INTERACTION STUDY Clients Initials: E.N.

Age: 60 y/o Medical Diagnosis: Bipolar disorder Nursing Diagnosis: Impaired memory r/ t inability to remember or recall information or behavioural skills secondary to the disease process and old age Goal of interaction: To maintain the trust and rapport that has been establish between the nurse and the resident Date and time: March 2, 2012 / 8:30 am Place and Description of the environment: At the Pavillion 10 hallway, at a bench on the hallway Environmental noise was present but yet tolerable. The weather was hot with slight breeze of air. The odor was pleasant. Nurse As we arrive at the pavillion 10, we are asked to have a talk to our designated client,. Upon approaching, I did not feel any fear or nervousness compared before. I greet her magandang umaga Ella with a big smile on my face. Kumusta naman po ang tulog nyo kagabi? Client The client was staring only on the grass in front of the bench where she sits,as she saw me coming closer ,her previous flat affect was then change into a happy face.She is still carrying with her is a bottle of water that she carry the first time I saw her. She also then smiles back at me and greet me Magandang umaga! Nakatulog ng mabuti, maganda gising ko MJ(smiling, no mark of restlessness on her face) Wow! Ang galing natatandaan nyo nap o yung pangalan ko!Ako nga po si MJ, nursing student po galing Ah. Biyernes nap ala ngayon, akoy Masaya , masayang Masaya at nandito na naman Nurse Action The same intimate distance was maintained between the nurse and the client throughout the whole course of conversation.My voice was maintain to a louder volume in everytime I talk to her.I become an attentive listener since her voice was so soft, low in tone and she speaks very slowly. Evaluation Since the client have difficulty in hearing this kind of distance and voice was maintained for her to hear and understand what am I saying.

I started our conversation with a light type question.

The conversation was then started and the clients condition was good. Giving the client appraisal can motivate her to do better next

Reorient the client to the

sa la sale, bali andito po tau sa NCMH, ang araw po ngayon ay March3, 2012 at 8:30 na po ng umaga Bakit nyo naman po nasabi na masayang Masaya kapag nandirito kami? The conversation was then cut, as the routinary exercise has started.

kayo(smiling) Kasi madaming ginagawa at masarap yung pagkain..HaHaha(the client laughs and drink water from her bottle) The client participated well during the exercise, her facial expression conveys that she is not mad, nor stress .

present time, date and place.Gave her appraisal as she remembers my name.

time. The client was then reoriented about the present time and date and the place where she is.

I started to explore the clients feelings on why did she says masayang Masaya.

Her statement proves that her mood had matched with her present affect.

Our conversation was then started as the exercise have ended. Kumusta naman po yung ginawa nating exercise

I also do exercise together with her to promote bonding and for me to serve as her guide on the steps during the exercise. Masaya, pero nakakapagod (smiles and drink again water from the bottle that she always carry) I made an introductory question and explore her feelings after the exercise.

The client can be able to exercise well and seems happy about it as she smiles back at me.

The client did not response. (she stares at me for a while, then smile and scratch her head. May gusto po ba kayung ikwento o pag usapan natin? The client started her story about her past experiences as a child.dati, lagi akong naglilinis ng bahay, walis ako ng walis, masipag ako, masipag hahha!(the client laughs and smile). Nung bata pa ko, Masaya kami nung

The clients opinion/feelings regarding the exercise was then evaluated and it was known that she is happy and enjoyed it.

I offer general leads to the client and encourage her to open up and verbalized anything about her.

Sige lang po, okey lang po kahit anong ikwento nyo at masisigurado nyo po na hindi

I encourage her to continue what she wants to say and assure her that everything that

As the client was encourage to verbalized she seems not still ready about it, shy or hesitant to tell something about her. I can be able to get the clients trust and she started to verbalized about her past.

ito malalaman ng iba

mga kapatid ko lagi kami nag lalaro, mahilig akkkoo..ssummayaw..hanggang may nakilala akong isssang lalaki..nnniligawan nya ko..isa syang basketball player..tapos dumalaw sya samin, tapos my dinala syang mga bagay....(the clients facial expression had change as she verbalized about the man, and she started to stutter.she then made a pause on her statement as she talks about the courting part. tapos nagging asawa ko sya, nagging ama sya ng mga anak ko, kaso ngayon patay na sya eh, hahhaha tapos ......wala hindi ko na matandaan eh (the clients previous serious face was then change into a smiling face and laughs as she verbalized patay na sya eh. Lagi akong natakbo tuwing umaga, dyan oh, (pointing to the spot where she usually runs), kasa-kasama ko lagi natakbo dito yung kapatid ko.un ate ko, mag kasama kaming dalawa dito ngayon.... ayon tapos kakain..matutulog..pero Masaya ako dito Masaya..

we would talk about will remain confidential.

pagkatapos po nun anong nangyari?

