The document appears to be notes from interactions between a nurse and patient. In the interactions:
1) The nurse asks the patient open-ended questions to encourage expression of feelings and thoughts.
2) The patient expresses some unrealistic beliefs, like being related to John F. Kennedy.
3) The nurse responds supportively but also gently redirects the patient back to reality.
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Nurse-Patient Interaction
The document appears to be notes from interactions between a nurse and patient. In the interactions:
1) The nurse asks the patient open-ended questions to encourage expression of feelings and thoughts.
2) The patient expresses some unrealistic beliefs, like being related to John F. Kennedy.
3) The nurse responds supportively but also gently redirects the patient back to reality.
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Nurse- Patient Interaction
July 10, 2018
Nurse Patient Inference Rationale Personal Analysis Unsa man Dance? Encouraging Encourages The patient imung Nalingaw kay expression client to answered gibati sa na active Open-ended make his appropriately atung akong brain question own but he just therapy? og na appraisal. focuses on the exercise dance therapy. akong body Ahhh… Client Accepting To indicate I answered continues to (Nodding) that I with answer the followed nonverbal question the train of cues. thoughts. Unsa man Kini usahay Encouraging Encourages The client is imong gikapoy kay expression the client to tired because pamati sa galisod kog Open-ended make his of having lack imung tulog question own of sleep due to lawas? panalagsa Identification appraisal some about his environmental own factors. feelings. Unsa man Galisod kog Encouraging Encourage The client diay naa sa tulog kay naa expression the client to perceived that imung koy insomnia Open-ended express his his trouble of tulog nga usahay question feelings sleeping is makaingon Identification especially due to his kag galisod his sleep. insomnia. ug tulog? Istoryahe Oy! Reflection Encourage He’s a little daw ko sa (little shock) Encouraging of him to shock because imung description of verbalize he doesn’t kinabuhi perception about his want to share daw Lord life his life bi. because he thought it would take a longer time. Summary Ah sige, General leads To lead him He wanted to lang sa summary on sharing just share the imung lang sa his story. summary of kinabuhi his life for Lord now. Oh sige, Gipanganak Closed-ended To know The patient is kanus-a ko atung June question the patient’s unable to man imung 23, 1973 Identification basic recall his birthday? information exact and to test birthdate. His the patient’s birthday is on memory June 24, 1973. Dayun Nakagraduate General Lead Encourage The patient Lord? diay kog patient to can still Mechanical further remember Engineering discuss where he sa UM topic. finished his BSME degree. UM? Oo, sir, UM, Closed-ended To validate The patient’s University of question his answer. able to Mindanao Consensual remember his Validation alma mater. Restating
July 11, 2018
Nurse Patient Inference Rationale Personal Analysis Musta man Ok ra man Broad opening To know the He just felt Lord? Sir Identification feelings of fine. the patient and to encourage him to express his emotions. Unsa man Kanang ok Open-ended To dig He just really imong lang jud Sir question deeper to felt fine. pasabot Identification freely anang ok ra express his Lord? emotions and feelings Velasquez, Close ended The patient The patient Sir? question wanted to thought that I clarify if my am a surname is Velasquez, Velasquez maybe because he had Student Nurse that is a Velasquez. Dili Lord, Ahh, Giving To reorient The patient si Laride Laride, information the patient thought that I man ko, tatay nimo Presenting about the am a son of the Kyle si John F. Reality reality late President Laride. Kennedy Orientation John F. (nodding) Kennedy. He has delusions. John F. Oo, katung Close-ended To validate The patient is Kennedy? President sa question the answer. knowledgeable Katong United Consensual and really President? States of Validation knows about America Restating John F. nga gipusil Kennedy but sa Texas. he’s still (smiling) delusional. Laride Ahh… Facilitation To reorient The patient has akong Laride, La, Giving patient and unrealistic apelyido ride, LA, information give information or Lord. Kyle Los Presenting information. belief and he Laride, Angeles, reality made some akong tatay ride, mag meaning of my si Joaquin ride ka sa surname. He is Laride. Los really Angeles. delusional. (smiling) Dili Lord, LA, Los Facilitation To reorient The patient has Laride, Angeles, Giving patient and an unrealistic apelyido ko mangadto information to take him belief. na. tag Presenting back to California, reality reality. mag ride ta, naa man koy duha ka balay dadto, tagsa dayun ta Ayy, sayang, dili man diay ka kalakaw kay gaeskwela pa man ka, humana sa na. (smiling) Naa kay Wala Closed-ended To further The patient has passport question discuss no passport so Lord? about his his belief is beliefs. really unrealistic or delusional. Kailangan Ahh, dapat Facilitation To reorient Maybe the man ug makaadto Giving the patient client has passport tag information and take him some reasons para California Presenting back to to go to makaadtog (smiling) Reality reality and California that California give the has to be Lord, so right unfold. wala pa ka information. kaadtog California. Lord, Ahh, sige Facilitation To reorient The patient makaadto Sir. Presenting the patient was able to rata ug Reality about the understand the California Giving reality information kung naa information given. tay passport.
