DATE: 11/15/2012

PROCESS RECORDING # 1

NAME: Brandi Anastacio

Dialogue N: Good Morning Mrs. N, my name is Brandi, Im going to be your nurse today. Can you tell me little bit what brought you in the clinic today? S: Stress, been feeling a lot of stress. N: Stress?

Non Verbal Communication

Technique

Student Feelings

Student Thoughts

T/N

Analysis

Smiling Hands on lap Head moving from side to side

Introduction and General Lead

Nervous

I wasnt sure what to expect and was trying to be sure to display therapeutic nonverbal communication

T and N

Smiling Eye contact Nodding Hands on lap Eye contact I was trying to attentively listen and gather as much data as possible, but still come up with a therapeutic follow-up question.

#1 Communication Error: The introduction and general lead was therapeutic, but I made an error by saying little bit. I should have omitted this and said Tell me what brought you in the clinic today? I want the client to open up to me more than just a little bit. My non-verbal appeared welcoming.

S: Yeah, um, Im a nursing student so school is really busy its its kind of a heavy workload its a lot of stress alone by itself. I also have two kids and a husband. So, its

No eye contact Hands on lap Making circling hand gestures, like wrapping an item

Restatement

Anxious

Just by restating one word, I was able to get a better understanding of what stress meant to her and what she believed was the cause of her stress.

sort of trying to take care of the family and take care of the kids and do all of the things I need to do and still find time to study and be a good student. Its just a lot, its N: I hear you having a lot of stress due to balancing school and family life. S: Yeah, yeah, theres just not enough time in the day,I just have too much stuff to do. I my list is just forever long. N: It sounds like maybe youre having a difficult time prioritizing the several tasks that are going on in your life Eyebrows raised Nodding head Making eye contact Head nodding no Making eye contact Hands moving up and down on lap Eyebrows raised Nodding head Making eye contact Open Clarification Empathetic

I began tying her emotions and situations with my own and had to remind myself T that I was there to help her with her stress levels, not my own.

I was able to clarify the information she provided me up to this point, so that I knew what I was hearing was what she was trying to say properly.

Paraphrasing Confused

She was opening a lot, but a little too fast for me and it was getting T difficult to remember all the information she was providing me

#2 Improvement: I made two statements in a row seeking clarification and could have asked a question regarding her feelings like ROF and said You sound overwhelmed. To allow the client to reflect on that feeling rather that focusing on her list.

right now. S: Yeah, my list of things to do ends up so long that I just dont know where to start and then Im just sort of stalled. Im sort of sitting there trying to figure what I should do, then nothing gets done. So, that just compounds and makes even more stress because then I just feel like Im just wasting time. I dont know what Im supposed to be doing. N: So what would happen if you didnt do those things? S: Well first Id flunk out of nursing school, my kids would be starving and

and build upon it.

Eye contact Head nodding Some laughter in voice

Eye contact Empathetic facial expression Neck hyperextends back Hand rubbing one another

Open Ended

Concerned

I wanted her to elaborate more on the things she felt T she had to do and explore just why she felt this way.

#1 Communication Error: This was a therapeutic question, but I should have been more specific as to what those things were. I could have said: What would happen if you didnt do your homework one or two times? What would happen if the clothes didnt get washed every day? Or

theyd have no clothes to wear to school. Um, yeah, it would just everything, Id, I would end up..its already snowballing and the less I do the worse it gets cause theres so much to do and then theres so much more to do, cause its continuous, you cant not wash the dishes today, then you dont have dishes for the rest of the week, you have to do it every day, so everything every single day, you have homework every single day. Even on the weekends I dont, I cant catch up on sleep, I cant get

Comical laughter No eye contact, until talk snowballing Hand gestures Appears exhausted

What would happen if you ate out one or two nights a week or if someone else made dinner? I got vague and extreme answers because my question was vague.

