The client is a 21-year-old female, Ineffective coping related to fear of failure as evidenced by the client’s

expression of hopelessness, restlessness, and difficulty concentrating on anything other than the current
worry.

I have provided patient Goal/Purpose:

 To develop a caring bond with the client, to aid in promoting a safe space through respecting
boundaries and fostering openness, trust, empathy, and to allow the client to experience holistic
and patient-centered care.
 To facilitate verbalization of the client’s anxious feelings and examine anxiety-provoking
situations if they are identifiable.
 To develop a caring bond with the client, to aid in promoting a safe space through respecting
boundaries and fostering openness, trust, empathy, and to allow the client to experience holistic
and patient-centered care.

STUDENT NURSE CLIENT

INTRODUCTORY PHASE
Magandang umaga binibini L. Ako po si “Magandang umaga din, student nurse
student nurse Camille B. Sanguyo mula sa Camille. Oo, siyempre, maaari tayong umupo
Baliuag University. Sa iyong pahintulot, at mag-usap. Hayaan mo akong ayusin muna
maari ko po ba mahingi ng 20 minutes ang aking mesa, at pagkatapos ay maaari na
ngayon para kamustahin ka sa kalagayan mo, tayong magsimula."
pwede ka bang maupo at makausap? NONVERBAL BEHAVIOR: Smiling and
waving

"(Deep breath/Sighs) I suppose I'm doing

“Kumusta ka naman po ngayon, Ms. okay
NONVERBAL BEHAVIOR: Incapable of
Legaspi?” maintaining effective eye contact, shoulders
lifted in a half-shrug, appearing uncertain.
“Maari mo ba ipakilala ang iyong sarili? “Marami akong iniisip sa ngayon dumagdag
Ano po ang iniisip mo? pa ‘tong pandemic. Nakakaranas na ako na
matinding pagkabalisa, at palaging pagod.
Bukod dito, nag kakaroon ako ng anxiety,
ngunit sa tingin ko naman ay bumubuti
naman na.”

"I see, Ms. Legaspi. (Nodding) Ano ang iyong “ Sa totoo lang, gusto ko sabihin at mas
layunin mo ngayon na tutulong sa iyo sa maliwanagan pa yung isip ko sa session na
kinakaharap mo?” ito dahil naniniwala ako na makakatulong ito
sa aking pakiramdam na kung saan
matutukoy ‘yung mga potensyal anxiety-
related mechanisms o mga dapat kong gawin
upang mawala ito.
 She appears solemn and defeated, with her
right palm resting on her face.
“Maaari kang magpatuloy, nandito ako para “Parang paikot-ikot nalang ako, sinusubukan
makinig... Sabihin mo sa akin ang iyong kong pasayahin at maging proud ang aking
nararamdaman, Mrs. Legaspi.” mga magulang at lola ko pero bakit ganto?
Natatakot akong mabigo."
Appearing hopeful
“Go on Ms. Legaspi…” “Parang nawalan na ako nang gana. Hindi
ako makatulog, pati pag aaral ko
naapektuhan at hindi na din ako makakain sa
tamang oras. Parang lahat nalang mabigat
sa pakiramdam ko. Parang lahat na nung tao
na kakilala ko, alam na nila patutunguhan
nila sa buhay, samantala ako, eto
nahihirapan…”

Appearing distressed, hand gestures in the

expression of concern and doubt, sighing

WORKING PHASE
“Tell me more about these emotions you're Sa totoo lang, pakiramdam ko parang hindi
experiencing. Ano ang nag-uudyok sa iyo na enough lahat ng efforts ko, kahit ginawa ko
gawin ang mga pahayag na ito?" naman lahat. May mga goals at plano ako na
hindi namemeet yung expectations ko sa mga
nangyayari, lalo na sa pag aaral ko.
Sinusubukan ko naman maging okay, at
maging positive lang. Mataas kasi
expectations ng magulang at lola ko sa akin,
kaya hindi ko maiwasan mag aalala, ano
nalang iisipin ng iba kung nag fail ako?
Nawawalan ako ng kompyansa sa sarili..
Hindi mawala sa isip ko kung ginagawa ko
ba to nang tama parang hindi pa kasi
enough?

