NURSE-PATIENT INTERACTION                                                                        ANALYSIS                                                       MODIFICATIONS
NURSE                                                  CLIENT
Nurse: Hello Angel! (smiles)                         • Greeting – recognition.
                                                 This statement is used to start the conversation with
                                                 the client. Smiling will let the patient be at ease with
                                                 the student nurse.
Client: Hello Cleng! (smiles back)                                                                           •   Shows that the client is willing to talk with the
                                                                                                                 student nurse.
                                                                                                             • Transactional analysis by Eric Berne-
                                                                                                             Because when the student nurse acknowledge the
                                                                                                             presence of the client by saying hello it is the
                                                                                                             transactional stimulus, and when the client
                                                                                                             responded something that is related to the
                                                                                                             stimulus then it is transactional response.
Nurse: Sabi mo ito ung time na pwede nating          •   Giving information- this statement shows the
umpisahan yung counseling session natin.                 overview of counseling. Student nurse giving
Makikinig at kakausapin kita tungkol sa                  information that the clients needs to know.
problema mo.
Client: Oo, pwede ngayon bago ko pupuntahan                                                                  •   The statement shows that the client is willing
naman yung patient ko sa Camp Dangwa. Sinabi                                                                     to accept what the student nurse has to offer
ko naman na mga 4 pa ko pupunta sa kanila.                                                                       and is willing to cooperate.
Nurse: Ano naman gusto mong pagusapan natin          •   Giving Broad openings- it shows that the
ngayon?                                                  client can take the lead in the conversation
                                                         and that she can freely choose the topic of
                                                         discussion.
Client: Kahit ano, magtanong ka lang sasagutin                                                               •   Filipinos are generally passive and lacks
ko naman. Cge magtanong ka lang.                                                                                 initiative. This is shown in the statement use
                                                                                                                 by the client.
Nurse: Sinabi mo sa akin nung tinanong kita          •   offering general leads- allows the client to
kung pwede kitang maging client na mayroon               take direction in the conversation
kang family problem. Ano ba itong tinutukoy
mo?
                                                                                                      •   Filipinos are generally passive and lacks
Client: Ahh yun, Tungkol sa family ko. Nahihiya                                                           initiative. This is shown in the statement use
ku sayo. (lowers head)                                                                                    by the client.
                                                                                                      •   The client has great love for the family to
                                                                                                          meet her needs for love and belongingness.
                                                                                                          This is the third level in Maslow’s hierarchy
                                                                                                          of needs.
                                                                                                      •   Rootedness by Erich Fromm – the need to
                                                                                                          attachment or sense to family to fulfill
                                                                                                          psychological needs. The client is concerned
                                                                                                          with her family problem since she is attached
                                                                                                          to the family especially to her mother where
                                                                                                          she find the feeling of being loved.
Nurse: Paused (maintained eye contact)            •   Using Silence- it gives the client time to
                                                      collect thoughts or think through a point.
Client: ahhhhmm (thinking)                                                                            •   Thinking (analytical, psychological by Carl
Medyo magulo kasi yung family ko, childhood                                                               Jung)- means evaluating thoughts or ideas
experience ko, ahhh ganito yon dati kasi                                                                  rationally and logically
sinasaktan ako ng mommy ko.                                                                           •   The client has great love for the family to
                                                                                                          meet her needs for love and belongingness.
                                                                                                          This is the third level in Maslow’s hierarchy
                                                                                                          of needs.
                                                                                                      •   Rootedness by Erich Fromm – the need to
                                                                                                          attachment or sense to family to fulfill
                                                                                                          psychological needs. The client is concerned
                                                                                                          with her family problem since she is attached
                                                                                                          to the family especially to her mother where
                                                                                                          she find the feeling of being loved.
Nurse: ha? Bakit? Pano? (shocked)                 •   Untherapeutic – belittling feelings expressed                                                          Nurse: Ikwento mo nga
                                                      by client                                                                                              sakin kung ano at pano
                                                                                                                                                             nagyari?
