MIRANDA, PATRICIA MAE, T.

NCM117a
BSN 3B MARCH 01,2022

DAILY JOURNAL

Day 1
1. What PHASE OF NPR (Nurse-Patient Relationship) in Day 1? What are the activities
involved in this phase?
- Pre- Orientation Phase: During this stage, we had a preparation for meeting
with the patient by observation of the area and the patients and examine our
thoughts and feelings about working with the patient.
4. Assignment: Prepare and review: MSE (mental status examination) form NURSING
PROCESS SOAPIE format

Mini-Mental State Examination

(MMSE)

Patient’s Name: EREN JEAGER Date: 02/17/202

Instructions: Ask the questions in the order listed. Score one point for
each correct response within each question or activity.

Maximum Patient’s
Questions
Score Score
5 3 “What is the year? 2022 Season? Summer Date? 22 Day of the
week? W e d n e s d a y , Month? August”
5 2 “Where are we now: State? County? Philippines Town/city?
Dinalupihan Hospital? Floor?”
The examiner names three unrelated objects clearly and
3 slowly, then asks the patient to name all three of them. The
3
patient’s response is used for scoring. The examiner repeats
them until patient learns all of them, if possible. Number of
trials: 0
2 “I would like you to count backward from 100 by sevens.”
5 (93, 86, 79, 72, 65, …) Stop after five answers.
Alternative: “Spell WORLD backwards.” (D-L-R-O-W)

3
1 “Earlier I told you the names of three things. Can you tell me
what those were?”

2
2 Show the patient two simple objects, such as a wristwatch and
a pencil, and ask the patient to name them.
1 1 “Repeat the phrase: ‘No ifs, ands, or buts.’”

3
2 “Take the paper in your right hand, fold it in half, and put it on
the floor.” (The examiner gives the patient a piece of blank
MIRANDA, PATRICIA MAE, T. NCM117a
BSN 3B MARCH 01,2022

paper.)

1
1 “Please read this and do what it says.” (Written instruction
is “Close your eyes.”)

1
1 “Make up and write a sentence about anything.” (This
sentence must contain a noun and a verb.)
“Please copy this picture.” (The examiner gives the
patient a blank piece of paper and asks him/her to draw
the symbol below. All 10 angles must be present and two
0 must intersect.)
1

30 18 TOTAL (increased odds of dementia)

NURSING PROCESS: SOAPIE

SUBJECTIVE OBJECTIVE ANALYSIS PLANNING INTERVENTION EVALUATION

“Noong Received Impaired Promote  Establish The patient
Sunday o kaya patient sitting memory awareness of rapport with was able to
miyerkules ata on the chair. related to memory therapeutic verbalize
ako pumunta? problems. awareness of
disorientation neurological communication
Hay, ewan di
to time, disturbances . memory
ko na maalala.” Monitor the
observed client’s  Promote problems as he
experience progress. opportunities reported: “
several for
Minsan talaga
occasions of nakakalimutan
reminiscence of
forgetfulness, ko yung ibang
past events.
pangyayari.”
scratches his  Encourage the
head when he patient to use
is unable to written cues
recall such as journal
information notebooks.
and certain  Encourage
events. ventilation of
feelings of
frustration,
helplessness,
and other
thoughts that
disturbs him.
 Refocus
attention to
areas of focus
MIRANDA, PATRICIA MAE, T. NCM117a
BSN 3B MARCH 01,2022

and progress.
 Determine
patient’s
response to
medication.
 Prescribe
medication to
improve
attention,
concentration
memory
process and to
modify
emotional
responses of the
patient, as
indicated.
 Evaluate the
outcome of the
nursing
intervention
provided.

