MEDICAL COLLEGES OF NORTHERN PHILIPPINES

Alimannao Hills, Peñablanca, Cagayan 3502

Tel: (078) 304 – 1010; Telefax (078) 846 – 7549

COLLEGE OF NURSING

Establishing Therapeutic Nurse-Patient Relationship

Activity: Recorded NPI with Process Recording

CASE STUDY: PSJ: Schizophrenia

PSJ was a 21 year-old male who was brought to the emergency room of CVMC by the security guard of MCNP from
which he had been suspended for several months. A professor had called and reported that PSJ had walked into his
classroom, accused him of taking his payment for his tuition fee and refused to leave.

Although PSJ had much academic success as a teenager, his behavior had become increasingly odd during the past
year. He quit seeing his friends and no longer seemed to care about his appearance or social pursuits.

He began wearing the same clothes each day and seldom bathed. He lived with several family members but rarely spoke
to any of them. When he did talk to them, he said he had found clues that his college was just a front for an organized
conspiracy and rebellion.

He had been suspended from college because of recurrent tardiness and absenteeism. His sister said that she had often
seen him mumbling quietly to himself and at times he seemed to be talking to people who were not there. He would
emerge from his room and ask his family to be quiet even when they were not making any noise.

PSJ began talking about conspiracy and rebellion so often which prompted his father and sister to bring him for
consultation.
Upon assessment, PSJ was found to be a poorly groomed young man who seemed inattentive and preoccupied. His
family said that they had never known him to use drugs or alcohol, and his drug screening results were negative. He did
not want to eat the meal offered by the hospital staff and voiced concern that they might be trying to hide drugs in his
food.

His father and sister told the staff that PSJ great-grandmother had a serious illness and had lived for 30 years in a
hospital, which they believed was a mental hospital.

PSJ’s mother left the family when he was very young. She has been out of touch with them, and they thought she might
have been treated for mental health problems.

PSJ agreed to sign himself into the psychiatric unit for treatment. His story reflects a common case, in which a high-
functioning young adult goes through a major decline in day-to-day skills. Although family and friends may feel this is a
loss of the person they knew, the illness can be treated and a good outcome is possible.

Significant verbalizations:

“May naririnig akong mga boses”

“Palagi nila akong pinupuntahan. Sabi nila may digmaan na magaganap”

“Hindi ako makatulog”

“Hirap akong makakain at baka may lason ang mga ulam” Medications:

Typican/conventional : EPS

Dystonia

- Haloperidol 1 mg OD
 - Fluphenazine Decanoate 50 mg IM once a month
- Benztropin Mesylate
- Clozapin

Guidelines:

1. The group will submit a recorded video of the Nurse-patient interaction based on the case scenario that they have selected
2. The video must contain the three phases of the NPR
3. The group must consistently apply therapeutic communication throughout the NPI
4. The group must come with their own script based on the given scenario
5. Identify the priority nursing diagnosis based on the given scenario
6. The video must be at least 6 mins in duration
7. The NPI must be transcribed using the format for process recording

● Disturbed thought process related to possibility to hereditary factors as manifested by non-reality-based thinking about
conspiracy and rebellion
● Risk for Imbalanced Nutrition: less than body requirements related to unwillingness to eat secondary to
schizophrenia as evidenced by fear of poisoning
● Risk for Imbalanced Nutrition: less than body requirements related to unwillingness to eat secondary to
schizophrenia as evidenced by fear of poisoning
● Disturbed Sleep Pattern related to altered psychological status as evidenced by patient’s verbalization and
perception

Verbalization Response Therapeutic

Communication
“Hindi ako makatulog”
May gusto ka bang pag-usapan natin na bumabagabag sa Broad openings
iyo?

Dito muna ako sa tabi mo. Pag-usapan natin an gang iyong Offering self
nararamdaman

Madalas ka bang hindi makatulog? Kailan pa ito nagsimula? Placing event in time or
sequence

Hindi ka makatulog? / Nahihirapan kang matulog? Restating

Marahil pwede nating pag-usapan at tuklasin ang mga bagay Suggesting Collaboration
na nagdudulot sa iyo patungkol sa pagtulog mo.