July 12, 2018
Nurse Patient Inference Rationale Personal Analysis Musta man Ok ra sir Close-ended To know The patient Lord? (Smiling) question patient’s just felt Encouraging feelings fine. expression and Broad opening emotions Unsa gali Sir Kyle Close-ended To test if The patient akong Velasquez question the patient insisted pangalan? (smiling) Identification can still that I am a remember Velasquez. my name He is not and if he is oriented to oriented to person. person He’s delusional. Sir Kyle Laride, Los Giving To reorient The patient Laride ko Angles information the patient gives Lord, Laride California Presenting and bring meaning to (smiling) Reality him back to my Facilitation reality surname. He is still not oriented to person. He still delusional. Lord, Velasquez oy, Giving To reorient The patient apelyido ko imong mama information patient has nang Laride. naay half- Presenting unrealistic sister si reality thought Barbarosa about me, (smiling) he is delusional. Lord, wala Naa oy, imong Giving Reorient The patient may half- lola man gani information patient to is sister akong kay gapuyo sa Presenting the reality delusional. mama Ukraine. reality Dili Lord, Ahh, Laride Giving To reorient The patient akong lola (nodding) information patient and accepted gapuyo sa Presenting take him this time amua sa reality back to that my Zamboanga reality surname is del Sur, Laride. dayun Laride ang apelyido sa akong lola, Bonifacia Laride Kinsa man di Kamo Exploring To help The patient ay na si patient insisted Velasquez, examine again that I Lord? more about am a the topic or Velasquez. issue He is still delusional. Dili Lord, La Laride, Los Giving To increase He is still Laride Angeles information patient’s insisting among Presenting knowledge and still apilyedo reality about the living in reality his delusions. Imong boot Dili, Ukraine, Close-ended To dig The patient pasabot ba taga-Ukraine, question deeper and thought nimo anang foreigner, Consensual clarify what that my Velasquez Ukraine, sa Validation he means family Lord kay Europe gud lives in Amerikano? Ukraine. His delusions are still intact and present. Dili man mi Wala pa Presenting To reorient The taga Ukraine Reality patient patient’s Lord, unsa Close-ended about the belief man di ay question reality before pud pasabot Consensual about that nimo sa Los Validation he has a Angeles? Exploring house in Nakaadto na Giving LA in the kag Los information last NPI is Angeles, not true California? and a sign of being delusional. Gusto baDepende, sa Exploring To gain The patient nimu mag- Los Angeles Close-ended information maybe trabaho saCalifornia man question about his want to go California? gud kay naa beliefs to LA due ang Lakers, about LA to he’s a Los Angeles California fan of LA Lakers Lakers. Ganahan di Oo, gusto ko Exploring To dig The patient ay kag mag coach sa Close-ended deeper maybe has basketball Los Angeles question about the a dream to Lord? Lakers naa si LA topic. be a coach Kobe Bryant of LA man didto Lakers Ahh, pero Wala pa Accepting To know if The patient nakaadto na Close-ended the patient have not kag question has dreams went to California? on going to California. California. Ahh, inig Dili sa, mag Consensual To know Maybe the gawas nimu eskwela sa ko Validation more patient still mag trabaho either BS Exploring patient’s have a kag Mathematics, knowledge dream to California? Aircraft, or belief work but Engineer, Civil about his before that Engineering o delusional he wants to Architecture, thoughts study more kay kulang about man gud Math. akong alam sa Mechanical Engineering Ahh, Oo, sir, dayun Close-ended To makeThe patient nagtrabaho scriptures question patient still man kag dayun (Nodding) recall thatremember Mechanical pagkahuman Consensual he worked that he Engineering nakog trabaho Validation at Taiwan worked at sa Taiwan as a Taiwan as no? Mechanical an ME and Engineerin he opened g and to dig another deeper topic about it. regarding about scriptures. Unsa diay Kanang Open-ended To dig The patient boot pasabot scriptures gud, question deeper has an nimu sa sa basketball o Consensual about what unrealistic scriptures kanang validation he mean thoughts