CAMARINES SUR POLYTECHNIC COLLEGES

ISO 9001:2015 CERTIFIED

COLLEGE OF HEALTH SCIENCES

NCM 107
Care of Mothers, Child and Adolescent
(well clients)
1st Semester A/Y 2021 - 2022

DARYL ASLOR. FIGURA, MAN

Clinical Instructor III
 Orientation on
Related Learning Experience
A. Clinical Uniform
AREA MALE FEMALE

1.  White Clinical Polo  White Clinical Dress

HOSPITAL  White Pants  White Chemise, skin-
 White, Plain V-neck toned, plain
Undershirt underwear
 White ward shoes  White ward shoes
 White socks  White stockings
 Nameplate  Nameplate
 School ID  School ID
 Orientation on
Related Learning Experience
B. Paraphernalia
 Blue Record Book/Ballpen (Blue, Black & Red)
 Bandage Scissors, Penlight
 Prescribed utility bag with complete content
 Procedure checklist
 Wristwatch with second hand
 Required materials in the area of assignment
 Reference book/Medical Dictionary/NANDA
 Orientation on
Related Learning Experience
C. Grooming
 Hair length should not touch the collar of the uniform
 Only black pins, ribbons, headbands and hair net are allowed
 Hair bangs should not cover the eyes. NO HIGHLIGHTS!
 Short, unpolished finger nails
 No mustache (male)
 No lavish make-up (female)
 No jewelry except wedding ring
 Orientation on
Related Learning Experience
D. Attitude
 Honesty should be observed at all times
 Only two or three students per group are allowed to have
their snack/lunch/dinner at a time
Snacks – 15 minutes (not to exceed 20 minutes)
Lunch/Dinner – 30 minutes (not to exceed 40 minutes)
 Students are not allowed to go out of the hospital premises
during the clinical hour/exposure
 Loitering, vandalism, smoking, gambling, drinking alcoholic
beverages, stealing are strictly prohibited
 Maintenance of cleanliness and orderliness of the area
should be observed
 Orientation on
Related Learning Experience
E. Attendance – whole duration of duty day
 Checking of attendance is 15 minutes before departure at the
school
 Tardiness
 Considered LATE if you arrives 10-15 minutes before
departure
 Considered ABSENT if you arrives 16 minutes late
without valid reason
 Orientation on
Related Learning Experience
E. Attendance – whole duration of duty day
 Valid reasons of coming/arriving late
 Heavy rains which hinders normal transportation
 Bad weather
 Accidents
 Unexpected circumstances
 Considered ABSENT if you will be left by the school
service. You must NOT follow in the area.
 Orientation on
Related Learning Experience
E. Attendance – whole duration of duty day
 A student who has been late for three (3) times will be
marked ABSENT.
 A student who have accumulated absences/penalties of 25%
of the total RLE hours shall not be allowed to enroll/take the
next RLE subject.
 A student who comes late without valid reason should have
the corresponding penalty
 Orientation on
Related Learning Experience
E. Attendance – whole duration of duty day
 A student who comes late without valid reason should have
the corresponding penalty
1st offense – warning/explanation letter to be submitted before
students goes off
2nd offense – explanation letter to the Dean and/or Clinical
Coordinator and CI concerned. To be noted by the Dean &
Clinical coordinator which will serve as the endorsement for the
following duty day.
3rd offense – 4 hours extension of duty hours
 Orientation on
Related Learning Experience
E. Attendance – whole duration of duty day
 Classification of Absences:
a. Excused absences with make-up duty (1:1)
Sickness with Medical Certificate
Absence due to illness with medical certificate (1:1)
Absence due to illness without medical certificate (1:2)
Death of nearest kin (immediate family only)
b. Unexcused absence (1:2)
Any circumstances not mentioned in letter a.
c. Excused absence without make-up duty
School representation
 Orientation on
Related Learning Experience
E. Attendance – whole duration of duty day
 If the students will go directly to the area of assignment or
will be fetched along the way, a WAIVER should be
accomplished two (2) days before the scheduled duty.

