ORIENTATION PHASE

Biographic data;

Name: IED

Date of birth: March 23rd, 1954

Age: 55yrs

Gender: Male

Status: Married

Educational attainment: Law

Religion: catholic

Setting;

Place: Pavilion 21, dinning hall

Date and time: January 9th,2009. 3pm-11pm

Description of patient;

My client is an adult male, dressed in blue shirt and shorts. He has a neat appearance. Yellow

skin colour and gray hair he is also well behaved and cooperative with good eye contact, good

body posture and body language. His vocabulary is fluent. My client has a confident and pride in

himself.

He is aware of his surroundings but is not acquainted to reality. He has inner creativity

which he shows when conversing, but is bound to fantasy. He smiles but when asked about his

condition and family his facial appearance changes (sad). When interacting with him he showed

interest .he thinks he is now better and ready to be united with his family. He often changes topic

and prefers discussing more on his inner creative thoughts.

Description of environment;

The environment is well kept with beautifications (trees) around and quiet and conducive for the

patients. It has boundaries that separate the patients from the health professionals.

Objectives;

Introduction and acknowledging the client

Establishing rapport with the client

Using therapeutic means of communication to discuss clients problems

Organizing the socializing activities of the day

1. News paper reading

2. Mind games

3. Bibilo theraphy

4. Music and art theraphy

Starting activities as scheduled and finishing on time

Making sure the socialization was successful and beneficial

Submission of the requirements for the day

NUSRE-PATIENT INTERACTION

NURSE PATIENT INTERPERTATION AND

ANALYSIS

Verbalize;

“Good afternoon. I am a

student nurse from FEU. I

will be your student nurse

for today for the 4days in

this hospital, i am here to

help you with your health

problems.

I will ask you some

questions it will take 20-

30mins, will that be okay

with you?”

“how are you today?”

“can you state your full

name, your date of birth,

your religion and

Verbalize;

“yes go on”

“I am fine thank you”

“ Ignacio Eriberto Y

Dimaano jnr. But you can

call me mang jun, i was

born in march 23rd 1954

and i graduated from the

Interpretation;

The interaction with my client

was therapeutic in that it made

him express his inner feelings

towards his environment and

the people around him. In my

interaction with him he

showed concerns and mood

changes from happy to sad

when asked about his

condition and his family

which shows that he is

emotionally alert. I noticed

that defense mechanism’s

were used such as

rationalization, projection,

denial)

My client has confidence and

educational attainment?”

“ how long have you been

in this institution?”

“how do you find your

surrounding and do you

get along with the people

here”

school of law”

“ I have been here for up

to 7years”

“ I get along with the

people here, i am the

president here. I have a

high rank here. But i am

not violent

I was in pavilion 1in Feb.

2002. Where i wash plates

and measure rice. It was

there i got scabies because

i slept on the floor. It was

the people who collided

against me that put me

there, it was a charity ward

but now i am in here and it

is much better than that

place”

“my adopted sister comes

once or twice in a year to

drop my toiletries but she

doesn’t spend much time

with me, i know she hates

pride in himself.

His body language; posture,

proper eye contact are

appropriate. He has

accelerated speech. He

understands what is been

asked and replies accordingly

but at the same time shifts

from one topic to another. He

sounds like an intelligent man

but seems to have inner

creativity which is over

shadowing his thoughts and

not realistic to his goals in life

due to what he thinks is true,

he blames people for his

present situation, for putting

him in the institution against

his own will.

His facts of reality are true to

him.

The nurse set bounds and

states her reason for the

interaction she tried to focus

more on the client when the

client wants to shift topic.

At the end of the interaction

the nurse advices the patients

on issues such as establishing

“ how often do you have

visitors?”

“Do you have a close

relationship with your

sister?

“Do you know the reason

u are in this institution?”

me”

“she is my adopted sister,

before i was brought here,

we had problems,

arguments. We are not

close at all, we don’t just

agree to a certain things”

“before i agree i was

depressed but i became

better”

“The reason i am in this

institution, you can believe

it or not, is that Gloria and

her fellow people collided

and put me here. I do write

to high class people.when

Gloria became a president

i wrote to her regarding the

programs that will benefit

this country, in order to

build the economy and

communication with other

inmates

Analysis;

Psychosis is a person’s

systems state that refers to the

presence of reality

misinterpretation,

disorganized thinking.

Psychosis may occur owing to

the presence of a medical

neurological or psychiatric

condition. Individuals who

incur psychosis may

experience altered sensory

perception at

small,taste,sight,illusion,

Hallucination, delusion

(Ref. Page 359, Psychiatric

Nursing. Biological and

behavioural concepts by

“lets focus on the time you

spent here”

“What activities do here?”

