Nursing-Patient InteractionIs the use of oral, gestures and facial expression of the client and nurse inestablishing a nurse-patient

relationship.Phases of Nurs e-Patient Interaction1. Orientation - During this phase, the individual has a felt need and seeksprofessional assistance. The nurse helps the individual to recognize an dunderstand his/ her problem and determine the need for help.2. Identification The patient identifies with those who can help him/ her. Thenurse permits explo ration of feelings to aid the patient in undergoing illness as anexperience that reorients feelings and strengthens positive forces in thepersonality and provid es needed satisfaction.3. Exploitation - During this phase, the patient attempts to derive full value fromwhat he/ she are offered through the relationship. The nurse can project newgoals to be achieved through personal effort and power shi fts from the nurse tothe patient as the patient delays gratification to achieve the newly formed goals.4. Resolution -The patient gradually puts aside old goals and adopts new goals. This is a process in which the patient frees himself from identification with thenurse. Techniques Effective in Nurse-Patient Interaction 1.Reflection. Repeating content or feelings. You might simply repeat whatthe pat ient has said, to give him time to mull it over or to encourage himto respond. O r, and often more effectively, you can reflect on what youthink the patient is f eeling. "It sounds like you're concerned about yourfamily." or "I don't think yo u're very happy about this." By reflecting on hisfeelings, you may be encouragin g him to talk about something he mayhave been hesitant to bring up himself. Or y ou may be helping the patientto identify his own feelings about something. 2.Restating. Rephrasing a question or summarizing a statement. "You'reasking why these tests are needed?" or "In other words, you think you'rebeing treated like a child. "3.Facilitation. Occasional brief responses, which encourage the speaker toconti nue. A nod of the head; an occasional verbal cue, such as "go on" or"I see;" and maintaining eye contact throughout the conversation all implythat you are liste ning and that you understand. ( 4.Open-ended questions. Questions that encourage the patient to expoundon a topi c. If you want to encourage the patient to speak freely, you mightask "How are y ou feeling?" rather than "Are you in pain?" 5.Closed-ended questions. Questions, which focus the patient on a specifictopic. If you want a short, straight answer, ask a question which will allowonly for a direct response, such as "When was your accident?" or "Do youhave pain after ea ting?" 6.Silence. A quiet period that allows a patient to gather his thoughts. Of cours e, this would be an occasional practice, used when you feel that the patient cou ld use a little time to think about his response to a question or just to think. 7.Broad openings. A few words to encourage the patient to further discuss atopic ; for example, "and after that..." or "you were saying..." 8.Clarification. Statements or questions that verify a patient's concern orpoint . "I'm a bit confused about...Do you think you could go over thatagain please? "Barriers in Nurse-Patient Interaction development of an emotional attitude of the patient eitherpositiv 1.Transference e or negative towards the nurse. 2.Resistance - development of ambivalent feelings toward self exploration. 3.Counter Transference transference as experienced by the nurse.

Name: UM Felipe ValenciaAge: about 42 years oldGender: MaleCivil status: UnknownAd dress: UnknownDate of Birth: UnknownPlace of Birth: UnknownPerson to Notify: Ann alyn Aguda (Escort)Date of Admission: September 6, 1995 at 7:20Admitting Doctor: Dr. GonzagaAdmitting Diagnosis: Psychosis, to be classifiedT/c Mental Retardati onS/p Exploratory Laparoscopy Descending Limb ColostomyAdmission notes: Found by the Brgy. Tanod of Muntinlupa City,along the railroad and side swiped by a runn ingtrain.Bought to the Philippine General Hospital andoperated.Stayed at 13 days in the PGH and was forwaded toSW of Muntinlupa.Final Diagnosis: Psychosis 2 to s eizure disorder s/p ExploratoryLaparoscopy Descending Limb Colostomy II. Objectives: Specific Objectives: 1. Establish rapport.2. To reduce the anxiety felt by the client towards the nur se.3. To know or gain information about what happened to thepatient.4. To unders tand the patient s problems.5. To know the symptoms manifested.General Objectives To distinguish the sickness of the client thru the observationdone. Assessment: The patient manifest the following symptoms of not having eyecontact to the nur se, there is disorganized speech, stuttering and repetitionof his own words (ver bigeation), obeying single command, doesn tremember the day, there is delusion and word salad.

Maganda Umagapo. P: Maganda Um-umaga rin. N: Ako po si Cheryland nurse niyongayon P: Ako-ako naman si Felipe N: Kuya, ano poaraw at petsangayon? C: 2 2 2 .21 .2010 Feb feb Februa ayon poay February 4, 2010Client was sitting andlooking at me in theeye.He was s itting stilllooking at me in theeyes with his handsintertwined.Staring at me smi ling.His head started tomove to the right andscratching his head.Giving recognit ion toindicate that you areaware of himGiving Information totell the client whoy ou are.Clarification on whatthe client knew of the date today.Presenting Reality toknow that whatreally is true.

Thursday. Pakiulitpo. C: 4 Feb February2010 thu thu thurdays.N: 19 yrs old na poako. Ila taon na pokayo P: Ako ako . 21 21 yrs na ako dito N: Kuya, Ilan taon napo kayo P: 3 3 . igurado po P: Oo 21..21 21yrs na ako dito salugar, Gawa ng lakadtapos pahinga Ulitgawa a raw-araw N: Anu po yun Kuya?Naglalakad? P: Lakad lakad satabi-tabi .Exercise . Tapos upop g pagod N: Anu-ano pa ngmga ginagawa ninyoditto? P: Ano . Kain lakad upo . Taposlakd pulot sura . Dun salabas ikot ikot lakadpag mainit ditto loobupo kinig ng music N: Ano panga lan ngmagulang ninyo P: A .a .a . Silapatay na. N: May asawa poHis head started to goleft right as heanswered.His eyes lookedstraight.His eyes started toroam around.He s tarted to point atthe room, outside andthe chairs.He started to makehand actions thatcorrespond on what hewas saying.He started to lookedaround again.He was mak ing handgestures and his eyes just looked straight.Eyes started to wanderaround. Giving Information toknow how old theclient is.Clarification to makethe client u nderstandthe questionValidation to confirmif the client said istrue.Restating to knowwhat the client saidand to repeat thesentence.Using broadopenings tointrodu ce a topicGiving information toknow the names of the client s parents.Giving infor mation toknow the name of the client s partner.Validation theclient s answer.Giving information toknow the name of

kayo? P: Oo . Yun tatay komay asawa. N: Kuya, ikaw po bamay asawa? P: Oo asawa mgakapati yasawa. N: Mga anak Kuya,meyroon? P: Oo . Damidami . Anak ngtatay ko mga anakrin ng kapat ko. N: May dumadala poba sayo ditto? P: Dalaw . Oo N: Sino-sino po? P: Mga anak ok .Anak atid magulangdito dalaw sa akin .Dala pagkain taposusap. N: Kuya ano ponagyari diyan sa

sugat ninyo? P: Ito y . kuha siyadoon . Tapos biglasiya dugo . Noon natuyo . Ako kamottapos go ulit .Noon dugo lit ako tigilkamot. N: Kuya, tayo munatayo atmageexercise P: Sige sige ami araw-arawexercise sa loob Head turns to the leftand stared.He stared straight thenhis head turn right.He was making handgestures and his eyes just looked stra ight.His head gestures upand down as he pointon his arm.He s shaking his headthat he agree as hestand upthe client s children.Giving information toknow if the clien t s isbeing visited.Giving information toknow the who arethe people visitinghim.Ex ploring to knowwhat happened tohis wound SuggestingCollaboration to theclient to participateon the excerise.