Sige lang… makikinig ako; magpatuloy ka sa iyong General leads

sinasabi…

Nasabi mo kanina, isa sa mga dahilan ng hirap mong Summarizing

makuha ang iyong tulog ay……
Client Nurse response Therapeutic Communication

“May naririnig akong

mga boses” (“I am “What is happening?” Encouraging description of
hearing voices.”
perceptions—asking the

“What does the voice client to verbalize what he

seem
or she perceives
to be saying?”

“Tell me more about Exploring—delving further into a

that.” subject or idea

“Would you describe it

more fully?”
 “When did this Placing event in time or
happen?”
sequence—clarifying the

relationship of events

in time

Verbalization of the Patient Response of the Nurse Type of Therapeutic Communication

“Palagi nila akong

pinupuntahan. Sabi nila How long has it been since you started seeing and PLACING EVENT IN TIME OR SEQUENCE
may digmaan na hearing them?
magaganap”

"Gaano katagal na po simula noong nakikita at

naririnig niyo sila?”
Nods. I see. That situation might have been ACTIVE LISTENING
difficult for you. You must’ve felt a lot of emotions
building up.

Tumango. “Ang sitwasyong iyon ay maaaring

naging mahirap para sa iyo. Tiyak na ito ay
nagdulot ng sari – saring emosyon sa iyo.”

Are you seeing or hearing them now? Do you think ENCOURAGING DESCRIPTION OF
they will go and speak to you here and now? PERCEPTIONS

“Nakikita o naririnig niyo po ba sila ngayon? Sa

tingin niyo po ba ay pupuntahan ka ulit nila ngayon
dito at sasabihan?”

Have they ever talked to you like face – to – face ENCOURAGING COMPARISON
like how we are having a conversation right now?

“Nakipag – usap na ba sila sayo gaya ng pag –

uusap natin ngayon na harap – harapan?

I might not be able to see or hear them but I know ACCEPTING

and understand that you do.
“Hindi ko man sila naririnig o nakikita pero, alam ko
po, at naiintindihan ko na naririnig at nakikita niyo
sila.

But isn’t it unusual? VOICING DOUBT

“Hindi po ba parang nakapagtataka?”

They are talking about war but as of the moment PRESENTING REALITY
there has been no news regarding an impending
war and if there were the country would be very
alert about this. And the war has ended several
decades ago.

“Sinasabi nila na may paparating na digmaan

ngunit wala namang balita tungkol dito, at kung
mayroon man ay magiging alerto ang Pilipinas sa
pagdating nito. Ilang dekada na din ang nakalipas
mula nung natapos ang huling digmaan.
 Patient’s Verbalization Response Therapeutic Communication Technique

“Hirap akong makakain at baka may lason

ang mga ulam”
“alam kong iniiisip mo na may lason ang ACCEPTING
pagkain, pero walang lason ang pagkain
mo..”

“Naiintindihan kita, Nahihirapan kang RESTATING

makakain”

“walang lason ang mga ulam, bakit mo SEEKING INFORMATION

naman sasabi yan?
 “walang lason ang pagkain mo, yan din PRESENTING REALITY
ang kinakain ng mga kasama mo..”

“ako po ang student nurse niyo at nandito GIVING INFORMATION

po ako para tulungan kayo”

“gusto mo bang ikaw ang maunang FORMULATING A PLAN

kumain?”

“Sasamahan kitang kumain..” OFFERING SELF

Date and Time of NPI:

Case Scenario
Patient’s Response Nurse’s Response Therapeutic Analysis
Communication and
Verbal Non- Verbal Non- Technique Evaluatio
Response verbal Response verbal n
response response
Ex: open “Ok lang.” (nods, Giving This is the
“Maganda posture, smiles a recognition Orientati
ng araw walking, little but • Offering on Phase
Mr. J, ako smiling) avoids self so it is
po si eye • Rapport importan
nurse contact) t that I
building •
James, at establish
Giving
ako rapport
information
makakasam and a
a trusting
nyo sa araw relations
na ito. hip with
kamusta my
ka?” ( client.

Greeting
the client
by name
shows
that you
 acknowled
ge the
patient as
an
individual,
and he by
responding
proves that
he knows
his
own name
and is
oriented
with what’s
happening
at
the
moment.

