NURS 223L Mental Health/Psychiatric Nursing Practicum Spring I 2018 - Interpersonal Process Analysis

Learn about communication techniques used in mental health/psychiatric nursing practicum. Read about therapeutic communication strategies, de-escalation techniques, and more.

NURS 223L Mental Health/Psychiatric Nursing Practicum Spring I 2018
INTERPERSONAL PROCESS ANALYSIS NAME: DATE:
Student:
• Verbal (quotes) and Nonverbal Communication (behavior, tone of
voice, eye contact, mannerisms, etc.)
• Document at least 5 interactions
• Goal for each interaction (realistic and measurable)
Patient:
Verbal (quotes) and Nonverbal
Communication (behavior, tone of voice,
eye contact, mannerisms, etc.)
Communication Techniques
• Identify communication technique
used then define your
communication
techniques
• Was the communication
therapeutic or non-
therapeutic?
• Which defense and coping
mechanisms didthe
patient use? Rationale
based on your patient.
Critique and Analysis
(effective or not effective? Could have said...) Document your thoughts and feelings
interaction.
Was your goal met?
Goal: Verbal: Speak in a reassuring manner
Nonverbal: Maintenance of proper eye contact
Verbal: Abusive language
Nonverbal: hitting and pushing others
The technique used by me was a
therapeutic communication technique
as it would help to calm the patient
down by reassuring that his problems
are understood and appropriate
solutions will be provided.
The communication was effective.
Goal:
Verbal: Language portraying retaliation
and revenge
Speaking in a non-judgemental and
non proactive manner and also in a
soft tone of voice will make the
The communication was effective.

Verbal: Speak in a non-judgemental and non proactive manner
Nonverbal: Maintain a soft tone of voice
Nonverbal: high pitched tone of voice
patient understand that the nurse is
concerned about his situation and is
not judging him by his medical
condition. Maintaining a soft tone of
voice also makes the patient
understand that the nurse is not
impatient and is actively listening to
his problems. This is a therapeutic
communication strategy.
Goal:
Verbal: Do not use insensitive language and be sensitive to the
preferences of the client
Nonverbal: Present a calm appearance
Verbal: Threatening language and gestures
Nonverbal: Threatening stance towards the
nursing professionals
The client can be from a different
culture and may want the treatment
accordingly. Thus, by using sensitive
and culture appropriate language it
will ensure the client that the nurse is
aware about his cultural preferences
and will provide remedies
accordingly. This is a therapeutic
communication strategy.
The communication was effective.
Goal:
Verbal: Do not use any form of racial or cultural abuse or slurs
Nonverbal: Maintain space and show respect
Verbal: Threatening to assault
Nonverbal: Restlessness, shaking and
increased muscle tension
It is essential for the nurse not to use
any forms of racial or cultural slurs or
abusive languages and also to
maintain space between the client.
Any form of abusive language will
further aggravate the situation and
make the patient even more
aggressive. This is a form of
therapeutic communication.
The communication was effective.
Goal:
Verbal: Do not use sarcastic language and be patient towards the client
and use quotes that ensures the client that the nurse will ensure his
Verbal: Verbal swearing and shouting
Nonverbal: Rapid breathing, sweating or
perspiring.
It is necessary for the nurse to use
reassuring languages that helps to
manage the aggressive nature of the
client. Moreover, use of sarcastic
language on the part of the nurses will
The communication was effective.

well-being
Nonverbal: Maintain control of the situation by use of hand gestures
and show empathy
further aggravate the situation. Thus,
use of reassuring language is a form
of therapeutic communication and
helps the client to remain calm.
However, reassurance should be in
the form of realistic solutions that can
be met and not false promises. This
therapeutic communication is termed
de-escalation.
West Coast University Course Syllabus Revision Date: January 3, 2018
Page 50Term: Spring I 2018
NURS 223L Mental Health/Psychiatric Nursing Practicum Spring I 2018
INTERPERSONAL PROCESS ANALYSIS SUMMARY
1. Evaluation: After analyzing the interaction, provide a description on how the interaction progressed.
Identify the reasons for successful process or unsuccessful process. What did you learn from the interaction
with your patient?
The interaction
progressed in a really nice manner and I was able to manage the aggressive behaviour of the alcoholic patient. The patient being
alcoholic he suffered from anxiety whenever he was not provided with alcohol. This anxiety resulted in him showing aggressive
behaviours and attitude that was found to be harmful with respect to other patients present in the hospital ward. The patient was using
abusive language, pushing and hitting the surrounding patients as well as the nursing staff. Thus, it was necessary to communicate
with him in an effective manner that would calm him down. Thus, I utilized the approach of therapeutic communication that involves
the use of psychotherapeutic relationships as well as de-escalation techniques in order to manage the situation at hand. These
techniques that involve communicating in a soft tone of voice, not making prior judgements, staying calm and handling the situation,

maintaining proper distances, showing empathy and genuine interest towards his condition enabled me to calm his anxiety and control
his aggressive behaviour (Cno.org, 2018; Berring, L. L., Pedersen, L., & Buus, 2016). Moreover, it is also necessary to acknowledge
the patient situation, actively listening to the patient concerns, not being impatient and providing reassurance to the patient (Richmond
et al., 2012; Heckemann et al., 2015). Thus, by utilizing these approaches I understood that rather by using harsh techniques and
abusive language, a more empathetic approach will help in managing the patient situation without giving rise to adverse events in the
form of harm to the patient himself, other patients or the nursing staff.
2. How did you personally feel about the interaction? What would you change if you had to redo the
interaction?
I personally feel that the interaction went in a smooth manner as I was able to handle the client in an effective manner without the
occurrence of any adverse events. After the application of my therapeutic communication strategies, the patient became calm and
actively listened to my solutions that would benefit him in overcoming the situation. Next time in trying to handle such patients I
would ensure that I isolate such patients and not keep them in the same ward with other patients as it would result in harm to the other
patients during times of aggressive behaviour.
Reference List
Berring, L. L., Pedersen, L., & Buus, N. (2016). Coping with violence in mental health care settings: patient and staff member
perspectives on de-escalation practices. Archives of psychiatric nursing, 30(5), 499-507.
Cno.org. (2018). Therapeutic Nurse-Client Relationship, Revised 2006. Cno.org. Retrieved 13 February 2018, from
https://www.cno.org/globalassets/docs/prac/41033_therapeutic.pdf
Heckemann, B., Zeller, A., Hahn, S., Dassen, T., Schols, J. M. G. A., & Halfens, R. J. G. (2015). The effect of aggression management
training programmes for nursing staff and students working in an acute hospital setting. A narrative review of current
literature. Nurse education today, 35(1), 212-219.

Richmond, J. S., Berlin, J. S., Fishkind, A. B., Holloman Jr, G. H., Zeller, S. L., Wilson, M. P., ... & Ng, A. T. (2012). Verbal de-escalation of
the agitated patient: consensus statement of the American Association for Emergency Psychiatry Project BETA De-escalation
Workgroup. Western Journal of Emergency Medicine, 13(1), 17.