reality are true to
there, it was a charity ward
him.
but now i am in here and it
is much better than that The nurse set bounds and
place” states her reason for the
interaction she tried to focus
more on the client when the
“my adopted sister comes client wants to shift topic.
once or twice in a year to
At the end of the interaction
drop my toiletries but she
the nurse advices the patients
doesn’t spend much time
on issues such as establishing
with me, i know she hates
me” communication with other
inmates
“she is my adopted sister,
before i was brought here,
“ how often do you have
we had problems,
visitors?”
arguments. We are not
close at all, we don’t just
agree to a certain things”
Analysis;
Psychosis is a person’s
systems state that refers to the
presence of reality
“before i agree i was
misinterpretation,
depressed but i became
disorganized thinking.
better”
Psychosis may occur owing to
“Do you have a close the presence of a medical
relationship with your neurological or psychiatric
sister? condition. Individuals who
“The reason i am in this incur psychosis may
institution, you can believe experience altered sensory
“Do you know the reason it or not, is that Gloria and perception at
u are in this institution?” her fellow people collided small,taste,sight,illusion,
and put me here. I do write
Hallucination, delusion
to high class people.when
Gloria became a president
i wrote to her regarding the
(Ref. Page 359, Psychiatric
programs that will benefit
Nursing. Biological and
this country, in order to
behavioural concepts by
build the economy and
proper ways to govern this Deborah antai-otong)
country”
“ Gloria is part of the sebu
One individual characteristic
business and other high
that is very relevant to
class people”
personality development is
“Erab is a good man, intelligence. Intelligence is the
although he gambles he aptitude or capacity for
uses the money to help the learning. Intelligence is
“lets focus on the time you poor but Gloria is corrupt biologically determined by the
spent here” she was among those that virtue at a fact that a person
helped put erab in jail” inherits a nervous system.
However, experiences
“What activities do here?” provided by the environment
“i do work with the PNA may retard and facilitate the
and i was in the police development of cognitive
force for 4years before skills. The ability to reason
going into law . i was through complex situations
recruited when i was has many implications for
“what do you do if you are 21years old.” personality development.
bored” Intelligence has a profound
“ most of the activities we
impact on many areas of
have here are done by the
development and behaviour
student nurses, they are
such as
fun”
talking,memory,understanding
“i do get bored but not that and applying new concepts
much because i have a and creativity
radio underground i do
The ability to cope with a
communicate with, the
variety of situations reflects
radio has a magnetic wave
an awareness of one’s
although i don’t get
strength, limitations and
responds from it” indicates capacity to tap one’s
resources as necessary at great
“Do you miss home?” “of course i do, i just wish
importance to personality
i will leave here and meet
development.
my family. Sometimes i
just get sad, i want to be
united with them”
“try and communicate with (Ref. Pg 125, mental health
your fellow inmates, have ursing. A holistic approach
activities in that way you edition 2 by
“okay i will try that but
won’t feel bored and home Pasquali,Arnold,Debsio &
they think different from
sick” Alesi)
me”
“Sir, my time is up
thank you for your
“Thank you, for listening
cooperation. But we are
to me” Impaired judgement in people
having socialization
who have socially aberrant
activities, in case you have
ways usually evidence poor
any questions or concerns
“no problem, thank you judgement. Many do not show
feel free to ask me”
again” any insight into their
“You are welcome” behaviour, nor do they
indicate any concern about the
consequences of that
behaviour. They may not learn
from experience.
(Ref. De meyer Gapin &
scott, 1977)
(Pg 126, mental health
ursing. A holistic approach
edition 2 by
Pasquali,Arnold,Debsio &
Alesi)
Communication generally
important in nurse patient
interaction but verbal and non
verbal. Eye contact; provides
a channel for nurses to
connect with clients in a
manner that conveys genuine
concern and care. inner
feelings are often reflected
through one’s eyes.
Body language refers to
manufacturing of feelings or
thoughts by ways of body
gestures. It is a powerful
nonverbal communication
tool. Recognizing it helps
nurse understand her own and
the behaviour of the client
(Ref. Pg.133. psychiatric
nursing. Biological &
Behavioural concepts by
Deborah antai-Otong)
Facial expression, releves
internal feelings and
emotions. They convey a
number of feelings that are
reflected in client. Intense
massage are easier to asses
than subtle responses;
flat blunted or congruent
affect often masks feelings &
emotions.
The physical appearance such
as personal hygiene, posture,
dress and appropriateness of
the clothes, revels the clients
level of functioning,
confidence, self worth.
(Ref. Pg.133. Psychiatric
Nursing. Biological &
Behavioural concepts by
Deborah antai-Otong
Regardless of the formality or
length of relationship, each
nurse actively encourages the
patient to feel comfortable in
the relationship. An effective
communication is based on
the patient and the nurse
getting to know each other.
(Ref. Pg.99, Psychiatric
Nursing by Norman L.
Keltne, Lee Hilyard
Schwecke,Carol E. Bostom)
The nurse patient relationship
is not a social relationship.
Although the nurse might
relate informally with
patients, the maintance of
objectivity and goal-directness
is crucial. Patients particularly
those with a history of
unsatisfying relationships,
might misinterpret the nurse’s
interest and concern.
(Ref. Pg.97, Psychiatric
Nursing by Norman L.
Keltne, Lee Hilyard
Schwecke,Carol E. Bostom)
Defense mechanism has two
aspects first; they keep
unwanted thoughts out of the
awareness and use energy to
do this. Secondly, energy
cannot be contained
indefinitely therefore some
defense mechanism allows the
energy to be discharged as in
projection, rationalization,
denial,sublimination,reaction
formation
(Anna Freud 1937)
(Ref. Pg 29. Psychiatric
Nursing. Biological &
Behavioural concepts by
Deborah antai-Otong)
Evaluation; At the end of the day;
• I was able to introduce and acknowledge my client
• I was able to establish rapport with my client
• I was able to use therapeutic means of communication to discuss clients problems
• Was able to properly Organize and carry out the socializing activities of the day as
follows:
1. News paper reading
2. mind games
3. Biolo theraphy
4. music and art theraphy
• Was able to start activities as scheduled and finish on time
• The participants was grateful at the end of the day
• With group cooperation activities where successful and beneficial
• Submission of the requirements for the day