I feel that
my
patient
 responded
rather
shyly.

NPR – Process recording

1. Appearance and setting

a. 3 – includes full description of appearance and setting/environment (client’s details; description of environment,
position of the nurse and client, presence of other people and distractions)
b. 2 – provides some description of the above
c. 1 – very limited information

2. Professional Goal
a. 3- clearly stated and defined; priority nursing diagnosis is relevant, timely and mutually agreed upon
b. 2- goal is clearly stated and defined; nursing diagnosis is not considered as priority
c. 1 – goal is not stated and defined; nursing diagnosis is irrelevant

3. Content and completeness

a. 3 – all phases of the NPI including tasks are complete and approprite
b. 2 – phases are somehow complete with some missing tasks
c. 1 – incomplete phases and tasks are not inappropriate

4. Therapeutic Communication (Patient)

a. 3- records both verbal and non-verbal communication; direct quotes are used for all statements; has at least 10
interchanges recorded from the client for each phase of the NPI
 b. 2 – records verbal and non-verbal response; has at least 5-7 interchanges
c. 1 – omits behavioral communication with less than 5 interchanges

5. Therapeutic Communication (Nurse)

a. 3- records both verbal and non-verbal communication; direct quotes are used for all statements; has at least 10
interchanges recorded from the client for each phase of the NPI
b. 2 – records verbal and non-verbal response; has at least 5-7 interchanges
c. 1 – omits behavioral communication with less than 5 interchanges

6. Self-awareness
a. 3- records thoughts and feelings for each interchange
b. 2- records thoughts and feeling for 80% or greater
c. 1 – records thoughts and feelings for less than 80 %

7. Nurse’s Self-evaluation
a. 3 – for each interchange, the student identifies communication skills or blocks used. Identifies correct therapeutic
communication technique and its corresponding rationale
b. 2 – Omits the above for 1-2 interchanges
c. 1 – does not provide appropriate communication strategy
Rubric for Video Demonstration
Category 4 - exemplary 3 proficient 2 partially 1 incomplete
proficient
Concept and Has a clear Has a fairly There is no clear Limited effort
completeness picture of what clear picture of focus in each of spent; focus is
of phases they are trying what they are the phases; not defined and
to achieve. trying to goals are not irrelevant;
There is an achieve. clearly defined; incomplete
adequate
Provided incomplete phases with no
description of
description on phases with descriptions
the phases of
NPI. most of the some description provided
All phases are phases
present
Content and the content has There is a clear The content The video lacks
organization clear statement statement of does not clearly content and
of the purpose the purpose; present the focus. The
of the video most of the purpose of the overall message
presentation; details are video; some is irrelevant and
messages and
there is a variety logical and inappropriate
information are
of supporting persuasive;
vague and
information in most messages
irrelevant
the video
presented; are relevant and
messages are accurate
well conveyed
and appropriate
to the scenario
Quality The presentation Video is Video lacks 1 or Video lacks
is complete and complete. The 2 elements. most of the
had all required transition is Transition needs elements
 elements. The somehow further required.
video transition smooth improvement Transition is
is smooth. poor
timeliness The video was Video was The video was The video was
submitted on submitted a day submitted 2 submitted 3 days
time after the set days after the after the
deadline deadline deadline
NURSE PATIENT INTERACTION

A. PROCESS RECORDING

ORIENTATION PHASE (JULY 06, 2009)

OBJECTIVES:

● to establish rapport and trust and cooperation

● to establish roles and purposes of the meeting

● to identify client’s problems and clarify expectations

ASSESSMENT:

● Wears pink dress with a face towel at her back

● Not well- groomed with good personal hygiene with good posture and gait

● Has good eye contact during interaction, good mood and appropriate affect

● Well oriented on time, place and identity

● Well nourished with fair skin

● Spontaneous speech and with relevant answers

● Able to recall past experiences and relate to the present situation and reality

● Alert and had good judgment and reality

 ORIENTATION PHASE (July 7, 2009 – 1:00 Pm)

