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ORIENTATION PHASE

Description of Phase:

This phase sets the tone for the rest of the relationship of the patient and the
nurse. It is also called the introductory phase or prehelping phase. During this initial
encounter, the client and the nurse closely observe each other and form judgement
about the other's behavior. The three stages of this phase are opening the
relationship,clarifying the problem, and structuring and formulating the contract. Other
inpostant task of this phase include getting to know each other and developing a degree
of trust.

Objectives:

-Intial interaction of nurse and patient.

-Getting to know each other.

-Establish rapport and trust.

-Contract setting.

-Believe the nurse will try to understand and respect their curtural values and beliefs.

-Feel comfortable talking with the nurse ablout feelings and sensitive issues.

-Gather personal data, chief complaint, History of present illness, previous illness, Past
medical history and Family history.

- Identify the dominant behaviot of the client pertaining to general appearance,motor


behavior and genereal obserbable characteristics.

Date/Time/Venue: January 4, 2011, 9:30am NCMH Pavillion 21


WORKING PHASE

Description of Phase:

During the working phase, the nurse and the client begin to view each other as
unique individuals. They begin to appreciate this uniqueness and care about each other.
It has two major stages: exploring and understanding thoughts and feelings, and
facilitating and taking action. The nurse helps the client to explore thoughts, feelings,
and actions and helps the client plan a program of action to meet preestablished goals.

Objectives:

-Explore problems, overcome resistance, learning and practicing new coping skills ansd
new way of thinking, developing helping behaviors.

-Explore and understand thoughts and feelings by having skills like Empathetic listening
and responding,Genuiness, Respect,Concreteness and Confrontation.

Date/Time/Venue: January 5, 2011, 10:00am NCMH Pavillion 21

NURSE-PATIENT RATIONALE OF THE NURSE ANALYSIS OF THE


INTERACTION COMMUNICATION PATIENT’S RESPONSE
TECHNIQUE
N:Good morning po. Asking Direct Question- using Client looks happy and excited.
Naalala niyo po ba kung open-ended questions to
sino ako? achieve relevance and depth in
P: Ikaw si EJ, yung student discussion
nurse
N:Kamusta po kayo? Ano Broad Opening–encouraging The patient anwers back the
pong ginawa niyo kahapon the patient to select topics for question and maintained a
nung umalis kami? discussion good eye contact.
P: Wala naman. Kumain at
natulog
N: Ang therapy po natin Giving Information The patient has knowledge
ngayon ang music and -Providing a simple and direct about the therapy.
arts. manner, factual information
P: Ah yung may slow at
fast.
N: Saan niyo po gustong Offering self Client excitedly entered the
umupo? Doon po muna -Suggesting to understand pantry and went to a place
tayo habang hindi pa client without any demands or which is comfortable to him. He
naguumpisa yung therapy. condition immediately talked about the
P:Dito na lang. May ituturo intelligence code. He explained
ako sayo yung intelligence the code as a military type code
code forever. Ichat mo yan which he uses.
sa cellphone. Ang bawat
letra ang may katumbas
na numero ang 1 ay A, 2
ay B hanggang Z yun.
N: Napansin ko sa drawing Exploring- this is used to Client answered the question
mo kulay itim at green ang explore and assess on how the smiling.
ginamit mo. patient perceive the situation
P: Favorite color ko kasi and climate that the nurse is
ang itim. Kasi kahit saang providing
damit pwedeng bagayan.
N: Nakalagay po sa Exploring- this is used to Client answered with joy in his
drawing niyo I love Korina explore and assess on how the face and he seemed shy .
Snchez. Sino po ba si patient perceive the situation
Korina Sanchez para sa and climate that the nurse is
inyo. providing
P: Mahal ko si Korina
Sanchez. Idol ko yun.
N:May nakasulat na Steoreotyping- Offering Client answered this with an
“Rattle Snake Nurse". Sino generalized beliefs about group explanation of a symbol.
ang binabangit mo dito? of people that are based on
P: Magiging ganyan ka experiences.
kapag naging nurse ka na.
N:Ano po itong electric Exploring- this is used to Client answered the question
ball? explore and assess on how the which give emphasize on
P: Ayan ay may patient perceive the situation fictional things.
kapangyarihan paganahin and climate that the nurse is
ang mga kotse kahit providing
walang gas. Parang yung
kay Son Goku.
N: Ah. Kahapon tinanong Seeking Clarification- Makes Client smiles while answering
kita kung paano ka the clients broad meaning of the question but he seems
napunta dito sa loob. Sabi the message more uneasy. He averts his attention
mo sakin kasi binasag mo understandable. to others direction
yung istante sa hardware
ninyo. Paano mo binasag
yung estante?
P: Bumuli ako ng lata ng
bear brand yung maliit
ayun ang ginamit ko.
N: Maari mo bang sabihin Exploring- this is used to Client smiles and giggles while
sakin kung bakit mo explore and assess on how the answering.
binasag ang estante? patient perceive the situation
P: Wala lang trip trip lang and climate that the nurse is
providing
N:Ano ang nangyari bago Rejecting-refuse to discuss a Client averted his eyes and
mo basagin yung estante? certain topic. does not want to talk about his
P:Nagkabiruan kami ng brother.
kapatid ko. Kinalimutan ko
n yon.
N:Paano ka napunta dito Using open-ended questions- Client is unaware that he has
sa hospital?Alam mo ba It invites the client to explore schizoprenia and believed that
ang sakit mo? thoughts and feeling. he is only rehabilitating due to
P: Nagwala ako sa his acts.
hardware namin at
nagbasag ng estante.
Hindi ko alam kung anong
sakit ko. Sabi nila
natutulala daw ako. yung
paranoid ba. Nandito ako
dahil nirerehab ako.
N:Kahapon may nabangit Seeking Clarification- Makes Clients described his soldiers
ka sa aking mga sundalo the clients broad meaning of and said that he is their master.
na nakikita mo? Nakikita the message more While talking he seem like a
din ba sila ng iba? anung understandable. leader or a military official that
itsura nila? has an army.
P: Oo, lumalabas sila Exploring- this is used to
kapag may mananakit sa explore and assess on how the
akin. Katulad noon patient perceive the situation
papatayin ako.May and climate that the nurse is
nakabantay doon sa labas. providing
Mukang tao din sila pero
mabibilis parang mga
ninja.
N:May mga nakikita pa po Seeking Clarification- Makes Client answer confidently he
ba kayo bukod sa mga the clients broad meaning of touched his head when he said
sundalo? o may naririrnig the message more karunungan.
po ba kayo? ano pong understandable.
sinasabi?
P: Sila lang ang nakikita
ko. May nagsasalita sa
utak ko mga boses.
Binibigyan nila ako ng
karunungan.