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PROCESS RECORDING: NURSE-PATIENT INTERACTION ORIENTATION PHASE (November 24, 2010; 6:00 PM) Nurse Verbal Hello!

Good Afternoon po Sir R.C. Ako po si Marianne, 3rd year nursing student po ng Manila Doctors College. Ako po ang magiging student nurse niyo simula po ngayon hanggang December 14. Non - Verbal Verbal Waves hand Hello! Smiles Afternoon din. Maintains moderate eye contact Good and open posture In face to face position to the client. PATIENT Good Non - Verbal Waves hand Smiles Maintains moderate eye contact Good and open posture In face to face position to the nurse. Maintains moderate eye contact Good and open posture In face to face position to the nurse. Therapeutic Communication Technique Giving recognition Rationale It shows that the nurse recognizes the client as a person, an individual that gives the client fulfillment of his worthiness. In addition, it does not imply and hold the notion of value that is of being good or bad. Informing the client of the facts increases his knowledge about the topic and what to expect on the interaction. It also builds trust with the client.

Moderate eye contact In face to face position Ako naman si R.C. to the client Nagagalak kitang Good and open posture makilala Leans forward Smiles Movement of hands Shake hands Moderate eye contact No response In face to face position to the client Good and open posture Smiles -

Giving information

Tuwing Monday to Wednesday nyo po kami makakasama simula ng 12 PM hanggang 8 PM Sir R.C. gusto ko pong malaman niyo na yung mga information pong makukuha ko galing sa inyo ay wala na po

Maintains moderate eye contact Good and open posture In face to face position to the nurse. Maintains moderate eye contact Good and open posture In face to face position to the nurse.

Establishing specifics of the relationship time, date, place and duration of meetings

Setting up the lucid boundaries of relationship time, date, place and duration of meetings clearly orients the patient when, where, and how will begin, go on and finally end. To set up a means of respecting the patients right to keep private any information about his mental and physical health and related care. This also

Moderate eye contact No response In face to face position to the client Good and open posture Smiles

Establishing confidentiality

akong pagsasabihan wala pong niyo.

ibang hanggat permiso Moderate eye contact Ok yun. Para naman In face to face position maaliw kami. to the client Good and open posture Smiles

means allowing only those dealing with patients care to have access to the information that the patient divulges. Maintains moderate eye contact Good and open posture In face to face position to the nurse. Establishing trust Building a trusting relationship with the patient facilitates a more reliable data collection because of the easier disclosure of information by the patient.

Makikinig po ako sa mga sasabihin ninyo tsaka magbibigay din po kame ng mga activities na makakatulong sa inyo at makakapagbigay din ng kasiyahan Kamusta kayo dito? naman

po -

Moderate eye contact Ayos In face to face position ako. to the client Good and open posture Nodding Increased tone of voice

lang

naman -

Maintains moderate eye contact Good and open posture In face to face position to the nurse.

Broad openings

It allows the patient to take the initiative to introduce the topic. It also simplifies that the patient has the lead in the interaction and to think of an interesting topic for them. This gives the patient an encouragement to continue on what he is saying. It also indicates that the nurse is listening and following what the patient is talking about without taking away the initiative for the interaction.

Maari mo po bang itanong kung ano po ba ang dahilan ng pamamalagi nyo dito? -

Moderate eye contact In face to face position to the client Good and open posture Slightly leaning forward

Actually nandito lang ako for safe keeping. Ang case ko kasi love depression tapos gumamit din ako ng drugs e gusto ko agad maagapan kaya voluntary ako pumunta dito. Akala nga nila yung kapatid kong special yung papasok dito kasi nakaporma pa ako nun.

Maintains moderate eye contact Good and open posture In face to face position to the nurse.

General leads

Ano pong dahilan ng love depression nyo? -

Moderate eye contact In face to face position to the client Good and open posture

Nagkaroon kasi kami ng problema ng girlfriend ko. Ang daming lies. Una, sabi nya single siya e hanggang sa naging close kami sinabi rin nya na may asawa siya for 2 years pero hiwalay na sila tapos may anak. E umuwi yung asawa galing Taiwan. Nakakatawa pa nga e. Kasi bumili ako sa tindahan tapos ako pa yung pinagtanungan nung lalaki kung saan nakatira si R. Tapos tinuro ko pa tapos yun pala yung asawa.

