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Process Recording Assignment
Psychiatric-Mental Health Nursing of Individuals (NURS 3481)
The University of Texas at Arlington
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Psychiatric Mental Health Nursing of Individuals, Families and Groups - NURS 3381
PROCESS RECORDING ASSIGNMENT
Student Name
Client Diagnosis MD: Depression with associated anxiety
Exchange Nurse (Verbal & Non- Verbal)
Patient (Verbal & Non-Verbal)
Nurse Thoughts & Emotions
Analysis of the Interaction (Communication Technique used and Rationale for Use)
Therapeutic or Non- Therapeutic? Alternate or Revised Response (if NT) 1 Verbal: “Hi, my name is and I am a nursing student at UTA, I would like to talk to you today for about 10 minutes about what is going on, are you available to sit down and talk with me?”
Non-verbal: “I have made eye contact. I am standing up with my hands resting on my sides and my feet were flat on the floor.”
Verbal: Patient responded by saying, “Morning, my name is MD and we can sit down and talk, let me just go put my book away and then I will meet you back here.”
Non-verbal: “Patient is making eye contact. He is standing with slightly slumped shoulders while holding a book. The patient’s feet are flat on the floor.”
Nurse’s Thoughts: As I approached this first client, I was preparing myself mentally for this because of the preparation I made the night before.
Nurse’s Emotions: At this time, I was feeling anxious as to whether or not I was able to ask the right questions.
Technique used: Offering self
Rationale: This technique is used and indicates to the patient that I am available to listen to the patient.
Therapeutic? Yes
Alternate or Revised Response: N/A
- Verbal: When the patient came back after placing his book in his room, I asked the client, “What brought you here today?”
Non-verbal: “I have made eye contact. I am sitting down with my hands resting on my sides and my feet were flat on the floor.”
Verbal: Patient responded by saying, “I have been struggling with my depression and things have not been getting better.”
Non-verbal: “Patient is unable to maintain effective eye contact. Patient is sitting down with slightly slumped shoulders with hands resting on his legs and feet placed flat on the floor.”
Nurse’s Thoughts: I began to think about how I could word my next questions based upon this initial response from the client.
Nurse’s Emotions: I was feeling ready to take on the challenge of effectively interviewing this patient.
Technique used: opening remarks
Rationale: This technique is used based on the initial assessments and upon observations of the patient.
Therapeutic? Yes
Alternate or Revised Response: N/A
- Verbal: I told the client to continue by stating, “Tell me more about that.”
Non-verbal: “I have
Verbal: Patient responded by saying, “Well things at home have not been great and sometimes I do not know what I can
Nurse’s Thoughts: The patient seem to be getting more anxious when asked this question. I thought about how I
Technique used: Encouraging elaboration
Therapeutic? Yes
Alternate or Revised Response: N/A
Psychiatric Mental Health Nursing of Individuals, Families and Groups - NURS 3381
made eye contact. I am sitting down with my hands resting on my sides and my feet were flat on the floor.”
do to feel better and on top of that my girlfriend has been having a hard time as well. Things were okay for one second but at some point, I don’t remember why things became the way they are.”
Non-verbal: “Patient is unable to maintain effective eye contact. Patient is sitting down with slightly slumped shoulders. Patient begins to play with hands and the patient’s legs are shaking with feet bouncing on the floor.”
could help reduce some of the anxiety that could be related to this interviewing process.
Nurse’s Emotions: I was feeling a little flustered because I thought at the moment that I was only adding onto the anxiety that this patient was already experiencing.
Rationale: This technique helps the patient continue to describe more fully the key elements related to his problems.
- Verbal: I responded to the client’s statement by saying, “You have talked about several problems. Which one bothers you the most?”
Non-verbal: “I have made eye contact. I am sitting down with my hands resting on my sides and my feet were flat on the floor.”
Verbal: Patient responded by saying, “I want to get better so that I can be there for my family and for others. I often become down that I am this way.”
Non-verbal: “Patient is unable to maintain effective eye contact. Patient is sitting down with slightly slumped shoulders. Patient begins to play with hands and the patient’s legs are shaking with feet bouncing on the floor.”
Nurse’s Thoughts: I needed to ask questions that will help the patient identify the main problem and then include a question about goals for today.
Nurse’s Emotions: I tried to put myself in the patient’s shoes because I know what it feels like to have the pressures stack on top of you and how hard it is at times to perform efficiently.
Technique used: encouraging elaboration
Rationale: This technique helps the patient continue to describe more fully the key elements related to his problems.
Therapeutic? Yes
Alternate or Revised Response N/A
- Verbal: I responded by saying, “Are you saying you are feeling
Verbal: Patient responded by saying, “at times, yes.”
Nurse’s Thoughts: I need to continue on by asking the hard
Technique used: Seeking clarification
Therapeutic? Yes
Psychiatric Mental Health Nursing of Individuals, Families and Groups - NURS 3381
hands and the patient’s legs are shaking with feet bouncing on the floor.”
this moment by remembering what question to follow-up with.
- Verbal: “What are some goals that you have today to help with what you are dealing with?”
Non-verbal: “I have made eye contact. I am sitting down with my hands resting on my sides and my feet were flat on the floor.”
Verbal: Patient responded by saying, “I want to be able to talk more during group sessions because everyone keeps telling me that it will make me feel better.”