NURSE CLIENT THERAPEUTIC RATIONALE

COMMUNICATION
Magandang Hapon po, Okay naman ako, Giving recognition Greeting the
kumusta po kayo? magandang hapon client indicates
din. the she is
acknowledge
and recognize as
a person.
Ako po si Jubilee Razon, Ganun ba? Giving Information This gives the
and magiging student client an
Nurse ninyo. Tawagin mo overview what
na lang po akong JM. were the reasons
Galing po ako sa Isabela. why you were
Simula po sa araw na ito, there and make
August 13, 2022, her aware what
makakasama niyo po ako are the
at makakausap hanggang boundaries of
sa susunod na Linggo, the interaction,
august 20, 2022.. the purposes,
Magsisimula po tayo ng the time and
alas otso ng umaga place and who
hanggang alas tres ng were to be
hapon. Pag-uusapan po involved
natin ang inyong mga
karanasan at mga dahilan
kung paano po kayo
napunta ditto. Lahat po
ang pag-uusapan natin ay
mananatiling sikreto at
tayo lamang pong dalawa
ang nakakaalam.
Tapos na po akong Ako si PSJ, Providing General It encourages
magpakilala, pwede po nakatira sa Leads the client to
bang kayo naman po ang Tuguegarao City. continue what
magpakilala? she is saying
and that the
nurse is active
in listening.
Ilang taon na po ba kayo? 21 years old na Seeking information Helps the client
ako. facilitate
thoughts,
feelings and
ideas clearly.
Nag-aaral pa po ba kayo? Oo, nag-aaral ako Seeking information
sa MCNP- BS
Criminology
Maari po ba ninyong Ipinasok ako ng Exploring Helps them both
ilahad kung ano po ang tatay ko sa the client and
dahilan kung pano po kagustuhan ko the nurse to
kayo napasok dito? rin. Sa katunayan, examine the
kakapirma ko issue more
lang yung form fully.
na binigay sa'kin.

(Base from the

statement: PSJ
agreed to sign
himself into the
psychiatric unit
 for treatment. His
story reflects a
common case, in
which a high-
functioning
young adult goes
through a major
decline in day-to-
day skills.
Ano po sa palagay ninyo Hindi ko nga Seeking Information
ang dahilan kung bakit alam e! Kasi
kayo ipinasok na tatay ayaw ibigay ng
niyo rito? teacher ko yung
pambayad ko
sana sa tuition fee
ko. Asar na asar
nga ako don eh
aalis sana ako sa
school kaso
sayang naman
yung rebellion na
ini-organisa ko sa
eskwelahan. May
araw din sa'kin
yun. Marami
namang akong
kasabwat kung
sakali.
Ano pong ibig niyong Basta! mga kasapi
sabihin sa "may kasabwat ko yun sa
kayo kung sakali?" organisasyon,
may magaganap
kasi na digmaan.
 Ayan nga si Luke
Morrow eh,
inatasan kong
magbantay sa
atin.

Sir, lilinawin ko lang po Ganon ba?

nandito po tayo sa
emergency room ng
CVMC at tayo lang po
dalawa ang nandito at
nag-uusap.

Opo sir!

May mga gusto pa po ba Wala na, JM. Offering self Making oneself
kayong sabihin? available and
showing interest
and concern to
the client let
them feel more
comfortable and
will develop
further trust.
Sige po sir PSJ, bukas po Sige, maraming Giving Recognition Greeting the
ulit ha. Magsisimula na po salamat. Paalam client indicates
tayo ng alsa otso ng the she is
umaga. Mag-isip po kayo acknowledge
ng mga ikukwento ninyo and recognize as
sa akin ha. a person.
 WORKING PHASE (July 08, 2009)

OBJECTIVES:

● To identify issues and concerns causing problems

● To guide client to examine feelings and responses

● To develop coping skills and more positive self image

● To examine consistency of thoughts and ideas

ASSESSMENT:

● Well dressed with pink dress

● Well groomed with pink hair band

● With good eye contact during interaction and oriented on date, time, place and identity

● With euthymic mood and appropriate affect

● With hand tremors on both hands

● Spontaneous speech, consistent answers to questions asked

● Has good communication skills, insight and judgment

● Alert, able ti think abstractly and make generalizations

 WORKING PHASE (DAY 1 – July 8, 2009)

