NURSE AND PATIENT THERAPEUTIC COMMUNICATION DIALOGUE

Pre-interaction Phase At Hospital X in room Y there is a patient named Sri Wahyuni 19 years old where
he is currently pursuing higher education at Poltekkes The Indonesian Ministry of Health in Padang, who
is in the Siteba area, at the hospital he was accompanied by his mother named Bintang, where Ayu was
undergoing postoperative wound care. accident, there he was treated by Ns. Elissa. (Accountability)

Orientation Phase

Morning at 07.30.

Nurse : "Happy morning

Patient : ”Good morning sis.."

Nurse : “Introducing mmy name is Elissa, I'm a student from Poltekkes Ministry of Health RI Padang,
starting this morning I will take care of Ms.from 07.00 to 14.00 noon. May I know what is your
name? and name who is your biological mother?"

Patient : "Yes, nice to meet you too, my name is Sri Wahyuni, you can call meby calling Ms. Ayu and my
biological mother's name is Bintang Ms.

(patient rights)

Nurse : “Baik Ms. Ayu, how is Ms. Ayu now? What are you doing?Ayu feel?”

Patient : “Ssince yesterday's accident, my knee still hurts a little sis (touches my knees and contemplates)
so I can't take a shower and myhead feels itchy sis

Nurse : Yes, Ms. Ayu, it is indeed the effect of the wound that Ms. Ayu experienced, because In Ms.
Ayu's wound there was an inflammatory response, and the itching occurred because you haven't
washed your hair in a long time

Patient : “AIso that dangerous, sis?”

Nurse : No, Ms. Ayu, inflammation is a beneficial symptom and is the body's defense that works to
neutralize and destroy the injurious agent in preparation for wound healing. So Ms. Ayu, you
don't have to be like thatworry."

Patient : "Yes Miss"

Nurse : "yes sis Ayu,Ok, I'll excuse myself first, please, Ms. Ayu, rest come back, later I will come
again around 08.00 noon to do hair care action, washing Ms. Ayu's hair (fidelity)

Patient : “yes miss."

Working Phase

Not long after the nurse approached the patient again.

Nurse : “Good morning,?”(smile)miss

Patient : "morning sis."(tesmile)

Nurse : "Miss Ayu,according to the agreement that was agreed earlier now I will perform hair care
actions, not long about 30 minutes (fidelity) and we just do it here, willMs. Ayu ready?"

Patient : "yes I am ready sis" (autonomy)

Nurse : "ok i will prepare athe tools first."

After the nurse prepares the tools, the nurse performs the act of washing the hair which begins with
washing hands (Bineficience) and installing sampiran (confidentiality).

Termination Phase

Nurse : "How do you feel after I wash Ms. Ayu's hair?"

Patient : "I feel like my head feels comfortable, sis, it feels fresh"

Nurse : "okay ma'am,because i finished bathing mba, i went back to

The room first, if you want to wash your hair for the next day, you can do it like I did earlier, ask your family
for help, do you understand?”

Patient : "Yes, thank you, I understand Ms.

Nurse : "Please mother rest again, later I will come again at around 04.00 pm, sis, if you need help,
just call me at nurse's room, sis! Assalamualikum".

Patient : "Yes ma'am, waalaikumsalam ma'am"

Documentation Phase
 Weigh Accept Role Play Scenario by

FG 2

Group name:

Annissa Novalia (KARU)

Farah Luthfi Kaulina (KATIM MORNING)

Kartika Krismeylinda (PATIENT)

Milazwarni Aisyah (KATIM SORE)

Putri Afrillia Budiyanti (PA SORE)

Utari Melinda Yanzami (PA MORNING)

CASE 2A : TEAM Assignment Method; weigh-in from the MORNING-AFTERNOON shift.

Pre-weigh a c c e p t

On Tuesday, February 25, 2019 at 14.00 at the Nurse Station of the Melati Hospital, there was a
routine process of weighing and receiving carried out between the morning service nurse and the
afternoon service nurse. The event was also attended by a Head of Room as a facilitator, two team
leaders (each from the morning shift team and the afternoon shift team) and the implementing nurse
for each service team. The following is the conversation that took place during the weigh-in.