NOTE:
 Absent without excuse letter will be graded 50 for that day.
 Absent with approved excuse letter – grade for the day will
be changed after the make-up duty.
 Orientation on
Related Learning Experience
F. Grading System
A student will be graded based on the following criteria:

KNOWLEDGE 40%
quizzes, recitation, etc
SKILLS 40%
ATTITUDE 20%
attendance
100%
VIRTUAL TOUR
 MISSION
 To treat our patients with Christian concern and
competent service;
 To provide an atmosphere of spirit-filled sacrifice and
love for our patients, staff and co workers;
 To make our work of caring for sick as our way of
witnessing Christ’s love
 VISION
To be the first-choice hospital in Rinconada District
offering a most competent and compassionate service that
reflects the love of Christ and the ideals of Santa Maria
Josefa Guerra to all patients, especially the marginalized
members of the society.
 GOAL and OBJECTIVES
To be an institute attuned to respond to the health needs of
Rinconada Community, as well as, to other communities that
would choose to avail of the medical services of SMJHFI

To provide holistic health services, with emphasis not just in

the curative but on the promotive and preventive aspects of
health care.
 GOAL and OBJECTIVES
To be the first-choice hospital in Rinconada District
offering a most competent and compassionate service that
reflects the love of Christ and the ideals of Santa Maria
Josefa Guerra to all patients, especially the marginalized
members of the society.
Consultation Area
Hallway
of the
OPD
Clinics
 DAILY WARD ASSIGNMENT OF STUDENTS
TIME PROGRAM OF ACTIVITIES
7:00 – 7:30 am  Logging-in
 Courtesy call to staff regarding schedule of duty as well as student activities (Day 1)
 Checking of attendance and paraphernalia
 Checking the number of patients in the ward to be assigned to the students.
 Short prayer before the start of duty
 Attend to the endorsement from the outgoing staff and initial rounds
 Brief pre-conference and review on the ward routines, procedures and policies
 Assigning individual responsibilities
7:30 – 10:30 am  Entrances into the ward
 NPI (Nurse-Patient-Interaction)
Take initial vital signs
Establish rapport with the patient and significant others
Physical Assessment
Morning care and bedside care
Check available medications at the bedside
Checking of chart and administration of medications
Render client education/health teaching
Construction of the FDAR Sample Charts while attending to the needs of the
patient
Checking and plotting of vital signs
 DAILY WARD ASSIGNMENT OF STUDENTS
TIME PROGRAM OF ACTIVITIES
10:30 – 11:00 AM  Checking of FDAR sample charts
11:00 – 12:30 PM  Continuation of providing nursing care
 Transcription of FDAR charts
 Final checking of individual charting
 Checking of Nursing Care Plan (NCP)
 Post-Conference
 Post-test
 Evaluation and sharing of experiences and activities observed/performed
in the area/unit
12:30 – 1:00 PM  Endorsement
 Exit in the Ward
FOCUS TOPICS:

•Nursing Health History/Interview

•Therapeutic Communication
•Nurse-Patient Interaction
NURSING HEALTH
HISTORY/INTERVIEW
- is the first step in health assessment which is to
gather subjective data from the patient and/or the
patient’s family so that the health care team and the
patient can collaboratively create a plan that
will promote health, address acute health problems,
and minimize chronic health conditions.
NURSING HEALTH
HISTORY/INTERVIEW
Data gathered may be subjective or objective in nature.
 
SUBJECTIVE DATA is information reported by the
patient and may include signs and symptoms described
by the patient but not noticeable to others.
OBJECTIVE DATA is information that the health care
professional gathers during a physical examination and
consists of information that can be seen, felt, smelled, or
heard by the health care professional.
NURSING HEALTH
HISTORY/INTERVIEW
The nursing health assessment is an incredibly valuable
tool that nurses have in our arsenal of skills. A thorough
and skilled assessment allows you, the nurse, to obtain
descriptions about your patient’s symptoms, how the
symptoms developed, and a process to discover any
associated physical findings that will aid in the
development of differential diagnoses.
 HEALTH HISTORY CHECKLIST
STEPS ADDITIONAL INFORMATION
Determine the  Source of history
following:  Name
1. Biographical data  Age
 Occupation (past or present)
 Marital status/living arrangement
 HEALTH HISTORY CHECKLIST
STEPS ADDITIONAL INFORMATION
2. Reason for  Chief complaint
seeking care and  Onset of present health concern
history of present  Duration
health concern  Course of the health concern
 Signs, symptoms, and related problems
 Medications or treatments used (ask how effective they
were)
 What aggravates this health concern
 What alleviates the symptoms
 What caused the health concern to occur
 Related health concerns
 How the concern has affected life and daily activities
 Previous history and episodes of this condition
 HEALTH HISTORY CHECKLIST
STEPS ADDITIONAL INFORMATION
3. Past health history Allergies (reaction)
Serious or chronic illness
Recent hospitalizations
Recent surgical procedures
Emotional or psychiatric problems (if pertinent)
Current medications: prescriptions, over­-the­-counter,
herbal remedies
 Drug/alcohol consumption
4. Family history  Pertinent health status of family members
 HEALTH HISTORY CHECKLIST
STEPS ADDITIONAL INFORMATION
5. Functional  Activity/exercise, leisure and recreational activities (assess
assessment for falls risk)
 Sleep/rest
 Nutrition/elimination
 Interpersonal relationships/resources
 Coping and stress management
 Occupational/environmental hazards
6. Developmental  Current significant physical and psychosocial
tasks changes/issues
 HEALTH HISTORY CHECKLIST
STEPS ADDITIONAL INFORMATION
7. Cultural  Cultural/health-related beliefs and practices
assessment  Nutritional considerations related to culture
 Social and community considerations
 Religious affiliation/spiritual beliefs and/or practices
 Language/communication
THERAPEUTIC COMMUNICATION
- is a collection of techniques that prioritize the physical,
mental and emotional well-being of patients.