Client: Kasi lalo na nung bata ako, sinasaktan                                                        •   Instinct by Freud– to keep the body free of
niya ko physically. Konting bagay lang pag                                                                tension or hurt. The statement that said that
nagagalit siya yun sinasaktan niya na ako.                                                                “Kasi sinasangga ko alangan naman ung
Minsan pa nga pumapasok me sa school may                                                                  muka ku db?” Justify this theory.
mga naiwang marks sa katawan ko, nung high                                                            •   The client has the need for safety and security,
school pa ko nun, lalo na sa mga legs at kamay.
Kasi sinasangga ko, alangan naman ung muka ku                                                             so by blocking her hands to stop her mom to
db? Pero pag tinatanung nila sa school kung san                                                           hit her means she protects herself. This is the
ko nakuha snsabi ko nalng na nauntog ako ganun                                                            in the second level of Maslow’s hierarchy of
o nascratch, basta di ko sinasabi yong totoo.                                                             needs.
                                                                                                      •   Neglect and Rejection by Alfred Alder-
                                                                                                          children whose parents are hostile go through
                                                                                                          infancy and childhood as characterized by a
                                                                                                          lack of love and security. Because of this
                                                                                                          theory we can relate why the client does not
                                                                                                          tell others what really happened to her since
                                                                                                          as a result of this she view others with
                                                                                                          distrust.
Nurse: Mayroon bang ginagamit yung mommy           •   offering general leads- allows the client to
mo pag sinasaktan ka? O ung kamay niya lang?           take direction in the conversation
Client: Gumagamit siya ng stick minsan sinturon.                                                      •   Neglect and Rejection by Alfred Alder-
Meron pa ung one time hinawakan niya ung                                                                  children whose parents are hostile go through
mouth ku (using gestures) nagsusugat ung labi ko                                                          infancy and childhood as characterized by a
nun. Natatakot nga ko nung bata ko sa kanya iyak                                                          lack of love and security. Because of this
ng iyak sinasabi ku “mama tama na wag na po,                                                              theory we can relate why the client does not
huwag niyo napo akong saktan”.                                                                            tell others what really happened to her since
                                                                                                          as a result of this she view others with
                                                                                                          distrust, becomes emotional or even feels
                                                                                                          anger.
                                                                                                      •   Neurotic anxiety by Freud- the unconscious
                                                                                                          fear of being punished. This was felt by the
                                                                                                          patient, she tells her mom to stop hitting her.
Nurse: Hanggang ngayon ba sinasaktan ka pa ng      •   offering general leads- allows the client to
mommy mo?                                              take direction in the conversation
                                                   •   Exploring- examining certain ideas,
                                                       experiences more fully.
Client: Hindi naman na. pero pinaka last eh                                                           •   The idea that it is horrible when things are not
malaki nako nun, siguro mga 2nd year college.                                                           the way we like them to be by Albert Ellis-
Pero halos lage kame nagaaway.                                                                          since the client is being hurt physically by the
                                                                                                        mother and also they fight together often she
                                                                                                        sees this things as bad.
Nurse: Sinabi mong halos lage kayo ngaaway,      •   Seeking clarification- clarifying unclear
gaano kadalas naman ito?                             thoughts can help client clarify their own
                                                     thoughts ad well as maximizes mutual
                                                     understanding between the student nurse and
                                                     client.
                                                 •   Exploring- examining certain ideas,
                                                     experiences more fully.
Client: Sa isang week siguro mostly sa araw na                                                      •   Neglect and Rejection by Alfred Alder-
yon nagaaway kami. Siguro kasalanan ko rin                                                              children whose parents are hostile go through
kung minsan kung bakit niya koh nasasaktan.                                                             infancy and childhood as characterized by a
                                                                                                        lack of love and security. Because of this
                                                                                                        theory we can relate why the client does not
                                                                                                        tell others what really happened to her since
                                                                                                        as a result of this she view others with
                                                                                                        distrust.
                                                                                                    •   The idea that we have virtually no control
                                                                                                        over our emotions and we cannot help feeling
                                                                                                        disturbed about things. – the patient said that
                                                                                                        it is her fault but we really have control over
                                                                                                        our emotions and that we can change our
                                                                                                        destructive thinking or emotions.
Nurse: Paano mo naman nasabi na kasalanan        •   Seeking clarification- clarifying unclear
mo? Ano yong mga instances na tinutukoy mo?          thoughts can help client clarify their own
                                                     thoughts ad well as maximizes mutual
                                                     understanding between the student nurse and
                                                     client.
