Professional Documents
Culture Documents
PROCESS RECORDING
2
Therapeutic Communication: Process Recording
On February 10, 2014, at lunchtime, this nursing student met the client. R.R. is a 62 yr.
old woman from Allentown who was admitted to the hospital the night before with the chief
complaint of severe abdominal pain. R.R. was selected to be interviewed because she was sitting
up in a chair, having just finished lunch, and appeared alert and receptive to being interviewed.
This was the first time the nursing student met R.R. This paper will discuss what this nursing
students thoughts and feelings were going into the first nurse-client interaction at the hospital.
The paper also discusses what the goals were going into the meeting and what outcomes this
nursing student was hoping to accomplish. Included in the paper is a five minute transcription of
the conversation that took place between this nursing student and the client.
Thoughts and Feelings
My thoughts and feelings, as a new nursing student, were varied. The night before
clinical, I felt nervous and anxious, as this was my first time interviewing a client or even
meeting a client. Physically, I felt my stomach jumping a bit and I had a little trouble getting to
sleep. However, I also felt excited in a very positive way and really wanted the morning to arrive
quickly. This was my beginning, my first attempt at interacting in a nurse-client relationship, and
I wanted to do this in an effective and compassionate manner. Yet I was a little concerned that I
would not have the comfort level to do this. My mother recently died of pancreatic cancer, and
this patient could possibly be a cancer patient as well. I know it is important, as a nurse, to be
professional and to keep our personal story and feelings out of the equation; but, as a student on
my first attempt at therapeutic communication, I could not help but have some thoughts of my
Mom enter my head. The morning of the interview I felt positive and really good but I couldnt
drink any coffee or eat because my stomach was a bit upset. When we went up to 5T and began
PROCESS RECORDING
walking around looking for a client, I felt really good and very excited, until Professor Weeks
gave me a nudge and told me to take the client in the room next to where we were standing. My
heart went thump but Im not one to back away from a challenge so I knocked on the door and
began my first nurse-client interaction. Surprisingly, my nerves faded immediately and I felt
confident.
Goals and Outcomes
This nursing student wanted to use newly learned therapeutic communication techniques
and be able to maintain a professional nurse-client conversation. One of the goals this nursing
student wanted to accomplish during the nurse-client interaction was to use active listening by
maintaining good eye contact, focus conversation on the client and nod to show interest in what
the client had to say. Another goal was for this nursing student was to use awkward silences to
encourage the client to reflect on thoughts and build on the conversation. This nursing student
wanted to establish trust and to use therapeutic touch appropriately.
The outcomes this nursing student set were:
The nursing student will maintain a client-centered discussion for the entire 5 minute discussion.
The nursing student will use therapeutic touch 3x during the 5 minute conversation.
The nurse will actively listen by maintaining eye contact for the 5 minute conversation, nodding
and leaning forward for at least 5x during 5 minute discussion.
The nursing student will use at least three awkward silences to practice therapeutic
communication.
PROCESS RECORDING
Nurses behavior
Inferences
Patients behavior
Inferences
Hello, my name is
Shawnee. Im a nursing
student with Cedar
Crest College. Do you
have about 15 minutes
to talk with me?
I introduced myself to
be polite and socially
appropriate. I
mentioned my college
and that I was student
to be professional. I
estimated the time
frame for the
conversation in order
for the patient to
decide if she wanted to
talk to me.
I wanted to offer an
explanation for putting
on the PPE in case this
made the patient feel
intimidated. I felt that
being direct was most
appropriate. I donned
the PPE due to the
pending C. Diff
results.
I have to go.
Someone is here to see
me.
Absolutely! Please
come in.
PROCESS RECORDING
(I approached where
she was sitting and
noticed there was no
other chair.)
(I redirected the
conversation to be
about her.)
(Smile faded.)
(I waited about 10
seconds after she spoke
to respond.)
Being back in the
hospital must be scary
for you.
Oh how exciting!
What do you want to
talk about?
PROCESS RECORDING
me time to get my
feelings under control
and gather my
thoughts before I
spoke. I wanted to
show empathy for her
situation.
(I sat up a little
straighter and smiled.)
Do your children that
live around here, too?
conversation to her
family and away from
her illness.
PROCESS RECORDING
(I raised my eyebrows,
smiled and nodded.)
It sounds like youre
close to your daughter
and her family?
It is. My daughter
and I sometimes do
battle but shes always
there for me.
The client is
appreciative for her
daughter. The client
wanted me to know
how close she and her
daughter are. The
client displays a lot of
love for her family.
PROCESS RECORDING
(I leaned forward and
touched her hand.)
You are so blessed to
have so many
wonderful people who
love you.
Evaluation
This nursing student achieved the outcome of maintaining a client-centered discussion for
the entire 5 minutes, except when the client began speaking while this nursing student was
putting on PPE. When the conversation started with the client asking about this nursing students
school, the student quickly directed the conversation to the client. The nursing student also
achieved the outcome of actively listen by maintaining eye contact throughout the discussion,
nodding and leaning forward for at least 5x during the conversation, when it was appropriate.
This nursing student did not accomplish using at least three awkward silences to practice
therapeutic communication. The conversation flowed easily and there were only two breaks in
PROCESS RECORDING
the conversation where silence was appropriate for this nursing student to use. Another outcome
not achieved was using therapeutic touch three times. This was an attainable outcome but this
nursing student has difficulty completely being comfortable around people. The client was very
pleasant and made it very easy for the nursing student to relax and be more open. The two
therapeutic touches that were used didnt feel completely genuine. This nursing student didnt
want to come across as feigning interest or forcing therapeutic behaviors so only two touches
were used where the student felt comfortable.
This student nurse is not typically able to keep a conversation going with a stranger and is
not able to keep the conversation completely about the other person. In stepping out of this
nursing students comfort zone, the student learned a lot in a short time about the client, such as
information about the clients family, medical condition and the vast support network. The client
was very pleasant and this student truly enjoyed time spent with the client. This nursing student
was able to see beyond the clients diagnosis and see the client as a person, not just a client. The
nurse-patient interaction helped this nursing student realize that meeting clients shouldnt cause
so much worrying or any need to be nervous and that each client is a real person.