Maintains moderate eye contact Good and open posture In face to face position to the nurse.

Exploring This means delving further into a subject or an idea. This also explores the patient to help them examine the issue more fully, not only superficially.

No response

Moderate eye contact In face to face position to the client Good and open posture Nods

Maintains moderate eye contact Good and open posture In face to face position to the nurse.

Silence

Provides limit to put clients actions, thoughts or feeling into words and shows place of interaction gives time to develop inside.

Ano na po ang nararamdaman nyo kay R ngayon? -

Moderate eye contact Galit pero hindi ko In face to face position yun masabi sa harap to the client niya. Good and open posture -

Maintains moderate eye contact Good and open posture In face to face position to the nurse.

Encouraging expression

Helps the client appraise his own rather than accept the opinion of others.

Nasaan po ba siya?

Moderate eye contact Nasa Bulacan na sila. In face to face position to the client Good and open posture Slightly leaning forward

Maintains moderate eye contact Good and open posture In face to face position to the nurse.

Exploring

This means delving further into a subject or an idea. This also explores the patient to help them examine the issue more fully, not only superficially. This means concentrates on a single important point.

Pwede ko po bang malaman sino po yung sila na tinutukoy nyo? Ah may anak po pala kayo? -

Moderate eye contact Si R at ang anak In face to face position namin. to the client Good and open posture Movement of hands Moderate eye contact Oo. Mag 1 year old na In face to face position nga siya e. Baby girl. to the client Good and open posture Movement of hands

Maintains moderate eye contact Good and open posture In face to face position to the nurse. Maintains moderate eye contact Good and open posture In face to face position to the nurse.

Focusing

Restating

This means repeating the main idea expressed by the client. This lets the client know that he communicated the idea effectively. This also encourages the client to continue. In addition, if the client has been misunderstood, he can clarify his thoughts.

Ano po yung ginagawa niyong paraan para mawala yung galit niyo kay R? -

Moderate eye contact In face to face position to the client Good and open posture

Hinahayaan ko na lang. Lilipas din naman kasi yun. Ginagawa ko na lang ito para sa anak namin.

Maintains moderate eye contact Good and open posture In face to face position to the nurse.

Formulating a plan This means planning in advance what he might do in of action certain situations. Making definite plans increases the likelihood that the client will cope more effectively in a similar situation.

WORKING PHASE ( November 30, 2010; 6:00 PM) Nurse Verbal Hello po Sir R.C. Kamusta naman po kayo? Non - Verbal Verbal PATIENT Non - Verbal Waves hand Smiles Maintains moderate eye contact Good and open posture In face to face position to the nurse. Therapeutic Communication Technique

Rationale

Waves hand Okay lang ako. Smiles Maintains moderate eye contact Good and open posture In face to face position to the client.

Giving recognition

It shows that the nurse recognizes the client as a person, an individual that gives the client fulfillment of her worthiness. In addition, it does not imply and hold the notion of value that is of being good or bad. This is verbalizing what the nurse perceives that sometimes patient cannot verbalize or make themselves understood or the patient may not be ready to talk. This gives the patient an encouragement to continue on what he is saying. It also indicates that the nurse is listening and following what the patient is talking about without taking away the initiative for the interaction.

Napansin ko pong medyo matamlay po kayo ngayon. -

Moderate eye contact Good and open posture In face to face position to the client. Slightly leaning forward

Medyo depressed kasi dinalaw ako ni R kasama yung anak naming pati parents ko. Hindi naging maganda yung usapan namin Masyado pong mabilis yung pagbisita nila kaya uminit yung ulo ko. Tapos hindi pa kami makapagusap ng maayos kasi nandyan parents ko.

Maintains moderate eye contact Good and open posture In face to face position to the nurse.