Day 2
1. What phase of NPR is P.M. (afternoon) of Day 2? What are the activities involved?
- Orientation Phase: In this phase, it involves the establishment of rapport,
utilizing therapeutic communication to our patients. We initiated conversation by
asking some reflection points for getting to know them deeper and explaining
confidentiality.
2. What is SELF-AWARENESS? What is the importance of a Psychiatric Nurse?
- Self- awareness allows the person to comprehensively assess our strengths and
weaknesses We identify how our emotions and capabilities impacts our daily
basis and to other people whom we interact with. Knowing ourselves can help us
to know which aspects of our behavior requires improvement.
3. Differentiate TRANSFERENCE from COUNTER-TRANSFERENCE?
- Transference is when a patient redirects (transfers) their feelings about a person
from their past onto the nurse.
- Countertransference is when the nurse is projecting their past thoughts about a
person onto the patient. In this situation, the nurse's feelings and responses
MIRANDA, PATRICIA MAE, T. NCM117a
BSN 3B MARCH 01,2022

toward the patient are influenced by previous relationships, resulting in a different

treatment of the patient.
4. What is the reason behind TRUST WALK and TRUST FALL activity?
- Trust walk: As partners work together to achieve a common goal, this game
fosters trust between them and improves their listening, communication, and
teamwork skills.
- Trust fall: It is a group exercise in which a person intentionally falls in order to be
caught by someone or others in the group. A variety of groups, organizations,
and businesses use the exercise to instill trust in the people involved. It is also
intended to foster team spirit among members in order to assist the group in
achieving its objectives.

Day 3
1. What phase of NPR is Day 3?
- Working Phase is where the therapeutic interventions and
communication are occurring.
2. What are the activities involved therein (Day 3)?
- Before performing the tasks, the team provides a series of lectures or
discussions to their clients about the activities. Our team observes in ward
for medication, exercises, and food handling. After fetching the clients
(part of ADL/Hygiene), our team members promote various activities that
were appropriate for their clients, such as calisthenics, song therapy, and
biblio-therapy. Following that, the team charted their observations and
identified problems in their clients.
Day 4
1. What phase of NPR is Day 4?
- Working Phase is where the therapeutic interventions and communication are
involved.
2. What are the activities involved therein?
In this phase, the team prepared a set of discussions or instructions for the clients with
regards to the upcoming activities they will perform. After getting clients (ADL), the nurse group
encouraged their clients in performing calisthenics (a warm-up exercise to achieve body fitness
and grace movement). This is followed by several therapies, including dance therapy, play
therapy, occupational therapy, and re-motivational therapy.

Day 5
1. What is DEFENSE MECHANISM?
-Defense Mechanisms are unconscious psychological strategies that we use to protect
ourselves from anxiety or stress. There are numerous types of defense mechanisms,
but they all serve the same purpose: to assist us in coping with difficult situations and
emotions.
MIRANDA, PATRICIA MAE, T. NCM117a
BSN 3B MARCH 01,2022

3. Briefly explain them.

● Compensation - Cover up something or know the weak points and strengthen
someone’s strong points
● Conversion - Transforming an emotional problem of physical symptom.
● Denial - Person acts as if the event or feeling does not exist.
● Displacement - Feelings toward one person are directed to another
● Dissociation - Transforming emotional to mental symptoms
● Fixation - Further development is blocked
● Identification - Copying imitating others
● Intellectualization - Thinking is disconnected from feelings
● Introjection - Replacement of personality or parts of personality
● Isolation - Feeling is disconnected from the experience
● Projection - Transfer own unacceptable ideas, thoughts, and feelings onto another
person.
● Rationalization - Attempt to make one’s behavior acceptable to self and others.
● Reaction Formation - Showing the opposite of what you feel.
● Regression - Going back/reverting to a lower level of development/functioning
● Repression - Unconscious forgetting of painful/embarrassing experiences and thoughts
● Sublimation - Channeling something undesirable to a more desirable
● Symbolization - Giving meaning to objects
● Undoing - A person tries to 'undo' an unhealthy, destructive or otherwise threatening
thought or action by engaging in contrary behavior.

Day 6
3. What phase of NPR is SOCIALIZATION?
The Pre-termination phase aims to prepare the client before bringing a
therapeutic end to the termination phase. The nurse comprehensively evaluates the
progress and the effectiveness of therapy provided and achievement of goals.
Furthermore, it encourages the patient to discuss their feelings regarding the pre-
termination phase.
4. What are the activities involved therein?
- A grand socialization is an event that was prepared and performed by our team.
In this activity, the facilitator or the committee held a program for the patients
where the nurses’ team will spend their last interaction to their clients by giving
food and play engaging activities. The purpose of this activity was to allow the
nurse and the patient to mutually share and explore their feelings and related
behavior by utilizing therapeutic communication.