Lord? gagovern o ga about and beliefs. manage scriptures Ahh, Lord si (silence) Presenting To reorient The patient Sir Kyle reality patient got silent Laride ko Nindot (Nodding) because ha… pagkabuhat he’s nang hotel oh. watching (pointing to the the building building near SPMC- near. IPBM) The patient appreciates the building because it is his forte. Diba, mao na Oo, pero Exploring To reorient The patient imong kanang Consensual patient of can still ginabuhat? gafocus mi sa Validation his past and remember mga machine, to know if his work pipes, he still can before. elevators, ug recall past uban pa memories. Maayo kaayo Oo sir Exploring To reorient He still ka ana Lord? Close-ended patient of remembers. question his past Kanus-a ang The patient music og wants to dance therapy know when Sir? the music and dance therapy cause his interested. Kanang, Ahh Giving To make The patient Lunes ang (nodding) Information patient is Music know more interested. therapy, og about our Thursday schedule of ang Dance therapies Therapy Ganahan Oo, kanang Close-ended To know The patient diay kag music nga It’s question what the shares his music Lord? My Turn og Exploring interest of favorites , You Decorated the patient. maybe he My Life is now Paminawa trusting gani na Sir me. Sige Lord, Ahh, karung Giving To share The patient karung Lunes information information is Lunes Lord (nodding) to the interested naay itudlo patient to move on mi nga kanta Music Therapy. Ugma Lord, Unsa may i- Giving To give He Art Therapy Art therapy information information understand sa ta nato Sir? about the s the next information therapy. given and is interested about it. Kanang Ahh..(nodding Giving To further He’s also magdrawing- ) information discuss on interested drawing ta the next about the ug maghatag therapy. art therapy lang ug impormasyo n ugma Lord Sige Lord, Sige sir, Giving gratitude To orient The patient salamat, salamat pud the patient is thankful ugma na pud that it’s the about the end of NPI. therapy.
July 13, 2018
Nurse Patient Inference Rationale Personal Analysis Musta man Oo sir pero Encouraging Encourage The patient Lord? Di ba makaya expression patient to has a good gikalintura raman nako, Consensual make his memory of ka? diba sir validation own the past days gipirmahan appraisal of especially the nako ang his feelings signed kontrata nga or emotions contract that gaingon nga on this day. he agreed. magparticipa te sa mga therapies (talking as somewhat tired) Oo, Lord, (nodding) (Smiling) To remind The patient dapat jud ta Giving patient of was able to magpartisipa information what his understand or r sa atng mga responsibiliti accept what therapies es especially I’ve said. the contract that he signed. Sige Lord, Oo sir, sa Close-ended To clarify The patient maghisgot Europe. question and focus on has a good tag mga Exploring reality memory and bansa o mga Giving knowledgeabl countries or information e about some mga lugar. countries. Ukraine Lord, kabalo ka asa na? Tama, sa Dili Sir Close-ended To test the The patient Europe, question patient’s has no plans ganahan ka Exploring perception on on working in diha Consensual Europe Europe. magtrabaho Validation Lord? Unsa may Gamay man Encouraging To encourage The patient rason sa gud ang description of patient to has a good pagdili sweldo dira perceptions express the comprehensio Lord? Sir pareha sa reason why n. Pilipinas he didn’t like to work at Ukraine Ahh mao? Oo sir. Accepting To make The patient nurse follow follows. train of thoughts Unsa gali Hmm... Italy Open-ended To test The patient is laing mga question patient’s knowledgeabl country sa Identification intelligence e and can still Europe or memory recall. Lord? Spain, France, Giving To share Patient able to Portugal Germany information information enumerate and has a good knowledge. Tama, sa Sir, ang UK Closed-ended To dig Patient Europe pud kay sa question deeper about accepts the diba ang Europe Consensual his information. UK? validation knowledge regarding Europe. Gusto ka Oo sir kay Closed-ended Dig deeper Patient has a dadto Lord? dako man question about his good gud ang Exploring perceptions memory. income in UK. dadto Ahh, asa pa Sa