PROCESS RECORDING ACTIVITY Observation of Setting The student had introduced herself and stated the purpose of the

interview to the patient the evening prior to this process recording. Analysis and Recommendations (Identify what facilitated the exchange, what were barriers, and positive and negative aspects of the exchange) Facilitators: • Introduced self the night before and stated purpose • Curtains drawn between beds • Client relaxed and verbalized excitement about talking with student • Turned TV off • Room had personal touches

This communication exchange took place at about 9 o’clock in the morning. The patient, Mrs. M., was in a semi-private room in bed number one which is the bed closest to the door. As a consequence, the room was quite noisy during the exchange since there were other health care workers coming in and out Barriers: of the room to attend to the other patient. The curtain was • Semi-private room with roommate present drawn between the beds to minimize the noise. Mrs. M., • Room entered by care providers for bed 2 however, requested that the door be left open in case someone • Noisy and cramped space wanted to come in and visit. Mrs. M. appeared rather relaxed • Door open—Mrs. M. looking for visitors could prevent and verbalized that she was excited to be able to talk with a her full participation in interaction nursing student. The television was on when the student entered the room but was turned off, with permission, before the process recording began. The room itself was rather cluttered and cramped making it difficult for the student to maneuver in the room. Mrs. M. also had balloons, flowers, and cards that added to the overall atmosphere of the room. Those items made the hospital room look warmer and more comfortable.

Interviewer: (Student)

Interviewee: (Mrs. M.)

Identify Communication Technique

“Good morning Mrs. M. We’re going to go ahead and start the short interview that we talked about yesterday, if that’s okay with you.” (using direct eye contact and a friendly tone of voice) Student pulls up a chair and sits near the head of the bed at patient’s eye level) “Well, let’s go ahead and get started. (using direct eye contact). “Why don’t you tell me how you feel about going home today?” “Um-huh. (nodding head, using good posture)

“Sure, come on in. You can just go ahead and do anything you want, honey.” (smiling)

Providing Information

Analysis of Interaction (was technique effective, why or why not? Was there anything else that could have been explored?) Telling Mrs. M. what she was doing would put her at ease and make her feel safe and secure.

Student positioned herself for active listening (SOLER)

• • • •

“Well (Mrs. M. sighs) I have mixed feelings you see because I really would like to get home so I can work on my geneology records I’ve been doing. But (pauses) I don’t want to go home until I’m completely better.
You see, I was in here before and I got this disease from the lady I was sharing the room with. I just know I got it from sitting in the same armchair as her. Then, (sighs and frowns), when I got home I was sick. I started coughing and vomiting. I ended up right back here again (puts emphasis on again).

Enhances trust Facilitates communication Conveys interest and involvement Eye contact conveys sincerity, interest, and professionalism To seek information To allow client to take the lead in the conversation and give pertinent information

Asking relevant questions

• •

Continued use of active listening

• •

Student continues to nod intermittently as well as saying “um-huh” or “yes”

Using positive non-verbal messages lets client know student is interested Use of paraphrasing or clarifying may have been helpful here

“So, you really aren’t sure you want to go home yet.”

“I (um) Oh, I don’t know. (puzzled tone of voice and puzzled look on face) You see my daughter, she lives in Springfield, and takes care of my husband who has Alzheimer’s Disease. She thinks that I ought to stay in here for a while longer to be sure I am better before I go home. She takes care of my husband in a home, you know, so she knows a lot about hospitals and stuff like that.

Reflecting and Focusing

• •

Trying to keep conversation focused May have needed to use a close-ended question here to zero in on only one area.

• •

“Has your daughter been in to visit you since you’ve been in the hospital?”

Probing “Mary?” (Mrs. M. pauses) No. But I have one son and three daughters you know. They’re spread out all across the United States. My son just got out of the hospital with some prostate problems so he couldn’t be here. He’s a lawyer too so he’s very busy. And then there are the twins (chuckling). Well, they aren’t really twins. They are 9 years apart but they look just alike.” (Interpreting Information and attempting refocusing was intent of the student) Changing the subject

• •

Trying to keep conversation on track An effective way to get more information but sometimes you get more information than you need Focusing could have been helpful here Would be interesting to know what prompted this question. If wanting to know why daughter wanted her to remain in the hospital, a more direct question may have worked better.

“I see you’ve gotten balloons “My son called me this and flowers all over there. But morning. He is doing pretty no one has been in to visit?” good. He just got discharged yesterday. But my neighbor came to see me yesterday.”

Conversation was becoming idle, needed to ask something like “How do you plan to manage when you go home?” or asking about the neighbor could be used to focus the conversation.

“Well good. It sounds like you’ve been keeping pretty busy in here, then.”

“Oh yes. And I am so glad. It is boring in here, you know.”

Summarizing

• • •

“Well my time is up. Thank “Oh you’re welcome honey. Terminating interaction you for allowing me to talk (smiles) Always glad to help a with you. (direct eye contact) I student. I hope I won’t have hope all goes well for you at to come back here for a long home.” time.” EVALUATION

Used to let Mrs. M. know the conversation was near the end. Did not really summarize key points Brought closure but was somewhat abrupt

(What is your overall impression of this communication exchange? Was the goal of the interview achieved? Were there any recurring themes in the exchange? What were the interviewers strengths or weaknesses? What was the social value of this exchange?)

This process recording conveyed that the student was comfortable talking with Mrs. M. It did convey some difficulty staying focused on the particular issue of concern. Mrs. M. shared a lot of information that was not really relevant to what the student wanted to know. Being comfortable and proficient with the use of paraphrasing, clarifying, and focusing may have helped the student gather the pertinent data needed with the client getting off the subject. Active and attentive listening can give cues to what is really important to a client. In this interaction the client’s family was very important to her. All in all the interaction was therapeutic, although the primary objective of finding out how she felt about going home was never really met. Follow-up questions were needed to guide the conversation back to that focus and get the information that was sought. The social interaction would have been beneficial to the client regardless of whether the main objective was realized or not. My goals for further communication growth would be: 1. Learn to use additional techniques such as paraphrasing, clarifying, and focusing redirect conversation so I can achieve the intended information. 2. Learn to use a variety of techniques naturally without having to think about them.

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