                                                 •   offering general leads- allows the client to
                                                     take direction in the conversation
Client: Meron yong isang beses nakatulog ako sa                                              •   Faith and Religiosity strength of a Filipino.
salas, di ko napatay ung ilaw at TV, nagulat na                                                  Since she want to serve her faith in the means
lang ako nung hinampas niya ko sa muka, as in                                                    of YFC, this leads to the fight with her mom.
sa muka talaga. (using gestures) tska meron pa                                                   Also this character makes the Filipinos daring
ung one time sa YFC kasi ineexplain ko sa kanya                                                  and also develop courage.
na gusto ko tlga magserve doon, eh pinaglalaban
ko yung faith ko eh di nya ata nagustuhan ayun
nasaktan niya ulit ako. Meron din yong nsasagot
ko siya kaya un nasasaktan niya na ako. Yun ung
mga times na nasasaktan niya na ako.
Nurse: Ano naman naramdaman mo tungkol             •   Exploring- examining certain ideas,
dito?                                                  experiences more fully
                                                   •   Encourages also description
                                                                                             •   Rationalization by Freud - interpreting our
                                                                                                 own behavior to make it more acceptable and
Client: Di naman ako galit kay mommy sa                                                          less threatening to us. The client said she is
katunayan love ko parin siya, kahit matagal na                                                   not angry though she is sad.
rin niya ko sinasaktan, kaso syempre nasasad                                                 •    The preconscious by Freud- storehouse
ako, bakit kelangan pa niyang manakit? Tska pati                                                 where it we are unconscious at the moment
sa kapatid ko nagagawa niya na rin yon, naawa                                                    but can summon easily. The patient can still
nga aku sa kapatid ko eh. Yong mga ginawa niya                                                   picture herself being hurt by her mother.
sakin malaki yong impact hanggang ngayon                                                     •   Passivity and lack of initiative as a Filipino
siguro kasi, hanggang ngayon fresh parin na                                                      trait- because Filipinos are too patient and can
naalala ko at napipicture ko ung sarili ko na                                                    endure long suffering they are mostly easily
sinasaktan niya. Dati nga pag kinekwento ko                                                      oppressed and exploited.
tong nangyari sakin iyak ako ng iyak ngaun hindi
nmn na.
Nurse: May gusto ka pa bang idagdag?               •   Exploring- examining certain ideas,
                                                       experiences more fully
Client: ahhmmm ( thinking)                                                                   •   Thinking (analytical, psychological by Carl
Ai oo pala, after naman naming mag away ni                                                       Jung)- means evaluating thoughts or ideas
mommy nagsosorry naman ako eh, example sa                                                                   rationally and logically
text ganon, minsan binibigyan ko pa nga siya ng                                                         •   Joy and humor as another Filipino trait-
flower eh. Malambing kasi akong person eh!                                                                  despite the presence of the problem the client
(laughs)                                                                                                    can still laugh and jokes around.
                                                                                                        •   Undoing by Freud- things that are done to
                                                                                                            cancel out unpleasant thoughts or feelings
                                                                                                            after they have already occurred. Like saying
                                                                                                            sorry and giving flowers.
Nurse: Ano naman nagging reaction ng mommy           •   offering general leads- allows the client to
mo pag nagsosorry ka? O natry mo na bang                 take direction in the conversation
kausapin yong mommy mo tungkol sa pananakit          •   Exploring- examining certain ideas,
niya?                                                    experiences more fully
Client: Parang wala lang. no reaction siguro. Oo,                                                       •   The client expresses desire to solve her
pero hindi talaga yong tinanong kung bakit ka                                                               problem by Erich Fromm- man has the ability
nananakit, sinabi ko mama sorry pero hindi                                                                  to solve problems. The client says sorry and
naman ako lang may kasalanan e, pati ikaw.                                                                  tries to talk to the mother.
Sasabihin niya, hindi! ikaw lang ang may                                                                •   The client has great love for the family to
kasalanan wala akong kasalanan ganon.                                                                       meet her needs for love and belongingness.
                                                                                                            This is the third level in Maslow’s hierarchy
                                                                                                            of needs.