Africa Sir Open-ended To know the Maybe the man ka gusto question patient’s patient really magtrabaho General lead thoughts have plans on Lord? Identification regarding working to work. Africa. Unsa may Dapat man Open-ended To know the The patient rason Lord? gud to i- question patient’s has visions on Unsay naa sa develop Sir, Exploring reasons on things that Africa? buhatan ug choosing should be mga Africa as hisdone if he buildings work place. works in Africa. Ahhh… So, Oo sir Closed-ended To test the The patient Lord, sa question knowledge of has a good America Consensual the patient memory. napud ta, Validation Texas Lord, sa USA na ba? Gusto ka Oo, gusto ko Closed-ended To know the The patient mag-adto magcoach sa question patient’s surely loves dadto Lord? basketball Exploring reason for basketball. dadto wanting to go to USA. Sa NBA Dili sir, naa Closed-ended To test Still has Lord? naman guy question knowledge logical nakakontrata about thinking. na daan sa basketball. NBA nga mga coach. Ahh, Oo Summarizing To give The patient ganahan man Giving information still knows kag information Lebron,and basketball Close-ended has good Lord no, naa question memory. kay ishare sa imu karun nga news, Kaila kang Lebron James, Lord? Si Lebron Oo Sir Giving To give The patient is James Lord information information. a fan of NBA kay ming Consensual balhin sa Los Validation Angeles Lakers Lord, diba Lord fan ka sa Lakers? Asa man na Sa Cleveland Open-ended To test The patient’s siya nga question knowledge memory is team gikan Identification intact about Lord? basketball. Oo, tama, sa Wala naman Giving Give some The patient Cleveland. gud si Kobe information information has logical Karun Lord dadto Sir about the thinking. naa na sa present Lakers si events Lebron James, kauban na sila ni Kobe” Kauban na Ahh Giving To reorient Patient man sila information patient accepts what I karun Lord, shared. kauban na silang Kobe” So, Lord, sa Australia, sir Open-ended To dig The patient Asia napud question deeper in has wrong ta, unsa sa Exploring order to answer this Asia man come up with time. nga lugar the Taiwan imung gusto incident adtuan Lord? topic. Dili Lord, di Ayy, oo sir Giving To reorient Patient able to ba continent information patient accept the na siya Lord information Unsa man Vietnam, Sir Exploring Slowly The patient nga lugar sa giving to the wants to go to Asia aside sa topic Taiwan Vietnam, this Philippines, maybe one of Lord? his dreams Unsa may Gusto man Exploring To test the The patient is rason nga gud ko mag- perception of really into Vietnam study dadto Lord engineering. Lord? ug Aircraft Engineering o Civil Engineering Unsa may Gwapo man Exploring To test the The patient rason nga gud ang thinking of answered dadto ka eskwelahan the patient logically magstudy dadto sa Lord? Engineering Sir. Ahh, asa Sa Hanoi, sir Exploring To test or The patient man pud sa know the was able to Vietnam perception of still know the Lord? the patient capital of Vietnam which he wanted to study. Ahhh, so Oo sir Giving To give Able to recall Lord, diba sa information information that Taiwan is Asia pud ang Consensual part of Asia Taiwan validation Nagtrabaho Oo sir Recalling To reorient The patient man ka didto Consensual the patient was able to sa Taiwan as validation and to pen up recall past a mechanical his past. event. Engineer Lord no? Pila gani to 2 kapin Sir, Exploring To know if The patient katuig Lord? dayun balik the patient able to recall dayun can still past event. Pilipinas, recall. tambay. Dayun Lord? (silence) Exploring To dig The patient is Unsa may (teary eyed) General lead deeper about emotional rason nga his story when he hears duha ka tuig Taiwan. ra kapin ra ka dadto? Unsa man di (teary eyes, Exploring To know There must ay naa dadto then wipes Open-ended more about something Lord? his eyes with question the Taiwan happened to tissues) incident. him at Kuan Sir, Taiwan. wala nako ganahi dadto Ahh, dayun Oo Sir General Leads To reorient Able to recall Lord, balik patient past events ka Pilipinas Lord? Ahh pero Oo sir, inig Giving To reorient The patient gusto man ka gawas nako information patient really wanted magtrabaho Consensual to have a job balik Lord Validation after. no? So dapat Salamat pud Giving To share The patient is magpaayo sa Sir. information information also thankful ta Lord no, Giving and reorient mag-iinom gratitude with the tag taraung reality sa atung mga tambal og magparticipa te sa atong mga therapies. So karun Lunes mag partisipar ta sa atong Music Therapy, naay itudlo nga kanta ug magkanta- kanta kita, sige Lord, salamat kaayo. Pagpaayo sa (Nodding) Giving To reorient The patient imung information patient able to kalintura ha understand para the makaapil ka information sa Music therapy