- Nurses provide patients with support and information

while maintaining a level of professional distance and
objectivity.
THERAPEUTIC COMMUNICATION
Therapeutic Communication Techniques
• Using Silence
• Accepting • Encouraging Descriptions of
• Giving Recognition Perception
• Offering Self • Encouraging Comparisons
• Giving Broad Openings • Summarizing
• Active Listening • Reflecting
• Seeking Clarification • Focusing
• Placing the Event in Time or • Confronting
Sequence • Voicing Doubt
• Making Observations • Offering Hope and Humor
THERAPEUTIC COMMUNICATION
TECHNIQUES
• Using Silence
At times, it’s useful to not speak at all. Deliberate silence can
give both nurses and patients an opportunity to think through and
process what comes next in the conversation.

• Accepting
Sometimes it’s necessary to acknowledge what patients say and
affirm that they’ve been heard. Acceptance isn’t necessarily the
same thing as agreement; it can be enough to simply make eye
contact and say “Yes, I understand.”
THERAPEUTIC COMMUNICATION
TECHNIQUES
• Giving Recognition
Recognition acknowledges a patient’s behavior and highlights it
without giving an overt compliment. A compliment can sometimes
be taken as condescending, especially when it concerns a routine
task like making the bed.

• Offering Self
Hospital stays can be lonely, stressful times; when nurses offer
their time, it shows they value patients and that someone is willing
to give them time and attention.
THERAPEUTIC COMMUNICATION
TECHNIQUES
• Giving Broad Openings
Therapeutic communication is often most effective when patients
direct the flow of conversation and decide what to talk about. To that
end, giving patients a broad opening such as “What’s on your mind
today?” or “What would you like to talk about?” can be a good way to
allow patients an opportunity to discuss what’s on their mind.

• Active Listening
By using nonverbal and verbal cues such as nodding and saying “I
see,” nurses can encourage patients to continue talking. Active listening
involves showing interest in what patients have to say, acknowledging
that you’re listening and understanding, and engaging with them
throughout the conversation.
THERAPEUTIC COMMUNICATION
TECHNIQUES
• Seeking Clarification
Similar to active listening, asking patients for clarification when
they say something confusing or ambiguous is important. Saying
something like “I’m not sure I understand. Can you explain it to
me?” helps nurses ensure they understand what’s actually being
said and can help patients process their ideas more thoroughly.

• Placing the Event in Time or Sequence

Asking questions about when certain events occurred in relation
to other events can help patients (and nurses) get a clearer sense of
the whole picture.
THERAPEUTIC COMMUNICATION
TECHNIQUES
• Making Observations
Observations about the appearance, demeanor, or behavior of patients
can help draw attention to areas that might pose a problem for them.
Observing that they look tired may prompt patients to explain why they
haven’t been getting much sleep lately; making an observation that they
haven’t been eating much may lead to the discovery of a new symptom.

• Encouraging Descriptions of Perception

For patients experiencing sensory issues or hallucinations, it can be
helpful to ask about them in an encouraging, non-judgmental way.
Phrases like “What do you hear now?” or “What does that look like to
you?” give patients a prompt to explain what they’re perceiving without
casting their perceptions in a negative light.
THERAPEUTIC COMMUNICATION
TECHNIQUES
• Encouraging Comparisons
Often, patients can draw upon experience to deal with current
problems. By encouraging them to make comparisons, nurses can
help patients discover solutions to their problems.

