Mariano Marcos State University
COLLEGE OF HEALTH SCIENCES
Department of Nursing
RLE 105:
Nurse-Patient Interaction
Submitted by:
Angelico L. Garaza
BSNIII-A, Group 3
Submitted to:
Ms. Myrel F. Garvida
Clinical Instructor
March, 2014
NAME: Joseph Jojo Alonzo
BIRTHDAY: December 2, 1962
AGE: 51 years old
GENDER: Male
ADDRESS: Brgy. 9, #256 Aglipay St., Cor Morales St
CHIEF COMPLAINT: Sleeping, talking incessantly and making noise all day and night.
DIAGNOSIS: Bipolar disorder, Manic with psychotic features, Alcohol and Drug abuse; Hypertriglyceridemia and Essential
Hypertension
DATE OF ADMISSION: June 21, 2012
ADMITTING PHYSICIAN: Dr. Medina
OVERVIEW:
Joseph Badula Alonzo is 51 years old and he was admitted at Medina Psychiatric Care Plus and Home Care last July 21, 2012
with a chief complaint of sleeping, talking incessantly and making noise all day and night and had an admitting diagnosis of Bipolar
Disorder Manic with Psychotic Feature, Alcohol and Drug Abuse; Hypertriglyceridemia and Essential Hypertension.
Before he was admitted, he already had a long history of treatment due to Myocardial Infarction and drug abuse. His family
locked him in a room outside their house due to continuous use of drugs, being destructive, and non-compliant to treatment. Based on
the chart, Mr. Alonzo had also been admitted to National Center for Mental Health seven times because of substance abuse. Upon
admission, his mental status examination revealed the patient to be hyperverbal, hyperactive, aggressive, assaultive, poor insight and
judgment, sexually preoccupied disorder with dependent personality.
Before my actual interaction with Mr. Alonzo, I performed measures to prepare myself in rendering care to my patient
emotionally, physically, and intellectually. These include self-awareness activities, reviewing on different communication techniques
both therapeutic and non-therapeutic, reading some books and articles related to possible cases that we will be encountering during
our exposure. After assuring that I and my group mates are completely prepared for our nurse-patient interaction, our clinical
instructor and two staff nurses oriented us about the possible patients, rules and brief background about the psychiatric ward. The
staff nurse assigned and gave us the charts of our patients and I got paired up with Ana Denise Quinajon, my group mate, in
handling a patient named Joseph Alonzo. After reviewing the chart of the patient, I have come to know the brief description and
background of the patient. I feel nervous as soon as the staff nurse warned us that our patient is a difficult one to handle.
NURSE
PATIENT
ANALYSIS
VERBAL
NON-VERBAL
VERBAL
NON-VERBAL
Good morning sir. Are Standing in front the Yes, good morning too Looking directly with a (Giving recognition)
you Mr. Joseph Alonzo?
client; looking directly sir.
faint smile
As soon I saw the client,
at client.
he sat and gave a faint
smile. I feel nervous
because I dont know
how
to
start
the
conversation.
But
gathered
all
of
my
courage.
hope
he
doesnt notice that I feel
I am Angelico Garaza Smiling;
so nervous.
maintaining Nice to meet you sir and Nods while introducing (Giving information)
sir. I am paired up with eye contact with client; maam. I am Joseph ourselves;
Ana Denise Quinajon. sat in front of the client
Alonzo.
trembling
looks
hands
at I
established
our
and contract as soon as we
We are student nurses
hides it under the table; sat in front. I noticed
from Mariano Marcos
bites his lips
State
University.
that as soon as we sat,
We
he hid his hands under
will stay here at Medina
the table between us.
until 12 oclock in the
Maybe he feels shy or
afternoon.
nervous too like we do.
I noticed that you bit Maintaining eye contact My hands cannot stop Shows hands and hides (Making Observations)
your lip sir, do you feel with client.
trembling. I hope you it right away; faintly As soon as I noticed that
uncomfortable?
dont mind sir.
smiles
he is a bit tensed I asked
him directly and I am
relieved that he opened
up with his concern. I
am not a bit bothered
with his hands. I know
that it is an effect of his
medications. I hope he
wont
feel
any
uncomfortable as we go
How long have you Lean forward to the Ive been here since Looks down; frowns
on with our interaction.
(Exploring)
been here sir?
client;
smiling; 2012. So its been more
maintaining eye contact. than a year. Sometimes I
think
that
life
isnt
heard
from
the
orientation that he is one
of the clients that have
You sound very down With
open
worth living and that
stayed here for a long
my family would be
time.
better off without me.
posture; Ive been here too long. Looks up after finishing (Making observations)
today. I can feel a sense maintaining eye contact; I feel like my family his
sentence; I was trying to express
of hopelessness. Am I low voice
really sent me here to unconsciously
puts empathy and mirror his
right about that?
get rid of me.
and sense of sadness. Its
hands
on
table
continues to tremble.
sad to here from the
client that he feels like
he
was
sent
away
purposely where in fact
they just wanted him to
Are these feelings that Nods;
with
get better.
open No actually I have Seemed brighter as he (Encouraging
youve had in the past posture.
always felt pretty good was talking; maintained comparison)
or are they newa
about myself. I have eye contact
I didnt feel like I could
reaction
is
been a good person and
reassure him so I tried
going on in your life
father and thought that I
to learn more about him.
now?
had
to
what
So lets put things in Open
same
person.
to
contribute.
posture; No, Ive not had the Frowns; looks at hands.
perspective. Youre still maintaining eye contact
that
something
courage to do it.
(Exploring)
I thought he should
explore what was going
Maybe
something
is
onto
confirm
or
going on with your
discount
relationship with your
perceptions. I thought I
brother or family. Have
could help him with
you talked with him
this.
about what you
feeling right now?
(Silence)
his
are
Nods;
open
posture; I really am fine now. Frowns; still looking at (Silence)
maintaining eye contact; Why dont they get me? hands.
I remained silent to give
leaning forward
Ive been here for too
room for the client to
long.
verbalize his feelings
more. It gives him time
to organize his feelings.
Im starting to feel sorry
Yes, I understand that Nods; maintaining eye (Silence)
Nods; frowns
for him.
(Accepting)
you really want to go contact; leaning forward
I felt the need to convey
home now sir.
my empathy. He just
nodded and remained
Since when did you Maintaining
eye December.
When
silent.
I Maintains eye contact; (Exploring)
have a call from your contact; leaning forward
called for them that I am plays with hands
Any problem or concern
brother sir?
good to go home.
can be better understood
So
what
are
you Maintaining
planning to do about it contact;
then sir?
eye Im planning to call Maintains eye contact
leaning them
forward; open posture
again
soon.
if explored in depth.
(Formulating a plan of
action)
Explain to them that I
I need to know what his
can really change my
plans
ways. Im better now.
problem.
are
I
for
his
hope
he
could really call his
brother soon and I hope
that he can know why
they havent got him out
We are about to begin Smiles; maintaining eye Yes, I will maam.
of here.
Maintains eye contact; (Giving information and
the activities we have contact; stands up
exchanged
prepared for you today
stands up and joins the Our
sir. I hope you will join.
group
smile; ending the interaction)
interaction
has
ended because its time
for our psychotherapy.
Im relieved that he was
able
to
convey
his
feelings regarding his
eagerness to go home.
