T.R.

ISTANBUL GELISIM UNIVERSITY

FACULTY OF HEALTH SCIENCES
DEPARTMENT OF NURSING
COURSE OF MENTAL HEALTH AND
DISEASES NURSING
PRACTICE FORM
 CLINIC APPLICATION RULES

 The student must wear a uniform that represents the Department of Nursing at the
University of Health and Welfare and must wear an identification card in the clinics
where he or she goes. There is a continuing need in clinical practice.

 During clinical practice, each student must attend, with registration, to be under the
responsibility of all teaching staff or service nurses in the course of the course in the
service routine, except for three separate sessions of therapeutic interviews with the
patient they are taking.

 During clinical practice, each student must have at least one visit to the patient and
must have a "Patient Identification Form", "Interaction Process Registration" and
"Care Plan" at the end of the visit and these forms must be delivered at the end of the
visit.

 During clinical practice, each student will use "Patient Identification Form",
"Interaction Process Registration" and "Care Plan" for at least 1 patient they have
taken as a case. In particular, the "Interaction Process Registration" will be filled
immediately after the therapeutic interview (which is important in terms of not
forgetting the information) and will be kept with the student in order to discuss it with
the responsible teaching staff and will never be drafted.
 The student can not leave the clinical area without obtaining permission from the
clinical training or unit responsible.
 During the clinical application, the meal time is 60 minutes, and the coffee tea interval
is 10 minutes twice daily. The student who is separated from the unit by food or tea is
obliged to deliver the patient to his friend or unit nurse.

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 T.R.
ISTANBUL GELISIM UNIVERSITY
FACULTY OF HEALTH SCIENCES DEPARTMENT OF NURSING
COURSE OF MENTAL HEALTH AND DISEASES NURSING
PRACTICE FORM

Name of patient:
Age:
Gender:
Marital status:
Number of children:
Training:
Medical diagnosis (if specified):
Name of the nurse giving care to the patient:

HEALTH / DISEASE STORY

Reason for Referral to the Hospital (From the patient or the nearest person):

Initial Story of the Disease (Time, initiating factors, symptoms, etc.):

Risk Factors (Suicide, self-harm or behavior to others, or potential to escape from the
hospital, etc.):

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PHYSICAL STATUS EVALUATION

Eating Features (Refusal to eat, Overeating):

Substance Use and Habits (Smoking, Alcohol, Drug use):

Emptying Habits:

Life Findings (Body Temperature, Pulse, Respiration, Blood Pressure):

Other Physical Features (Edema, Cyanosis, Cough, etc.)

Independent Daily Activities Status:

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SPIRITUAL SITUATION EVALUATION

Appearance, General Behavior and Attitude (Posture, face expression, personal hygiene,
etc.):
Speech Features (Speed, mutism, perseveration, reasonableness, etc.):

Emotional State (Excessive or inappropriate affection, etc.):

Thought Content (hallucination, confusion, delusion, obsession, compulsion, etc.):

Orientation Status:

Attitude and Insight to Disease (Disease denial, attachment to a physical cause of disease,
lack of knowledge about the disease, attitude towards treatment and referral, etc.):

Interview notes on the patient's family (the effect of the patient's hospitalization on the
family, the patient's understanding and acceptance, family relationships, observations of the
nurse's patient and family during the visit):

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SPECIAL REQUIREMENTS FOR TREATMENT AND MAINTENANCE:

HOSPITAL DRUGS AND DOSE:

SIDE EFFECTS THAT CAN BE SEENING ABOUT DRUGS:

SIDE EFFECTS RELATED TO DRUGS:

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 INTERACTION PROCESS RECORDING
Name and Surname (Initials only):
Diagnosis Name of Student Nurse:
Service: History:
Aim Message from the Nurse The message of the patients Communication Method Evaluation

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 NURSING CARE PLAN
HISTORY PROBLEM AİM PRACTICE EVALUATION
 T.R.
ISTANBUL GELISIM UNIVERSITY
FACULTY OF HEALTH SCIENCES DEPARTMENT OF NURSING
COURSE OF MENTAL HEALTH AND DISEASES NURSING
CLINICAL PRACTICE STUDENT EVALUATION FORM
Student's name and surname:
EXPECTED /EVALUATED ACTIVITIES POINT NOTE THOUGHTS
1. PROFESSIONAL BEHAVIORS (20 P)
a) Conducting responsibilities
Coming to / leaving clinic on time 2
Receiving and delivering the patient 2
Seminars, visits, case discussions, etc. Participation 2
Taking responsibility in service routine 2
b) Contact
Communication with patient and family 3
Communication with the health team 3
Communicate with your friends 3
Communication with instructors 3

2. THERAPEUTIC COMMUNICATION
SKILLS (40 P)
Getting to know the patient 5
Ability to initiate / terminate communication 5
Purposeful communication skills 5
Using therapeutic communication skills 10
Communication evaluation skill 10
3. NURSING CARE PLAN (40 P)
Data collection (observation, recording, team) 8
Identifying issues 8
Objective development, 8
Developing appropriate solutions to problems 8
Evaluation of the implemented application 8
TOTAL POINTS