KARU : Assalamualaikum wr.wb, good afternoon Ners. Alhamdulillah, this afternoon, we can
gather in this room in good health. As usual, this afternoon we will weigh and accept shift
changes. Previously I will register nurses first. Please for each team leader is welcome to
introduce his team.

KATIM 1 : Good afternoon everyone, I am Farah as the head of the morning shift nurse which
consists of 4 people. Alhamdulillah, this afternoon, the four nurses were present at this
meeting. Introducing Ners Utari, Ners Melinda, Ners Pedry and Ners Yanzami.

KATIM 2 : Good afternoon, I'm Milaz as the head of the afternoon shift nurse. This afternoon service
team also consists of 4 people. The one on my left is the female nurse, next to me is the
Afrillia nurse, then there is Budi's nurse, and Yanti's nurse.
KARU : Alright then, let's start weighing it up. I invite the nurse on the morning service to explain
about the client and his current condition as well as the treatment that has been carried out.
For nurses on the afternoon shift, please pay attention and record important data related to
clients.

CATIM 1 : Thank you, Ms. KARU. The number of clients held by my team is 11 people with
dependency levels: minimum care 2 people, partial care 5 people, and total care 4 people.
All patients are in stable condition. However, there is one patient named Mr. K who just
entered on February 22, 2019, was medically diagnosed with B20 accompanied by
pulmonary TB. This patient has a nursing problem of ineffective airway clearance. Patient
K has a blood pressure of 140/90, temperature 37 degrees, RR 30, looks thin, coughs,
shortness of breath, slight dizziness, does not vomit, does not have stomach pain, the
frequency of defecation is reduced to 2 times a day, less able to control urination, weakness
in both lower extremity, still infusion and catheter, NRM 5 liters/minute.

PA 1 : Yes, the data submitted by the team leader is correct, the patient has been educated
regarding the correct disposal of sputum.

KARU : Thank you for the morning nurse who has conveyed the current condition of all patients,
especially regarding the condition of Mr. K. Team leader or morning nurse, is there anything
that needs to be added regarding the report that has been submitted?

PA 1 : Yes sound Mr. K's ronchi appeared at around 12 noon this afternoon but could be overcome
by collaboration with the doctor. For the afternoon service nurse, please re-evaluate and
prepare what needs to be noted about the client's condition when you will validate the
client's condition.

PA 2 : Well of course i will do.

Implementation

Next, KARU, KATIM 2, and Implementing Nurse (PA) 2 went to the client's room to validate.

KARU : Good morning Mr. K, as usual, sir, we are here to weigh and accept shift changes. Its
purpose is to communicate the client's current state and convey important information
between shifts. Introducing the implementing nurse who is on duty for the afternoon shift,
there is a female nurse

KATIM 2 invites each PA in the afternoon to carry out direct validation to the client
PA 2 : Good morning sir. Introducing, I am Ners Putri and this is my friend Ners Budi.
We are nurses on duty this afternoon. Right this is with Mr. K?

PATIENT : Yes Ners. I'm Mr K.

PA 2 : Okay sir, then I will check your physical condition now, it will take about 10 minutes. How
are you sir?

PATIENT : Please Ners

PA 2 : Alright, I'll wear gloves for a while, sir, and close the curtain. (then the nurse performs a
TTV examination and also a physical examination related to the client's condition).

PA 2 : Yes, so there is still a buildup of fluid, sir, in your airway, we usually call it a buildup of
secretions. Are you comfortable with this position? Or do you still feel short of breath?

PATIENT : Yes, you're still having a hard time breathing.

PA 2 : Alright, I'll position it for a moment, sir. Alright then, father, the examination is over.

Post weigh-in

The weigh-in activity in the room was finished and then the team returned to gather at the Nurse station
to close the activity.

KaRu : Well, we have carried out a weigh-in process through the joint discussion process
earlier and have visited and validated data and conditions to patients directly direct.
Maybe from all of our discussions, there is something you want to ask or convey
before starting the afternoon shift?

Team Leader : None. Alright, then let's start the afternoon shift today. And thank you for our
cooperation earlier in carrying out weighing and receiving activities.

KaRu : I hope that with this activity the process of delegating tasks is conveyed clearly.
Hopefully all Ners are given fluency in carrying out their respective roles and duties.
I end this weigh-in. Wassalamualaikum wr. Wb.