NURSE PARIENT THERA-COMMUNICATION
INTERACTION AND DEFENSE MECHANISM
N: “Good Afternoon Ian!”
P: “Hi Good afternoon”
N: “How are you today?’
P: “I’m fine mam!”
N: “Ian, do you still remember
me?
P: “yes po!”
N: “Ian, can you tell me a
story about your past? About
your bad and good
experience in life?”
P: “I was 14 years old when I
try to used drugs, and I
experience anxiety, I am
suicidal back then, march 3,
2003 is my admitted date
here in synergy. But before
RATIONALE ANALYSIS
-Giving recognition -Greetings the client by name, -The nurse is acknowledging
indicating awareness of the patient indicating
change, or noting efforts the awareness and gaining trust
client has made all show that
the nurse recognizes the
client as a person, as an
individual. Such recognition
does not carry the nation of
value, that is, of being “good”
or “bad”.
-Exploring -When client deal with topics -The nurse is delving further
superficially, exploring can into a subject or an idea.
help them examine the issue
more fully. Any problem or
concern can be better
understood if explored in
depth. If the client expresses
an unwillingness to explore a
subject, however, the nurse
must respect his or her
wishes.
-Exploring
synergy I was admitted first
in different hospital because
of my condition. I experience
to play with girls, not raped
ok what I mean is I cheated
on my relation, I never get
serious in our relationship
like that. Then I try to use
cigarettes, drinking alcohol,
drugs. I remember, I think I
already told u that I have a
girlfriend before, I was high
school back then and I feel
that I realized that I love her,
however,,, maybe I am
thinking that she’s older than
me, I’m 14 and she was 16
so….i think… aahhmm she
break up with me but I don’t -Denial -Denial is one of the most -The patient is in denial but in
know what the reason, she common defense the end of his story he
never told me, why she ‘s mechanisms. It occurs when mention that he knows the
breaking up with me,,, and you refuse to accept reality or reason of break up.
she replaced me with another facts. You block external
guy and then I become events or circumstamces
depressed, I feel lazy to study, from your mind so that you
but I did not stop, I continue don’t have to deal with the
studying, but I don’t study emotional impact. In other
hard, I’m always with friends words, you avoid the painful
every time, I just survived at feelings or events.
school without doing any
effort to study. After that I
became a music lover, but the
music I like is different, -Sublimation -This type of defense -The patient choose to
because other people said is a mechanism is considered a channel his frustration into
devilish kind of music like positive energy. That’s music, he is trying to cope by
that. Then I join the musical because people who rely on it using music.
band, i focused my self in my choose to direct strong
band even thought our band emotions or feeling into an
is not that professional, its jut object or activity that is
like a hobby, my depression appropriate and safe.
about my girlfriend before
who affected me the most,
but I realized that its not her
fault and I think the reason
why she break up with me
because she realized that she
don’t have a bright future
with me because I am not in a
good state, either she will
leave me or I will get her
impregnated. I know she
think about that she’s
smarter than me, so maybe
she think that I don’t deserve
her that’s why she break up
with me,

-So now I am moved on, but I
want to reconcile with her,
because I am looking for her
for the long time, even on
Friendster, I cant find her, I
don’t know why maybe she
change her name or she’s
already married that’s why
she change her surname, in
-Reaction formation -People who used this
defense mechanism recognize
how they feel, but they
choose to behave in the
opposite manner of their
instincts.
-The patient feels he should
not express negative
emotions, such as anger or
frustration. He choose to
react in an overly positive
way
Friendster and also in
Facebook, I did everything to
find her but I can’t.
N: “you mention drugs, what
kind of drugs did u take?”
P: I used Shabu I’ve been
addicted, sometimes I scratch
my arm with the knife.
N: “I see! Did the doctor tell
you about your diagnosis?’
P: “yes, they said I have
schizophrenia and bipolar”
N: “What medicine are you
taking?”
-Summarizing -Summarization seeks to -The nurse is organizing and
bring out the important summing up that which has
points of the discussion and gone before.
to increase the awareness
and understanding of both
participants. It omits the
irrelevant and organizes the
pertinent aspects of the
interaction. It allows both
client and nurse to depart
with the same ideas and
provides a sense of closure at
the completion of each
discussion.
-Encouraging Description of -To understand the client, the -The nurse asking the client
perception. nurse must see things from to verbalize what he
his or her perspective. perceives.
Encouraging the client to
describe ideas fully may
relieve the tension the client
is feeling, and he might be
less likely to take action on
ideas that are harmful or
frightening.
-Encouraging Description of - To understand the client, -The nurse asking the client
perception the nurse must see things to verbalize what he
from his or her perspective. perceives.

P: ”yes, I am taking
RISPERDAL, SEROQUEL,
OLANZAPINE AND NOZINAN”
N: “I see, did you take it
regularly?”
P: “yes I did, but Nozinan is
not good for me”
N: “Can you tell me the
reason?”
P: “My eyes rolled up, I sleep
whole day and I feel weak, my
doctor change it to olanzatin,
and seroquel is also fine with
me.”
Encouraging the client to
describe ideas fully may
relieve the tension the client
is feeling, and he might be
less likely to take action on
ideas that are harmful or
frightening.
- Encouraging Description of - To understand the client,
perception the nurse must see things -The nurse asking the client
from his or her perspective. to verbalize what he
Encouraging the client to perceives.
describe ideas fully may
relieve the tension the client
is feeling, and he might be
less likely to take action on
ideas that are harmful or
frightening.
-Exploring -When client deal with topics
superficially, exploring can -The nurse is delving further
help them examine the issue into a subject or an idea.
more fully. Any problem or
concern can be better
understood if explored in
depth. If the client expresses
an unwillingness to explore a
subject, however, the nurse
must respect his or her
wishes.
N: “Seroquel is medicine for?
P: “Bipolar”
N: “tell me what you feel?”
P: “I feel extreme sadness.
Extreme anger, extreme
happiness, sudden mood
change.”
N: “Ok Ian, that’s all for today,
thank you for your time.”
P: “ Ok mam, Thank you! God
bless po!”
YANTO, JHOAN MELODY. R.
MABINI COLLEGES INC.
NPI 2 (WORKING PHASE)
-General leads -General leads indicate that
the nurse is listening and -The nurse is giving
following what the client is encouragement to continue.
saying without taking away
the initiative for the
interaction. They also
encourage the client to
continue if he or she is
hesitant or uncomfortable
about the topic.
- Encouraging Description of - To understand the client,
perception the nurse must see things -The nurse asking the client
from his or her perspective. to verbalize what he
Encouraging the client to perceives.
describe ideas fully may
relieve the tension the client
is feeling, and he might be
less likely to take action on
ideas that are harmful or
frightening.