Making observations

Paano niyo po nasabi na hindi naging maganda yung usapan niyo? -

Moderate eye contact Good and open posture In face to face position to the client.

Maintains moderate eye contact Good and open posture In face to face position to the nurse.

General leads

Kumpara niyo po sa nakaraang dalaw nila sa inyo, gaano po katagal yung pinakamatagal nilang dalaw? Ano pong dahilan at saglit lang sila bumisita sa inyo? -

Moderate eye contact Actually first dalaw nga Good and open posture nila yun e. 15 minutes nga In face to face position lang sila. to the client. May aasikasikasuhin pa daw kasi si R. Ewan ko ba kung ano yun. Sa liga daw! Ang babaw noh? Halatang may kasalanan. Oo. Tapos yung baby ko pa parang nagkatinginan pa kami tapos binuhat ko maya maya umiyak. -

Maintains moderate eye contact Good and open posture In face to face position to the nurse. Maintains moderate eye contact Good and open posture In face to face position to the nurse. Maintains moderate eye contact Good and open posture In face to face position to the nurse.

Encouraging comparison

Looking at similarities and differences.

Moderate eye contact Good and open posture In face to face position to the client.

Exploring

It explores the patient to help them examine the issue more fully, not only superficially. This is expressing uncertainty about the reality of the patients perceptions which permits the patient to become aware that others do not necessarily perceive events in the same way like others or draw the same conclusion. The nurse will encourage the patient to re-evaluate what has happened. Helps the client appraise his own rather than accept the opinion of others.

Ah ganun po ba?

Moderate eye contact Good and open posture In face to face position to the client.

Voicing doubt

Ano po yung naramdaman niyo nung umiyak yung anak niyo? -

Moderate eye contact Good and open posture In face to face position to the client.

Medyo kinabahan kasi first time kong nabuhat yung bata pero masarap yung feeling. -

Maintains moderate eye contact Good and open posture In face to face position to the nurse.

Encouraging evaluation

Natatandaan niyo po ba kailan nyo po binuhat yung anak niyo? -

Moderate eye contact Nung Sunday. November Good and open posture 28. In face to face position to the client. Paglabas ko dito aayusin ko buhay ko para sa baby ko. Mag-tatayo ako ng business tska aayusin ko yung relationship namin ni R in a casual way.

Maintains moderate eye contact Good and open posture In face to face position to the nurse. Maintains moderate eye contact Good and open posture In face to face position to the nurse.

Placing time or event in Assessing time frame and sequence sequence of an event overtime.

Sa tingin niyo po ano po yung pwede niyong magawa pag labas niyo dito para mapalapit yung loob ng anak niyo sa inyo?

Moderate eye contact Good and open posture In face to face position to the client.

Formulating a plan of This means planning in action advance what he might do in certain situations. Making definite plans increases the likelihood that the client will cope more effectively in a similar situation.

WORKING PHASE (December 1, 2010; 6:00 PM) Nurse Verbal Good afternoon po Sir R.C. Non - Verbal Verbal PATIENT Non - Verbal Maintains moderate eye contact Good and open posture In face to face position to the nurse. Smiles Nods Therapeutic Communication Technique Giving recognition Rationale

Moderate eye contact Good Morning din. Good and open posture In face to face position to the client. Smiles Waves

It shows that the nurse recognizes the client as a person, an individual that gives the client fulfillment of his worthiness. In addition, it does not imply and hold the notion of value that is of being good or bad. It allows the patient to take the initiative to introduce the topic. It also simplifies that the patient has the lead in the interaction and to think of an interesting topic. This gives the patient an encouragement to continue on what he is saying. It also indicates that the nurse is listening and following what the patient is talking about without taking away the initiative for the interaction.

Kamusta na po kayo?

Moderate eye contact Good and open posture In face to face position to the client. Slightly leaning forward

Medyo okay na ako. Kelangan ko na mag move on basta para sa baby ko ito. -

Maintains moderate eye contact Good and open posture In face to face position to the nurse.

Broad openings

Ah ganun po ba?

Moderate eye contact Oo. Mas okay na siguro Good and open ng ganun. posture In face to face position to the client. -

Maintains moderate eye contact Good and open posture In face to face position to the nurse.