Non-verbal: “Patient is unable to maintain effective eye contact. Patient is sitting down with slightly slumped shoulders. Patient begins to play with hands and the patient’s legs are shaking with feet bouncing on the floor.”
Nurse’s Thoughts: I believe that the patient has the right idea and will continue to get better when he will actively engage in group sessions.
Nurse’s Emotions: I was happy to know that the patient is actively trying to seek help and confirms the desire to feel better.
Technique used: Focusing
Rationale: This technique helps the patient helps the patient focus on the key characteristics that would be beneficial to him subjectively stating that he feels better.
Therapeutic? Yes
Alternate or Revised Response: N/A
- Verbal: “It is important for you to actively engage in your treatment process. The staff here supports you and will continue to encourage you even when you do not feel like doing your best.”
Non-verbal: “I have made eye contact. I am sitting down with my hands resting on my sides and my feet were flat on the floor.”
Verbal: The patient did not verbal say anything but acknowledges that this was heard from the non-verbal cue of nodding his head with agreement.
Non-verbal: “Patient is unable to maintain effective eye contact. Patient is sitting down with slightly slumped shoulders. Patient begins to play with hands and the patient’s legs are shaking with feet bouncing on the floor.”
Nurse’s Thoughts: I believe that I helped the patient realize the importance of participation within these group sessions by saying that the staff cares about his treatment process.
Nurse’s Emotions: I was feeling happy that I could help and confident towards the end of the interview.
Technique used: Giving information
Rationale: This technique involves sharing with the patient relevant information for the well-being and treatment process for this patient.
Therapeutic? Yes
Alternate or Revised Response: N/A
10 Summary
Verbal: “Unfortunately, our time has come to an
Verbal: Patient responded by saying, “the conversation
Nurse’s Thoughts: I believe that I concluded the
Technique used: Encouraging evaluation
Therapeutic? Yes
Psychiatric Mental Health Nursing of Individuals, Families and Groups - NURS 3381
end, thank you for taking the time to talk to me. Before I let you go, what were your thoughts on our conversation today?”
Non-verbal: “I have made eye contact. I am sitting down with my hands resting on my sides and my feet were flat on the floor.”
helped me to try to speak more later on today during the group meeting.”
Non-verbal: “Patient is making effecting eye contact. The patient is sitting down with hands resting on his sides with his feet placed flat on the floor.”
interview session efficiently.
Nurse’s Emotions: I felt excited, happy, and confident in the fact that the patient said, “this conversation helped me to try to speak more.”
Rationale: This technique implemented towards the end of the discussion could help the patient reflect upon the conversation that was held to help the patient to continue to engage actively in the treatment process related to the main theme from this conversation.
Alternate or Revised Response: N/A
Summary of the Therapeutic Encounter
Discuss the influence of your setting on this interaction.
After the first morning group session that was held in order to talk about the goals that each of the patients on the floor had for the day. The main topic of discussion that was talked about was certain coping skills that worked for that particular individual. Briefly after group session, MD approached me and then we continued to talk for about 10 minutes. I decided to put my binder down and just let the flow of the conversation guide me. I was surprised because I actually did not feel lost as I thought I was going to experience prior to the actual client conversation.
Evaluate the overall effectiveness and therapeutic value of exchanges and techniques that were most useful for you.
I believe that the overall effectiveness of these exchanges was beneficial to the client. This is evident from the client being unable to maintain eye contact at the beginning of the conversation, to being able to maintain effective eye contact and also no longer playing with hands and shaking his legs. The most useful therapeutic technique for me was encouraging elaboration and encouraging evaluation. I believe that this client knows some of the things that are helpful, but at times is afraid to engage actively because of his anxiety. However, the patient verbalizes that he wants to feel better and will actively try to engage more in his treatment plan. This conversation contains therapeutic value as evidenced by the willingness of the patient to become and feel better. Identify areas for improvement and lessons learned.
I believe that some areas for improvement could include being more confident during the interview process, asking more individualized questions, and paying attention to more non-verbal patient cues. Although by definition, the questions that I asked this question were therapeutic and was evidenced by an overall positive outcome, I believe that there could be improvement mainly in the delivery of the questions themselves. Overall, I learned that sometimes things may seem hard and the associated anxiety with that task may make you think you are incapable; however, those thoughts and feelings go away when you realize that the most important thing right now is the patient.
Reference:
Boyd, M. A. (2018). Psychiatric nursing: Contemporary practice (6th ed.). Philadelphia, PA: Wolters Kluwer.
Qaseem, A., et al. (2016). Nonpharmacologic versus pharmacologic treatment of adult patients with major depressive disorder: A clinical practice guideline from the American college of physicians. Annals of Internal Medicine, 164(5), 350–359. (Level I).
Taylor, C., Lynn, P., & Bartlett, J. L. (2019). Fundamentals of nursing: The art and science of person-centered nursing care (9th ed.). Philadelphia, Pennsylvania: Wolters Kluwer.
Varcarolis, E. (2017). Essentials of psychiatric nursing: A communication approach to evidence-based care. Evolve Health Sciences.
Process Recording Assignment
Course: Psychiatric-Mental Health Nursing of Individuals (NURS 3481)
University: The University of Texas at Arlington
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