July 16, 2018
Nurse Patient Inference Rationale Personal Analysis Musta man Ok ra sir. Broad-opening To make He just felt Lord? (nodding) patient fine. express feelings Kadumdom Wala ra ba Closed-ended To focus on The patient is pa kasa question specific unable to atong points or recall recent gihisgutan topic events. atung Biyernes, Lord? Lord, nag- Aww oh. Giving To remind The patient therapy ta, information patient forget about art therapy the last therapy Unsa man Nalimot na Open-ended To test Unable to pud atong pud ra ba ko question patient’s remember the gihisgutan Exploring memory last therapy atong adlawa, Lord? Lord di ba Sa Laos, Open-ended To test The patient naghisgot Myanmar, question knowledge able to tag mga Vietnam about places enumerate lugar sa Asian Europe, countries Africa, America, ug Asia, sa Asia ta Lord, asa man nimu gusto mag- adto? Asa pa man Ahh Open-ended To dig deeper The patient nimu gusto, (Thinking) question took time to Lord Exploring answer. Unsa pa Nakatrabaho Exploring To know The patient man Lord? naman kog what happen able to share Taiwan pero to him at what ming-uli ra Taiwan happened at dayun k Taiwan. okay gibunalan kog baseball bat. Asa man Sa ulo. Open-ended To make The patient pud ka question patient shared what gibunalan Exploring express what happened to Lord? happened to him him Kinsa man Si… Exploring To dig deeper The patient pud nag- what unable to bunal nimu happened answer Lord? immediately. Kauban ra Dili… Exploring To dig deeper The patient nimu Lord? what able to happened answer. Taga- Dili Exploring To make Able to Taiwan siya patient recall answer fast Lord? the past event and in a direct answer Pinoy ra Oo, Pelayo Exploring To test The patient gihapon siya patient’s able to Lord? memory answer and still thought that “Pelayo” is the one who beat him Kinsa man Si Ched Exploring To test The patient na si Pelayo, Pelayo patient’s able to Lord? memory answer and still thought that Ched Pelayo is the one who beat him. Ched Oo Closed-ended To dig deeper Able to Pelayo? question what happen answer Siya ang Consensual directly nagbunal sa validation imo? Unsa man Gusto unta General leads To explore The patient is dayun ko what scared for his imung mudemanda happened safety. gibuhat pero Lord? mahadlok ko kay basin balikan ko. Nagbalik Oo, Closed-ended To focus on Able to dayun ka sa nagtambay question one point answer Pilipinas? ko. immediately. Unsa man Wala Open-ended To dig deeper Able to imung question answer gibuhat sa immediately. imung ulo Lord? Unsa may Mahadlok Exploring To make The patient rason nga naman gud patient was afraid for wala kay ko explore his safety. gibuhat feelings Lord? Ahh… Oo. Accepting To make Able to (Then patient answer silence for believe that I immediately. longer time) follow our conversation. Lord, ugma Salamat pud Giving To prevent The patient is napud atu gratitude separation also thankful. nang anxiety hisgutan napud na, salamat
July 18, 2018
Nurse Patient Inference Rationale Personal Analysis Musta man Ok lang Broad-opening To begin the The patient Lord? conversation just felt okay. Unsa man Ok lang Broad-opening To make The patient imong gibati patient is okay. sa atong express therapy? feelings Sa asa man Okay kay Exploring To dig deeper The patient nga part atoiya mang gi about his really nga okaycareer ang feelings. appreciate lang? drama Ruena’s act (pointing to Ruena) Ahh, Oo, gicareer Exploring To dig deeper The patient nindutan ka lagi niya really niya mo appreciate drama? Ruena’s acting Asa gani ta Mental Open-ended To test the Able to karun Lord? Hospital