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
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,
PATIENT INTERPERTATION AND
ANALYSIS
Verbalize; Interpretation;
“yes go on” 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
“I am fine thank you” that defense mechanism’s
were used such as
“ Ignacio Eriberto Y
rationalization, projection,
Dimaano jnr. But you can
denial)
call me mang jun, i was
born in march 23rd 1954 My client has confidence and
your religion and and i graduated from the
educational attainment?” school of law”
“ how long have you been “ I have been here for up
in this institution?” to 7years”
“how do you find your “ I get along with the
surrounding and do you people here, i am the
get along with the people president here. I have a
here” 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
 me” communication with other
inmates

“she is my adopted sister,

before i was brought here,
“ how often do you have
we had problems,
visitors?”
arguments. We are not
close at all, we don’t just
agree to a certain things”
Analysis;

“Do you have a close
relationship with your
sister?
“Do you know the reason
u are in this institution?”
“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
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