Day 7
1. PROCESS, using your resource materials, ALL the therapies that you have done to
your patients? (Based on week 1).
MIRANDA, PATRICIA MAE, T. NCM117a
BSN 3B MARCH 01,2022

 Occupational Therapy
PROCEDURE:
1. Choose an occupational therapy suited to patient’s interests and background.
2. Prepared all the materials needed and explained it to patients in terms of appearance, use,
color, and price.
3. Show the step by step procedure on how to assemble a certain product such as decorative
basket.
4. After explaining the procedures carefully, provide each patient a complete set of kit for a
product to assemble.
5. Simultaneously, instruct the patient assemble the product with proper guidance by designated
student name.
6. Ensure patient’s safety on the course of the therapy.
7. Evaluate by allowing the patients explain how he or she come up with the finished product
and expressing their processing their feelings and experience on what they did.

 Play Therapy
PROCEDURE:
1. Select a game or relay suited for patients.
2. Explain the mechanics as well as the materials needed on the game carefully.
3. Start the play or relay by ensuring patient’s safety on the course of the play.
4. Evaluate by allowing the patient express their feelings on the outcome of the game or relay.

 Re-motivation therapy
PROCEDURE:
1. Choose a topic to be discussed such as geography, history, literature, science, industry,
sport, hobbies and nature. Subjects not to be touched are religion, politics, family problem, sex,
and love.
2. Provide a quiet environment without interruptions.

 Song Therapy
PROCEDURE:
1. Choose a song which lyrics are written on a manila paper. Explain the song in terms of its
composer, beat, and significance
2. Instruct the patient to read first the song and let them pick a word/s or phrase/s that reflects
his or her life and allow them to explain it.
3. Student nurse sing the song with great emphasis on bet, rhythm, wording, and harmony.
4. Patient together with student nurse sign the song
5. After which the patient is given a chance to sing a song of their own choice as well as the
student nurse.

 Dance Therapy
PROCEDURE:
1. Choose a dance music that can stimulate patient’s utmost participation.
MIRANDA, PATRICIA MAE, T. NCM117a
BSN 3B MARCH 01,2022
2. Incorporate sequential steps that can easily be followed and enjoyed by the patients.
3. Demonstrate first the steps to patients after which followed by them one step at a time.
4. Play the music and incorporate the steps
5. Ensure patient’s safety at all times.

 News Therapy
PROCEDURE:
1. Select a newspaper in English or Filipino version.
2. Cut the different parts of the newspaper and attach it to manila paper for easy recognition.
3. Explain the attached parts one at a time and participation by allowing him or her to read the
newspaper’s contents.
4. Evaluate patient’s understanding by asking them how they understand the discussion and the
news that has been read.

 Biblio Therapy
PROCEDURE:
1. Choose a fiction story
2. Tell the story through puppetry and symbolism to make it easily appreciated and understood.
3. Ask the patient what they learned about the story. Moreover, recall all the characters of the
story to practice their retention.
4. Allow the patients to incorporate the story to their own lives and experiences as reflection

Day 8
1. What phase of NPR is Day 8?

The Working phase is where the therapeutic interventions and communication

are involved. Before we start the nurse-patient interaction, our team evaluated the
activities and provide short lectures with the assistance of the clinical instructors prior to
the performance tasks dedicated for the clients for preparation.

Afterward, our team introduced several therapies appropriately and engaging for
the patients, such as dance therapy with calisthenics, song therapy with other music
and art therapy, and bibliotherapy that facilitates nurse-patient interaction. It also
enables them to minimize their stress and express their feelings either in a positive or
negative manner.

Lastly, we encouraged our patients to draw a family tree and designed this art in
their own preference. All of these therapies are used to cope better with their stress,
work through traumatic experiences, increase cognitive abilities, have better
relationships with family and friends, and just be able to enjoy the life-affirming
pleasures of the creative experience.