NURSE CLIENT THERAPEUTIC RATIONALE

COMMUNICATION
Magandang Hapon po, sir Magandang Giving recognition Greeting the
PSJ. umaga din JM. client indicates
the she is
acknowledge
and recognize as
a person.
Napansin ko po, bagong Maaga kasi akong Making observations To make them
ligo na kayo, kumusta po nagising kaya aware what are
ang araw ninyo. naligo na ako. their actions and
Masaya ako dahil what the client
andito ka na feels.
naman.
Maaari niyo po bang Nagpakilala tayo Summarizing This seeks to
ilahad kung ano yung sa isa’t isa at bring out the
ginawa natin kahapon? pinag-usapan important points
natin kung bakit of the
 ako andito? discussion and
increase
awareness to the
client
Ano po uli yung dahilan Gusto ko lang Seeking information
kung bakit po kayo magrelax at
andito? magpahinga
Ganun po ba. Kapag wala Kumakanta Seeking information
po tayong activity ano po lamang ako.
ung kadalasan ninyong
gingawa?
Ano po ung paborito Kahit anong Seeking Information
ninyong kanta? religious song
Ano naman po ung mga Gumagaan Encouraging Encouraging the
nasa isip at nararamdaman pakiramdam ko expression client to make
ninyo kapag kayo ay dahil di ako her own
kumakanta ng religious pinababayaan ng appraisal rather
song? Diyos. than to accept
opinions from
others.
Sa activity po natin kanina Masaya at medyo Encouraging
na Music and arts therapy, malungkot? expression
ano po ang nararamdaman
ninyo habang ginagawa
ang activity?
Ano pong dahilan at Naalala ko kasi Seeking information
nasabi po ninyong yong mga anak
malungkot? ko at pamilya ko.
Ang ibig niyo po bang Oo, gusto ko nang Translating into This technique
sabihin ay gusto nap o umuwi. feelings is to verbalize
ninyong umuwi at clients feeling
maksama ang pamilya of what she said
ninyo? indirectly
Ano naman po yung mga Magpapakabuti Exploring Helps them both
naiisip ninyong paraan o ako ditto at the client and
solusyon para makauwi na sinusunod ko the nurse to
kayo? yunmg mga examine the
sinasabi ng mga issue more
nurses at doctor. fully.
Ano naman po ang una Magsisimba ako Seeking information
niyong gagawin kapag para
nakalabas na kayo ditto? magpasalamat sa
Diyos at
mamamasyal
kaming buong
pamilya
Maari niyo po bang May tatlo akong Seeking information
ibahagi sa akin tungkol sa anak, dalawang
inyong pamilya? lalaki at isang
babae.
Nasaan po sila ngayon? Nag-aaral sila Seeking information
Sino po ang nag-aalaga sa Yung tatay at Seeking information
kanila? asawa ko.
Ano po ba ang pangalan Fernando yung Seeking information
ng asawa at Tatay Ninyo? asawa ko at yung
tatay ko eh
clarito.
Ano po yung trabaho nila? Wla nasa bahay Seeking information
lang yung asawa
ko, ung tatay ko
naman ay nasa
shop.
Sinabi po ninyo kahapon Pagod na kasi ako Seeking information
na gusto niyo ppong eh, kaya gusto ko
magpahinga at magrelax. nang magpahinga.
Iyon lang po ba ang
dahilan?
Sa palagay niyo po ba Oo, kasi konti Seeking information
makakapgpahinga po kayo lang yung mga
rito kung andito po kayo? ginagawa.
May gusto pa po ba Wala na Rho. Offering Self
kayong ibahagi sa akin?
Sige bukas ulitCharito. Salamat, Paalam Giving Recognition

DAY 2 (July 9, 2009)