“what do you do if you are

bored”

proper ways to govern this

country”

“ Gloria is part of the sebu

business and other high

class people”

“Erab is a good man,

although he gambles he

uses the money to help the

poor but Gloria is corrupt

she was among those that

helped put erab in jail”

“i do work with the PNA

and i was in the police

force for 4years before

going into law . i was

recruited when i was

21years old.”

“ most of the activities we

have here are done by the

student nurses, they are

fun”

“i do get bored but not that

much because i have a

radio underground i do

communicate with, the

radio has a magnetic wave

although i don’t get

Deborah antai-otong)

One individual characteristic

that is very relevant to

personality development is

intelligence. Intelligence is the

aptitude or capacity for

learning. Intelligence is

biologically determined by the

virtue at a fact that a person

inherits a nervous system.

However, experiences

provided by the environment

may retard and facilitate the

development of cognitive

skills. The ability to reason

through complex situations

has many implications for

personality development.

Intelligence has a profound

impact on many areas of

development and behaviour

such as

talking,memory,understanding

and applying new concepts

and creativity

The ability to cope with a

variety of situations reflects

an awareness of one’s

strength, limitations and

“Do you miss home?”

“try and communicate with

your fellow inmates, have

activities in that way you

won’t feel bored and home

sick”

“Sir, my time is up

thank you for your

cooperation. But we are

having socialization

activities, in case you have

any questions or concerns

feel free to ask me”

“You are welcome”

responds from it”

“of course i do, i just wish

i will leave here and meet

my family. Sometimes i

just get sad, i want to be

united with them”

“okay i will try that but

they think different from

me”

“Thank you, for listening

to me”

“no problem, thank you

again”

indicates capacity to tap one’s

resources as necessary at great

importance to personality

development.

(Ref. Pg 125, mental health

ursing. A holistic approach

edition 2 by

Pasquali,Arnold,Debsio &

Alesi)

Impaired judgement in people

who have socially aberrant

ways usually evidence poor

judgement. Many do not show

any insight into their

behaviour, nor do they

indicate any concern about the

consequences of that

behaviour. They may not learn

from experience.

(Ref. De meyer Gapin &

scott, 1977)

(Pg 126, mental health

ursing. A holistic approach

edition 2 by

Pasquali,Arnold,Debsio &

Alesi)

Communication generally

important in nurse patient

interaction but verbal and non

verbal. Eye contact; provides

a channel for nurses to

connect with clients in a

manner that conveys genuine

concern and care. inner

feelings are often reflected

through one’s eyes.

Body language refers to

manufacturing of feelings or

thoughts by ways of body

gestures. It is a powerful

nonverbal communication

tool. Recognizing it helps

nurse understand her own and

the behaviour of the client

(Ref. Pg.133. psychiatric

nursing. Biological &

Behavioural concepts by

Deborah antai-Otong)

Facial expression, releves

internal feelings and

emotions. They convey a

number of feelings that are

reflected in client. Intense

massage are easier to asses

than subtle responses;

flat blunted or congruent

affect often masks feelings &

emotions.

The physical appearance such

as personal hygiene, posture,

dress and appropriateness of

the clothes, revels the clients

level of functioning,

confidence, self worth.

(Ref. Pg.133. Psychiatric

Nursing. Biological &

Behavioural concepts by

Deborah antai-Otong

Regardless of the formality or

length of relationship, each

nurse actively encourages the

patient to feel comfortable in

the relationship. An effective

communication is based on

the patient and the nurse

getting to know each other.

(Ref. Pg.99, Psychiatric

Nursing by Norman L.

Keltne, Lee Hilyard

Schwecke,Carol E. Bostom)

The nurse patient relationship

is not a social relationship.

Although the nurse might

relate informally with

patients, the maintance of

objectivity and goal-directness

is crucial. Patients particularly

those with a history of

unsatisfying relationships,

might misinterpret the nurse’s

interest and concern.

(Ref. Pg.97, Psychiatric

Nursing by Norman L.

Keltne, Lee Hilyard

Schwecke,Carol E. Bostom)

Defense mechanism has two

aspects first; they keep

unwanted thoughts out of the

awareness and use energy to

do this. Secondly, energy

cannot be contained

indefinitely therefore some

defense mechanism allows the

energy to be discharged as in

projection, rationalization,

denial,sublimination,reaction

formation

(Anna Freud 1937)

(Ref. Pg 29. Psychiatric

Nursing. Biological &

Behavioural concepts by

Deborah antai-Otong)

Evaluation; At the end of the day;

I was able to introduce and acknowledge my client

I was able to establish rapport with my client

I was able to use therapeutic means of communication to discuss clients problems

Was able to properly Organize and carry out the socializing activities of the day as

follows:

1. News paper reading

2. mind games

3. Biolo theraphy

4. music and art theraphy

Was able to start activities as scheduled and finish on time

The participants was grateful at the end of the day

With group cooperation activities where successful and beneficial

Submission of the requirements for the day