Appearing distraught and worrisome,

furrowed eyebrows.
""Are you implying that you are under Tama ka, ganon nga talaga ako.”
pressure, which results in you having Nodding, shoulders slightly slumped
difficulty controlling your emotions or
worry?"
"Naiintindihan ko kung gaano kahirap para After a few seconds of silence, she begins
sa iyo na pag-usapan ito." (Pause) speaking...
"Oo, mataas ang expectations sa akin ng
parents at ng lola ko."
 Looking down, sighing, heavy breathing
“Maari ko ba maitanong kung nakibahagi ka Sa totoo lang, oo sumali na ako. Ano sa
na ba sa mga grupo ng therapy na maaaring palagay mo ang magandang gawin para
tumulong sa iyong anxiety?" malabanan ko tong damdaming ito? Paano
ko ba to maoovercome ‘to?”
"How do you believe that would be beneficial “Na realize ko na sa halip na iwasan ko
in your situation?" maging anxious, dapat ko din bawasan at
hayaan ang sarili ko na reflect kung saan ba
ako nag kulang o ano man ang nagawa kong
pagkakamali para magkaroon ako ng idea
kung paano ito mareresolba. Gayunpaman,
pwede ako mag sulat na kung saan
napapahayag ko yung sa loobin ko mahilig
kasi ako mag journal o kaya naman
drawing.”

Furrowed eyebrows, appearing dejected

"I see what you're saying, Ms. Legaspi. "(Breathes a sigh of relief and then begins
Other people in your situation have speaking... I'm relieved to learn that I'm not
considered practicing self-kindness by alone in feeling this way, student nurse
taking a break or simply engaging in self- Camille. Tatandaan ko lahat ng mga sinabi
care activities. They bear in mind that no mo..."
one has it all figured out on the first day.
Additionally, they have expressed their fear Nodding, smiling, maintaining eye contact
of failure, particularly when others are
rooting for them and expecting them to
perform in a certain way.
"Nakakatuwa naman marinig ‘yan, Ms. "Secretive akong tao. Kakaunti lang talaga
Legaspi. You're doing quite well." yung mga tao na sinasabihan ko, kaya bago
lang ‘to sa akin. Nakakagaan ng
pakiramdam. Alam mo, pag nakikita ko yung
mga kaibigan ko, nakikita ko sila kung gaano
kataas ang confidence nila sa sarili, at
masaya habang ako eto, masyado nag
eexpect sa sarili ko.”
Appearing teary-eyed
"You're frustrated, despite your efforts, you're “Without a doubt. Naiintindihan ko na lahat
not achieving the results you desire. It may tayo ay may kanya kanyang problema na
appear as though others are catching up to dapat tugunan at hindi natin i-expect na
you, but they are not." maiintindihan nila nararamdama natin.
Lahat tayo ay may takot at alalahanin sa
buhay.”
Appearing dejected.
 As you stated, you have given it your all and “Tama, tatandaan ko ‘yan, student nurse
worked extremely hard to get to where you camille.”
are now. Remember that nobody is judging Maintaining appropriate eye contact and
you for having a difficult time; everyone relaxed shoulders
experiences a slump every now and then.
TERMINATION PHASE
"I notice that you appear relieved once the Yung session na ‘to ay nakatulong sa akin.”
realization that you recognized your feelings,
vent it out, and were able to reevaluate With a small smile and a relaxed demeanor
them.. Speaking with someone you trust and
taking a break every now and then are two
strategies you can use in the future if you
ever feel suffocated by your own thoughts."
"You have taken a significant step by “Thank you so much for listening and
deciding to seek help. Today, we've addressed assisting me, student nurse Camille!”
the source of your concerns and even devised Smiling, waving goodbye
coping mechanisms that you can incorporate
into your daily routine. If you wish, we could
speak again at a later date. I wish you rapid
relief from your anxiety and the ability to
persevere in the face of adversity."
“Again, I appreciate your honesty and “Goodbye, student nurse Camille”
willingness to share your concerns with me."

INTRODUCTORY PHASE: It establishes the tone for the remainder of the relationship during this
phase. Throughout this initial encounter, the client and nurse closely observe one another and
make judgments about one another's behavior.
EVALUATION: Effective
 By clearing fixing her table first, the client demonstrated her willingness to participate and
redirected her attention to the conversation.
 By introducing myself, stating my intentions, and addressing the client by name, I was able
to put the client at ease.
 By eliciting information about the client's current state through open-ended questions, I
was able to express my concern for her well-being and give the client the sense that she is
in control of the conversation.
 The client began to open up and provide lengthy responses that allowed her to express her
concerns completely.
 The client was able to articulate goals for the session, indicating an openness to discussing
her feelings.
 By starting with coaxing questions, I can earn the client's trust and demonstrate that I
genuinely care about her well-being.
 The client was initially evasive, but I guided her through it by establishing a safe space for
her to speak through my non-verbal cues.
 I was able to track down the client's concern or issue.