NURSE CLIENT THERAPEUTIC RATIONALE

COMMUNICATION
Magandang umaga po (Client smiled) Giving recognition
Nanay Charito, andito na Magandang Offering self
naman ako para kausapin Umaga din
kayo.
Kumusta po ang tulog Mabuti naman Seeking information
niyo?
Kumain nap o ba kayo? Katatapos lang at Seeking information
uminom nari ako
ng gamut.
Mabuti po kung ganun. (Client smiled) General leads
Sige po magsimula na
tayo
Tungkol pos a napag- Mga religious Clarifying Clarifies further
usapan natin na paborito songs. Gusdto mo knowledge and
niyo pong kanta, ano ulit kumanta ako. understanding
ang mga yun? (Client sung) on what is
verbalized
Wow, ang galling pop ala Salamat Giving recognition Greeting the
ninyong kumanta. client indicates
the she is
 acknowledge
and recognize as
a person.
Saan po ninyo natutunan Sa simbahan Seeking information
yun? naming, active
kasi ako doon.
Ano naman po ang Jehovas Witness Seeking information
pangalan ng simbahan
ninyo?
Ano naman po ung mga Masaya (Client Seeking information
naaalala ninyo sa become silent)
simbahan ninyo?
Maari po ba ninyong (Client become Silence Making silence
sabihin sa akin? silent) let the client
formulate and
organize ideas
and makes feel
the client that
she is
understood and
with
companion.
May sasabihin pa po ba Wala na. Seeking Information
kayo sa akin?
Sige po Nanay Charito, (Client smiled Giving Recognition Greeting the
bukas po ulit. Punta na po and just followed) client indicates
tayo dun sa mga the she is
kasamahan natin at may acknowledge
gagawin po tayong and recognize as
activity. a person.

DAY 3 (July 10, 2009)

 NURSE CLIENT THERAPEUTIC RATIONALE
COMMUNICATION
Magandang umaga po. Magandang Giving recognition Greeting the
umaga din client indicates
the she is
acknowledge
and recognize as
a person.
Kumusta naman kayo Mabuti naman at Seeking information
ditto? nakakatulog din
Napansin kop o kanina Naiisip ko lang Making Observations To make them
nung nag-eexercise po yung mga anak aware and to
tayom parang matamlay ko. Parang know what
po kayo, maaari niyo po nakikita ko sila really the client
bang sabihin sa akin ang kapag andito ka. feels
dahilan?
Ano po bang pangalan ng Yung panganay, Seeking information
mga anak ninyo? si Clarence, 19
taon na siya,
tapos si
Frederick, 18
naman at tsaka si
Ruth, magteten
years old na siya.
Saan po nag-aaral yung Si Clarence, sa Seeking information
mga anak ninyo? UST. Nursing din
siya kagaya mo.
Si Frederick ay sa
UE, civil
engineering at si
Ruth sa POLA.
Ang gagaling pala ng mga Salamat Giving Recognition Greeting the
anak ninyo Nanay client indicates
Charito. the she is
acknowledge
and recognize as
a person.
Habang pinag-uusapan po Namimiss ko na Making Observations To make them
natin sila, parang naluluha kasi sila at aware what are
po kayo, ano po ang naaawa ako sa their actions and
dahilan? kanila kasi di ko what the client
sila maalagaan feels.
dahil andito ako
sa Mental
Sige po, ipagpatuloy niyo Lalo na ksi yung Giving general leads
lang. bunso, di ko siya
naalagaan at
nagyon malaki na
siya at pasalamat
ako di siya
pinabayaan ng
Diyos.
Kahapon sa activity natin, Opo Giving recognition Greeting the
ang saya-saya po ninyo. client indicates
the she is
acknowledge
and recognize as
a person.
Nanalo nga rin po kayo sa Masay, kahit Encouraging Encouraging the
mga games, ano po ang papano expression client to make
nararamdaman ninyo? nakakalimutan ko her own
yung mga appraisal rather
problema ko at than to accept
para rin sa mga opinions from
anak ko yun, others.
inspirasyon ko
 kasi sila.
Ano pa po? Miss ko na sila, Giving general leads
gusto ko nang
umuwi.
Sige po Nanay Charito, Sige (client Giving recognition Greeting the
hanggang sa susunod ulit. smiled) client indicates
May gagawin po tayo the she is
nagyon, puntahan nap o acknowledge
natin yung mga kasama and recognize as
natin. a person.