I try to explore the clients story and reach for its deepest part.I used silence as she tries to recall what had happen next but still the client cannot remember.

The client can be able to tell a story up to the part where she could not remember everything.

I then change the topic of our conversation and ask Anoano po yung maalas nyong ginagawa dito?

As the client could not say anything regarding her previous story, I decided to change the topic of our conversation to a much lighter one.

Changing the topic can made our conversation to continue

Ako nga lang pala mag isa(become sad face) Naiintindihan kop o kayo,pero wala po kayong kapatid o kamag anak na nandidito o kasama nyo Presenting the reality to the client although it can make her sad, can make her realized the difference between the real and the unreal one and making herself reoriented on her present environment.

The reality was presented to the client.

The conversation was then stop as the program was then needed to be start. Our program was started with a prayer, followed by a song that was sung by the residents together with an action.

She participated well in the song and dance although she did not sing, she is trying hard to imitate the actions done by her coresidents and still laugh with them.

I perform the sing and dance performance beside my client for her to imitate my moves/action and encourage her to participate with us. I only observe what will be her reactions regarding the pictures and again ask her loudly about her opinion regarding the pictures. I perform the sing and dance performance beside my client for her to imitate my moves/action and make the environment for her to be harmonious.

The client was enthusiastic in doing sing and dance activity although it was unknown if she can be able to hear well the song. The clients attention was still on the said activity because she can still be able to give her own opinion about it.

It was then followed by a remotivational therapy wherein different pictures about nature had been presented and their opinions was then asked after the presentation. The clients was then asked to sing a song with action entitled as Shout for joy

The client have a blank stare on the pictures but when she was asked to say something about it, she can be able to express her opinion regarding the pictures. Like on the first sing and dance activity, the client can be able to participate, smiles and full of energy.

The client really enjoy to sing and dance compared to other activities.

The next activity was about a video presentation wherein their feelings after they have

The client become attentive about I observe the client what will the video presentation,as can be be her attitude or reactions seen by her eyes focus on the said regarding the video that was

The video really catches the clients attention since all of her focus was on the video.

watched iit had been asked.

video. She can be able to give shown. also her insights regarding the videomaganda..maganda(smiles) The client starts to socialized with other residents during the game and it can be seen on her face that she is enjoying the game Like the first 2 activity which have a dance, the client participated well during the dance therapy and try her best to pick up the steps although she have some difficulties on it. The client immediately eats her food and asks for more drinks.It can be seen on her face the happiness that she felt as her expression have change from a previous apathetic look to a smiling face. Bye bye!salamat!Kelan balik nyo? Kelan yung lunes?(her facial expression becomes gloomy.) salamat(smiling face while waving her hand good bye. I assure the clients safety during the activity that they will not going to bump or cause harm to each other whenever they run. I become one of the leaders who taught the residents about the dance steps. The client enjoys activity that requires body movements

It was then followed by a play therapy wherein the residents are asked to group themselves into(the facilitator will give a specific number) And lastly is a dance therapy wherein the residents are thought about the steps to be used in the dance

The client really loves to dance, her attention and heart was on it and she seems enjoying and very happy on doing it.

The program was ended with a snack wherein the residents are asked first to wash their hands before they eat

I serve the client with a snack after all of the activity that was done.

She seems become tired after all of the activity that was done and also become hungry but yet blissful about it.

After they eat, we said goodbye to each other.Nay, bali aalis nap o kami..Marami pong salamat! Pero babalik po uli kami sa lunes..Bali 2 days pa po, Sabado at linggo bago mag lunesSige po kita tayo uli sa lunes(smiling while waving my hand)

I said good bye to the client but says the specific time of our meeting next coming Monday for and the day of the end of our contract next week for her expectations.

The exact day of meeting and termination of our contract was again repeated to the client for her to be reoriented.

Goal of Evaluation: During the 3rd day, there is a noticeable changes on the clients behaviour, attitude and verbalization of her feelings. She become more open up in verbalizing her story about her past, she becomes more cooperative and participative during the activities, her mood and affect have change from being apathetic to a more lively and joyful facial expression. She did not report any untoward behaviour like being anxious nor angry.

Mary Joy S. Estaris BSN-34