Working Phase:
The nurse and the client begin to view each other as unique individuals. They begin to
appreciate this uniqueness and care about each other.

Evaluation: Effective
 The client discussed her concerns and I was able to help her phrase them in a clearer way.
 By visibly tuning in and providing room for the client to explore her feelings, she was able to
develop insight into her behavior and how she relates herself to other people.
 Seeking clarification and gauging the client’s nonverbal response allowed both of us to
create a mutual ground for understanding her thoughts.
 Through the use of silence, attentive listening skills, and open hand gestures, the client was
able to pinpoint the source of her concerns.
 The client demonstrated trust by soliciting my opinion and inquiring about my perspective,
demonstrating our mutual respect for one another as unique individuals.
 The client was able to accept and identify her feelings through the technique of reflecting.
Despite her apparent reluctance, she made an effort to process and verbalize her thoughts.
 My goal was to demonstrate to her that her feelings are legitimate and that life is not about
sprinting to the finish line, but about + embracing one's own journey.
 Additionally, I reasoned that it would be in the client's best interest if I suggested the
perspectives of others who had similar experiences.
Evaluation: Effective
 Providing verbal support and restating the client's words in order to help her understand
what she has said.
 I was able to articulate a more rational viewpoint, one that has the potential to eradicate
negative thinking.
 Presenting reality and assuring the client provided her with an alternate point of view,
without imposing or dictating how she should feel about her difficulties.
 I was able to delve into and comprehend her thoughts and emotions.

Termination Phase:
It is beneficial for both the nurse and the client to express their feelings about termination
openly and honestly during the termination phase. This discussion about termination should
begin prior to the termination interview.
Evaluation: Effective
 We were able to establish caring, harmonious relationships.
 Collaboration was encouraged, and the conversation was smoothly summarized and
concluded.
 The client was able to glean meaningful excerpts from the conversation.
 Both participants left the conversation at ease and free of anxiety or dependence.

OVERALL EVALUATION:
The goal has been accomplished because the client has demonstrated signs of growing insight,
trust, and security along with her newly enhanced ability to speak up and perceive her feelings
as legitimate responses to difficult circumstances. Rather than avoiding confrontation, the
client confronted her thoughts in her head and even made progress by identifying coping
mechanisms that would help her avoid anxiety-provoking situations and thoughts.
Collaboration and the development of an action plan were also suggested at the conclusion of
the conversation, indicating that both the nurse and the client recognize the other's uniqueness
and importance in achieving the stated goals. Similarly, the client's agreement with an
expression of gratitude for the nurse's statements during the working phase demonstrates her
cooperation and participation in her treatment. Additionally, with the proper support and
guidance, the client was able to grasp a clearer perspective. Additionally, she was given the
opportunity to reflect and vent out her thoughts independently, which was complemented by
the student nurse's open-ended questions and gentle coaxing. Both the client and the nurse
were able to communicate their feelings and points of view without misunderstanding one
another. I believe that the client benefited from these exchanges' overall effectiveness. This is
demonstrated by the client's inability to maintain effective eye contact at the start of the
conversation, as well as by her smile and appearance of hope at the session's conclusion. In my
opinion, the most effective therapeutic communication techniques were reflection and open-
ended questions. The client is aware of several factors that are beneficial to her well-being but
is occasionally afraid to participate actively due to her anxiety. Overall, this conversation has
therapeutic value, as evidenced by the client's desire to improve his or her health and well-
being.

Reflection
In summary, the session went smoothly due to both participants' openness and
willingness to communicate. I have discovered that therapeutic communication is critical in
nursing care because it increases client participation and accelerates recovery through
patient education. As a result, this exercise can be replicated with additional clients by
demonstrating situational awareness, maintaining open communication, and catering to
and respecting their unique needs, which will result in appropriate client support.
Individuals have varying levels of experience and beliefs. Therefore, a nurse must exercise
adaptability and flexibility as this could result in more positive outcomes and harmonious
nurse-client relationships. On the contrary, some areas for improvement could include
 asking more personalized questions, paying closer attention to non-verbal patient cues, and
reducing barriers to therapeutic communication.
Analyzation
I had an analysis of the importance of process recording in a nurse-client relationship during
the interview and the creation of the written documentation of the process recording.
Nursing students benefit from process recording because it teaches them how to
conceptualize, organize, communicate with clients, be efficient, and comprehend or
evaluate even the smallest details. The primary goal of the interview during the process
recording is to obtain clarifications and determine whether the conversation and techniques
used are therapeutic or not. Process recording identifies strengths and weaknesses in the
nurse-client relationship and aims to improve the overall conversation.