question orientation of answer Orientation the patient correctly, he is oriented to place. Unsa ta Wednesday Exploring To test Able to adlaw Orientation patient’s answer karun? orientation correctly, , he is oriented to day. Kanus-a ta Huwebes Exploring To test Unable to adlaw Orientation patient’s answer taman? orientation correctly. He is disoriented. Di ba Friday (silence) Giving To give facts Unable to Lord, Petsa? information answer Orientation immediately Di ba Lord 19 Giving To give facts Unable to Wednesday information answer ta karun, Orientation correctly petsa 18, unsa may petsa pagka- Friday? Wednesday Petsa 20 Giving To test The patent man ta information patient’s was able to karun, petsa Orientation orientation answer 18, pagka correctly Friday kay? Tama, duha (nodding) Giving To give Able to na lang ta ka information information accept adlaw mag- Orientation information uban-uban, karung Friday ta taman, petsa 20 Sige Lord, Sir… Exploring To test Unable to unsa gani Orientation patient’s answer akong knowledge immediately ngalan balik? Kinsa ko Sir Kyle Exploring To test Able to Lord? Identification patient’s answer knowledge of me Sir Kyle? Velasquez Exploring To testUnable to Identification patient’s answer orientation correctly, he is still disoriented to person. Dili Lord, Laride, Giving To give facts Able to Sir Kyle ahh… information answer Laride Orientation correctly Dayun 93 *and so Giving To test Able to Lord, mag on* information patient’s answer minus ta, concentration correctly 100 minus *and so on* Sige Lord, Sige pud Giving gratitude To give Able to diri ra ta salamat information answer taman. gratefully Salamat ug sa Friday atong culmination
July 19, 2018
Nurse Patient Inference Rationale Personal Analysis Lord taman Ugma, Giving To inform The patient ra biya ta Friday? information the patient clarify if our ugma mag- Orientation regarding the last day is on uban-uban contract Friday ending Oo Lord, Culmination Giving To give facts The patient ugma Friday na nato? information to patients asks when is Orientation our culmination maybe he’s excited. Oo Lord, Mag-lechon Giving To inform The patient culmination mo? information the patient expected that na nato regarding the we’ll serve ugma termination lechon to be of the served during contract. culmination Dili Lord, Naay Islam? Giving To give facts He thought kay daghan information that the man bawal reason ana behind we won’t serve lechon because there’s a Muslim Oo Lord, Ahh, nag Giving To give The patient Islam ug lechon man information information expected that SDA gud tong we’ll serve taga-Xavier lechon University because he experienced lechon that is served during culmination from other school. Daghan man Lagi pud Giving To give The patient bawal ana (laughing) information clarification agreed to the Lord hehe to the patient information I Naa lagi bag- gave ong building? (pointing to the blue building) Ahh kato Unsa kaha na Accepting To make The patient is nga patient curious about building? knows that I the blue Basin sa also see the building Ateneo na building Wala raba Ahh mao pud Giving To give facts He agreed to ko kabalo (laughing) information that I don’t the ana Lord, (laughing) have an idea information I kay dili ko about the gave taga diri blue building Lord Wala man ko Giving To inform Maybe the magsayaw ra kadumdom information the patient patient likes ba mo ugma sa steps ato about the slow dance ha, katong mas nindot dance than the fast gipractisan unta tong dance ninyo ganiha nga sayaw nga gitudlo.
Kato mang Aww Giving To inform The patient
gipraktisan (laughing) information the patient agreed and man inyong remembers. sayawan Lord Ug Lord, Kanus-a man Giving To inform Able to ask naa moy ninyo ihatag? information patient about about the suoton nga the shirt to shirt maybe sanina ugma wear for the because he’s Lord, nga culmination excited about naay ngalan that. ninyo Ugma pa Ahh, makauli Giving To inform The patient Lord na dayun ko information the patient also excited pagkahuman to go home. sa culmination no? Oo lord, sige Sige, salamat Giving To make The patient is Lord salamat pud gratitude patient also grateful knows that I’m grateful