• Summarizing
It’s frequently useful for nurses to summarize what patients have
said after the fact. This demonstrates to patients that the nurse was
listening and allows the nurse to document conversations.
THERAPEUTIC COMMUNICATION
TECHNIQUES
• Reflecting
Patients often ask nurses for advice about what they should do
about particular problems or in specific situations. Nurses can ask
patients what they think they should do, which encourages patients
to be accountable for their own actions and helps them come up
with solutions themselves.

• Focusing
Sometimes during a conversation, patients mention something
particularly important. When this happens, nurses can focus on their
statement, prompting patients to discuss it further.
THERAPEUTIC COMMUNICATION
TECHNIQUES
• Confronting
Nurses should only apply this technique after they have established
trust. It can be vital to the care of patients to disagree with them, present
them with reality, or challenge their assumptions.
 
• Voicing Doubt
Can be a gentler way to call attention to the incorrect or delusional
ideas and perceptions of patients.

• Offering Hope and Humor

Because hospitals can be stressful places for patients, sharing hope
that they can persevere through their current situation and lightening the
mood with humor can help nurses establish rapport quickly.
NURSE-PATIENT RELATIONSHIP
Is defined as a helping relationship that's based on
mutual trust and respect, the nurturing of faith and hope,
being sensitive to self and others, and assisting with the
gratification of your patient's physical, emotional, and
spiritual needs through your knowledge and skill.

Effective verbal and nonverbal communication is an

important part of the nurse-patient interaction, as well as
providing care in a manner that enables your patient to be
an equal partner in achieving wellness.
NURSE-PATIENT RELATIONSHIP
Therapeutic nurse-patient relationship starts with

Introducing yourself to your patient and use her name

while talking with her. A handshake at your initial
meeting is often a good way to quickly establish trust
and respect.
Make sure your patient has privacy when you
provide care. Be sure that her basic needs are met,
including relieving pain or other sources of
discomfort.
NURSE-PATIENT RELATIONSHIP
Therapeutic nurse-patient relationship starts with

Actively listen to your patient. Make sure you

understand her concerns by restating what she has
verbalized. Be real, showing your genuine self when
communicating with her.
NURSE-PATIENT RELATIONSHIP
Therapeutic nurse-patient relationship starts with

 Maintain eye contact. Smile at intervals and nod your

head as you and your patient engage in conversation.
Speak calmly and slowly in terms that she can
understand.
Maintain professional boundaries. Some patients need
more therapeutic touch, such as hand-holding and
hugging, than others and some patients prefer no
touching. Always respect differences in cultures.
 PHASES OF THE NURSE-PATIENT
RELATIONSHIP
Pre-interaction Phase
• The pre-interaction phase begins before the nurse's
first contact with the patients. The nurse's initial
task is one of self-exploration.
• The self-analysis of the pre-interaction phase is a
necessary task.
• Other tasks of this phase include gathering data
about the interaction with the patients.
 PHASES OF THE NURSE-PATIENT
RELATIONSHIP
Introductory or Orientation Phase
• It is during the introductory phase that the nurse
and patient first meet.
• An additional task is to establish goal consensus
and collaboration.
• The tasks in this phase of the relationship are to
establish a climate of trust, understanding,
acceptance, and open communication and
formulate a contract with the patient.
 PHASES OF THE NURSE-PATIENT
RELATIONSHIP
Working phase
• Most of therapeutic work is carried out during the working phase.
The nurse and the patient explore stressors and promote the
development of insight in the patient by linking perceptions,
thoughts, feelings, and actions.
• Patients often display resistance behaviors during this phase
because it involves the greater part of the problem-solving
process.
• As the relationship develops, the patient begins to feel close to the
nurse and respond by clinging to old defenses and resisting the
nurse's attempts to move forward.
 PHASES OF THE NURSE-PATIENT
RELATIONSHIP
Termination phase
• Termination is one of the most difficult but most
important phases of the therapeutic nurse-patient
relationship.
• This is a time to exchange feelings and memories and to
evaluate mutually the patient's progress and goal
attainment.
• Levels of trust and intimacy are heightened, reflecting the
quality of the relationship and the sense of loss
experienced by both nurse and patient
THANK YOU