Accepting

Maiba naman po tayo. Nasabi nyo po nung 1st day natin na drug user po kayo. Sa papanong paraan niyo po natutunan mag drugs?

Moderate eye contact Dala ng curiosity nung Good and open kabataan at impluwensya posture nang mga kabarkada. In face to face position to the client. -

Maintains moderate eye contact Good and open posture In face to face position to the nurse.

General leads

This gives the patient an encouragement to continue on what he is saying. It also indicates that the nurse is listening and following what the patient is talking about without taking away the initiative for the interaction. It helps both the nurse and the client to see relationship of events in perspective. It explores the patient to help them examine the issue more fully, not only superficially.

Kailan niyo po ba unang natikman yung drugs? -

Moderate eye contact Good and open posture In face to face position to the client.

15 yrs old pa lang ako nun. Hindi ko na natatandaan yung exact date. Sa tito ko nakuha. Akala ko lang pagkain yun ng butete tapos bigla akong nilapitan ng barkada ko. Tinikman niya at sinabi niya na shabu nga daw yun. Tinikman ko din at dun na nagsimula. Ilang buwan lang, pina rehab na ako ng parents ko. Pag labas ko, nagshabu pa din ako. Pero on and off naman. -

Maintains moderate eye contact Good and open posture In face to face position to the nurse. Maintains moderate eye contact Good and open posture In face to face position to the nurse.

Placing event in time and sequence

Saan niyo po ba unang nakuha iyon? -

Moderate eye contact Good and open posture In face to face position to the client.

Exploring

Tapos po?

Moderate eye contact Good and open posture In face to face position to the client.

Maintains moderate eye contact Good and open posture In face to face position to the nurse.

General leads

This gives the patient an encouragement to continue on what he is saying. It also indicates that the nurse is listening and following what the patient is talking about without taking away the initiative for the interaction.

Bukod po sa shabu, ano pa po yung ibang drugs na ginamit nyo? -

Moderate eye contact Nagtry din ako ng Good and open marijuana pero alternate posture sila ng shabu. In face to face position to the client Paiba iba e. Madalas masaya na walang dahilan. Feeling ko nga para akong si James Bond laging tumitingin sa salamin. Minsan din malungkot. Gusto kong magaral kahit vocational lang kasi ayoko na maging dependent sa parents ko at maranasan ulit yung mga nangyari sa buhay ko. Gagawa din ako ng business at aayusin ko ang pamilya ko.

Maintains moderate eye contact Good and open posture In face to face position to the nurse. Maintains moderate eye contact Good and open posture In face to face position to the nurse.

Exploring

It explores the patient to help them examine the issue more fully, not only superficially. This directs the patients actions, thoughts and feelings back to the patient and encourage patient to recognize and accept his own feelings.

Ano pong pakiramdam pag gumagamit ng drugs? -

Moderate eye contact Good and open posture In face to face position to the client

Reflecting

Ano pong balak niyong pagka abalahan kapag kayo po ay pinagbigyan na makabalik sa inyo? -

Moderate eye contact Good and open posture In face to face position to the client

Maintains moderate eye contact Good and open posture In face to face position to the nurse.

This means planning in Formulating a plan of advance what he might do action in certain situations. Making definite plans increases the likelihood that the client will cope more effectively in a similar situation.

TERMINATION PHASE (December 13-14, 2010; 6 PM) Nurse Verbal Good R.C. Afternoon Sir Non - Verbal Verbal PATIENT Non - Verbal Moderate eye contact Good and open posture In face to face position to the nurse. Smiles Nods Therapeutic Communication Technique Giving recognition Rationale

Moderate eye contact Good Afternoon din. Good and open posture In face to face position to the client. Smiles Waves

It shows that the nurse recognizes the client as a person, an individual that gives the client fulfillment of her worthiness. In addition, it does not imply and hold the notion of value that is of being good or bad. It allows the patient to take the initiative to introduce the topic. It also simplifies that the patient has the lead in the interaction and to think of an interesting topic for them. Informing the client of the facts increases her knowledge about the topic and what to expect on the interaction. It also builds trust with the client.