DAY 4 (July 13, 2009)

NURSE CLIENT THERAPEUTIC RATIONALE

COMMUNICATION
Hello po Nanay Charito, Magandang Giving recognition Greeting the
magandang umaga. umaga din client indicates
Andito na naman po ako. the she is
acknowledge
and recognize as
a person.
Ano po ang Masay kasi may Seeking information
nararamdaman ninyo? makakausap na Giving recognition
naman ako.
Pwede niyo po bang Marami. Summarizing. This seeks to
sabihin sa akin yung mga Nagmusic and bring out the
napag-usapan natin noong arts tayo, tapos important points
nakaraang lingo? may palaro at of the
tsaka yung discussion and
bugtungan na increase
bingyan natin ng awareness to the
mga importansiya client
 yung mga sagot.
Ano po ang naaalala Di ko sigurado Clarifying Clarifies further
ninyong bugtong? yung tanong, pero knowledge and
yung sagot ay understanding
yung gatas ng on what is
ina? verbalized
Napansin ko po nung Unaware naman Making observations To make them
Makita ninyo yung ako dun sa aware what are
larawan, napahawak po nagawa ko. their actions and
kayo sa inyong dibdib, Naalala ko lang what the client
ano po yung naalala yung mga anaqk feels.
ninyo? ko lalo na yung
bunso.
Ano po yung mga naalala Lahat kasi sila Seeking informations
ninyo tungkol sa inyong nagbote lang, di
mga anak? ko sila napasuso.
Maganda pala ang
gatas ng ina.
Iyon lang po ba ang Oo Seeking information
dahilan?
May mga gusto pa po ba Wala na. Seeking information
kayong sabihin?
Sige nanay Charito, Sige Giving recognition.
pumunta nap o tayo sa
mga kasamahan natin.
DAY 5 (July 15, 2009)

NURSE CLIENT THERAPEUTIC RATIONALE

COMMUNICATION
Magandang umaga nanay Magandang Giving recognition Greeting the
Charito. umaga din Rhod. client indicates
the she is
acknowledge
 and recognize as
a person.
Kumusta po ang tulog Mabuti naman. Seeking information
ninyo?
Kumain nap o ba kayo? Oo, inom na rin Seeking information
ng gamut.
Ano pong petsa ngaun ang July 14 ay nagyon Seeking information
anong araw? ay Miyeskules.
Magaling. Tama po. (client Smiled) Giving recognition
Sa tuwing nag-uusap po Mga anak ko, Seeking information
tayo, ano po yung mga miss na miss ko
naaalala ninyo? na kasi sila at
yung mga lugar
na parati naming
pinupuntahan.
Saan po yung mga lugar Sa Batangas, Seeking information
na parati ninyong Palawan, tapos sa
pinupuntahan? Thailang nung
nagtour kami.
Ano po yung ginagawa Nagsuswimming Seeking information.
niyo dun kapag kami,
pumupunta po kayo? namamasyal at
kumakain.
Kung sakali po, Sa Batangas, Exploring Helps them both
makakalabas kayo ditto, magsuswimming the client and
saan po yung lugar na kami. Tapos the nurse to
pupuntahan ninyo at ano punta kami sa examine the
yung mga gagawin ninyo? Mall. Bibili kami issue more
ng maraming fully.
pagkain,
mamamasyal
kahit saan kasama
ang mga anak ko.
May gusto pa po ba Wala na. Offering self
kayong sabihin sa akin?
Sige po, puntahan na natin Sige. Salamat Giving recognition.
yung mga kasama natin, (Client smiled
may activity po tayo ulit. and followed)
TERMINATION PHASE (July 15, 2009)

NURSE CLIENT THERAPEUTIC RATIONALE

COMMUNICATION
Magandang umaga po Ganu din sayo Giving recognition Greeting the
(Client smiled) client indicates
the she is
acknowledge
and recognize as
a person.
Kumusta po kayo? Mabuti naman Seeking information
Ngayon pong araw na ito, Ganun ba, sige. Giving Information
bale ito nap o yung huli
nating pagsasama’t pag-
uusap. May kunti po
tayong programa at
maaasahan kop o ba ang
kooperasyon ninyo?
AFTER THE PROGRAM
Nag-enjoy po ba kayo? Nag-enjoy naman Seeking information
Sige po, hanggang ditto Maraming salamat Giving recognition
nalang po an gating pag- din. Paalam
uusap Nanay Charito. (client shoke
Maraming salamat pos a hands with me)
inyong kooperasyon at
tiyaga sa pakikinig sa
amin.