                                                                                                        •   Rootedness by Erich Fromm – the need to
                                                                                                            attachment or sense to family to fulfill
                                                                                                            psychological needs. The client is concerned
                                                                                                            with her family problem since she is attached
                                                                                                            to the family especially to her mother where
                                                                                                            she find the feeling of being loved.
Nurse: Natry mo nabang makipag usap ulit sa          •   Non therapeutic. Should use open ended                                                                 Nurse: mayroon ways ka pa
mommy mo?                                                questions.                                                                                             bang nagawa para
                                                                                                                                                                makausap mo ung mommy
Client: hndi na, kasi naman baka magalit ulit siya                                                      •   Filipinos are generally passive and lacks           mo tungkol sa siruation
sakin eh. Lagi naman niya sinasabi kasalanan ko                                                             initiative. This is shown in the statement use      niyo?
lahat.                                                                                                      by the client.
                                                                                                        •   Irrational Belief by Albert Ellis- that one can
                                                                                                            not and must not face life difficulties and it is
                                                                                                            easier to avoid them.
Nurse: Uhuh…                                         •   Accepting- acknowledging client’s statement.
                                                        Does not necessarily indicate agreement but it
                                                        is non judgemental.
Client: Alam mo ba nun nung kinekwento ko toh                                                            •   Pychogenic needs by Henry Murray
sa iba iyak ako ng iyak. Pero ngaun medyo hindi                                                              (Personology) arise indirectly from primary
na.                                                                                                          needs and are concerned with emotional
                                                                                                             satisfaction and include psychological eeds
                                                                                                             such as affiliation.
Nurse: ahhh.. nasasabi mo sa iba tong experience    •   Restating- repeating the idea expressed
mo.
Client: Oo, ikaw na siguro ung fourth na group or                                                        •   Extreme family centeredness as a Filipino
person pero recently lang mga college na ksi dati                                                            trait. We tend to cover up for the mistake of
ayaw ko tlgang pagusapan yon. Kasi mabait                                                                    our family member so as to have a good
naman mommy ko eh.. baka pag nalaman niyang                                                                  perception or name in the community.
kinekwento ko sa iba baka isipin niya sinisiraan                                                         •   Denial by Freud- refusal to admit the
ko siya. Tsaka yaw ko ksaing isipin ng ibang                                                                 existence of an external threat or traumatic
masama siyang tao porket sinasaktan niya ako                                                                 event.
kasi mabait naman talaga siya.
Nurse: ahmmm may 10 minutes pa tayo may             •   Giving information regarding the time left for
gusto ka pa bang sabihin?                               the conversation. This is making available
                                                        facts that clients need.
Client: Yan muna sa susunod ko nalang ikkwento                                                           •   This means that the client is willing to talk to
yong iba sayo.                                                                                               the student nurse again, rapport has been
                                                                                                             gained.
Nurse: Ok, napagusapan natin yong mommy mo          •   Summarizing- collecting all the important
na sinasaktan ka niya physically at di ka namn          points of discussion to enhance
galkit sa kanya pero nasasad ka.                        understanding.
Client: Oo un.. (nods) ahmm set tayo ng date at                                                          •   Indicates that the client agreed on the
time para sa next meeting natin.                                                                             summary of discussion given by the student
                                                                                                             nurse and is interested for the next counseling.
Nurse: Ok kelan ba bakante mo? Kung kelan ka        •   Setting the contract so that the client will
pwede kasi db magppc ka rin . para di conflict sa       know when to see the student nurse again.
schedule mo.
Client: Oo cge ( smiles) sa Tuesday nalang 11-1                                                        •   Shows that the client is willing to talk again
vacant ko.                                                                                                 with the student nurse.
Nurse: Sige sabay nalang tayo kain.. salamat ha?    •   Therapeutic ending or appropriate closure to
Isip ka ng paguusapan natin next time bbye!             the counseling session
(smiles, kiss in cheek and waves)
Client: Ok bbye cleng (kiss back smiles and also                                                       •   Marks the end of the counseling sessioin
waves)                                                                                                 •   Complementary Transaction by Eric Berne-
                                                                                                           two persons are sending and receiving the
                                                                                                           same ego state.