Kamusta po kayo?

Moderate eye contact Ok lang naman. Good and open posture In face to face position to the client. Slightly leaning forward

Moderate eye contact Good and open posture In face to face position to the nurse. Smiles

Broad openings

Tulad po nang aming binanggit nung unang araw ng nakasalamuha namin kayo, ang ating huling araw ay December 14 which is today.

Moderate eye contact Ah oo nga pala. Good and open posture In face to face position to the client.

Moderate eye contact Good and open posture In face to face position to the nurse. Decreased tone of voice

Giving information

Sa nakalipas na apat na linggo heto na po yung nagawa natin: naglaro, nagexercise, nagkakwentuhan, nagdrawing, nagtahi ng wallet, gumawa ng picture frame, kumain, at iba pa.

Moderate eye contact No response Good and open posture In face to face position to the client.

Moderate eye contact Good and open posture In face to face position to the nurse. Nods

Summarizing

This is organizing and summing up which has gone before and seeks to bring out the important points of discussion and to increase awareness and understanding of both participants. It omits irrelevant and organizes the pertinent aspects of interaction. It allows both patient and the nurse to depart with the same ideas and provide a sense of closure at the completion of each discussion. This is more effective with movements of hands, moderate eye contact and good and open posture. This is organizing and summing up which has gone before and seeks to bring out the important points of discussion and to increase awareness and understanding of both participants. It omits irrelevant and organizes the pertinent aspects of interaction. It allows both

At sa mga nakaraan po nating pag-uusap, napag-usapan po natin ang ilang mga bagay tungkol sa inyong nakaraan.

Moderate eye contact No response Good and open posture In face to face position to the client

Moderate eye contact Good and open posture In face to face position to the nurse. Nods

Summarizing

patient and the nurse to depart with the same ideas and provide a sense of closure at the completion of each discussion. This is more effective with movements of hands, moderate eye contact and good and open posture.

Nasabi po ninyo sa mga pag-uusap natin na talagang nalulungkot kayo at naguguluhan kayo sa sitwasyon niyo ni R. Nabanggit niyo rin na nabitin kayo sa bisita nila dito nung nakaraang linggo. Nasabi niyo rin po na namimis niyo na po ang anak niyo kaya gusto niyo na makalabas. Naikwento niyo rin po sa akin paano niyo po nakuha yung drugs. Nai-share niyo din po sa akin yung mga plano niyong gawin sa oras na makalabas po kayo.

Moderate eye contact Good and open posture In face to face position to the client Movement of the hands

Oo. Iyon nga ang mga napag-usapan natin.

Moderate eye contact Good and open posture In face to face position to the nurse Nods

Summarizing

This is organizing and summing up which has gone before and seeks to bring out the important points of discussion and to increase awareness and understanding of both participants. It omits irrelevant and organizes the pertinent aspects of interaction. It allows both patient and the nurse to depart with the same ideas and provide a sense of closure at the completion of each discussion. This is more effective with movements of hands, moderate eye contact and good and open posture.

May iba pa po ba kayong gusting sabihin?

Moderate eye contact Wala na Marianne. Good and open posture In face to face position to the client

Moderate eye contact Good and open posture In face to face position to the nurse Smiles
Moderate eye contact Good and open posture In face to face position to the nurse. Smiles Waves

Encouraging description of perception

Asking for patient to describe feelings, perceptions, and views of their situations. To understand the client, the nurse must see things from her perspective. It shows that the nurse recognizes the client as a person, an individual that gives the client fulfillment of her worthiness.

Kung ganun po, maraming salamat po Sir R.C. sa tiwala pong ibinigay ninyo sa amin, sa cooperation at sa maganda po ninyong pagtanggap. Merry Christmas. Good bye po. Ingat po kayo parati.

Moderate eye contact Good and open posture In face to face position to the client Smiles Waves

Merry Christmas din. Salamat sayo Marianne at sa mga kaklase mo. Mag ingat rin kayo. Bye. -

Giving recognition

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