all the things done that I need to do because I still have all those things that I need to do. N: Uh Huh, tell me a little bit of how you normally prioritize those things that you do. S: Without school its, its not too hard. You know, the kids come home from school, I can sit down and do homework with them, cook dinner, wash dishes when were pau eat, you know everything is just, its a lot to do, but still you get into a habit and everything is just good, then you throw in four

Eye contact Concerned facial expression Hands on lap

Looking to ceiling, then making eye contact when speaking about dishes Eyebrows scrunched Hand gestures

Open Focusing

Eager

I wanted to know more about how she prioritized life before school started, but soon realized, I didnt state this in my question.

#1: Communication Error: Tell me a little bit. Like my general lead, I want to know as much as the client is will to divulge. I would omit this and state: Tell me about how you prioritized your tasks before you started school.

chapters to read, then you gotta write a paper then you gotta find time to get your case study person that you can interview, then its just one thing after another. Then its sort of dinner went out the window, so then I guess I have to go to McDonalds, then you feel guilty cause you have to go to McDonalds instead of feeding the kids something good to eat. N: Can you tell me more about that guilt you were feeling? S: Theres guilt about everythingif I Concerned facial expression Eye contact Hands in lap Big smile Hand gestures Eye contact in I wasnt sure what she meant by feeling guilty and I wanted to hear her reflect on her thoughts of feeling guilty. #4 Clients non-verbal : When she smiled, I felt that I had hit the button, but she was trying to cover it up. This is the moment that I started to think, maybe she has a feeling of overwhelming guilt, resulting in her stress. This prompted me to ask the next

Open Clarification

Inquisitive

dont study, I feel guilty Im not studying and if I dont do the housework stuff, I feel guilty about that, its just so hard to of course, you know, you gotta feed the kids that comes first, but then, oh well, mommy, I need a shirt for school tomorrow, then you gotta do laundry, then by the time you get to bed its 11 oclock at night and you still have to study and be up at 5 oclock in the morning, its crazy N: Is there anything that you feel that could help alleviate that feeling of guilt? S: I dont know,

and out Shocked facial expression at end

question.

Eye contact Concerned facial Nodding Hand gestures,

Open Ended

Concerned

I wanted to help steer her to a plan that would help her with her stress, without actually provoking her in

#3: My feelings/thoughts: I was trying very hard to stay neutral as she spoke about her guilt. Especially knowing that our situations are similar. This was harder than I anticipated.

graduating nursing school, then being a nurse and having the time and the money so that I dont have to worry about all of the little things and get on with having a life with my family but in the meantime, the right now Im having the most difficult with because I know thats the goal, I know thats where I want to get to, its just kind of everybody putting up with it right now. N: What do you mean when you say putting up with? S: Its like everything that I gotta do,

rubbing, pointing to goal

any direction.

Eye contact Confused facial expression Hands on lap Hand gestures pointing to self Eye Contact

Open Clarification

Confused

I wanted clarification and I wasnt sure if she met herself, her family and even if it was a negative or positive feeling

#3: My feelings: I had to keep my own thoughts and feeling from muddling my perception of putting up with and having her explain it, kept the focus on her perception of it.

everybody else has to suffer for it. Everybody else has to wait. Everybody else has to put their stuff on hold and then I feel guilty because its all Im being selfish because I gotta do this, I gotta do that, I dont have time for this and that. I keep pushing things and shuffling things around and I never know where to start or where to put the focus. N: Im hearing a lot of I. S: Yeah, I feel guilty about that. Everything is about me and I feel like it shouldnt be like that, it should be Eye contact Concerned facial Nodding Smiling, laughing Simple Observation Statement Lost

for her.

I really wasnt sure what to say next, so I said the first thing that popped into my head. As soon as NT I said it I thought Great, you just helped your client feel even more guilty.

#1: Communication Error: Challenging: I didnt mean to come across like this, but when I hear it on the tape, that is what I sounded like. I should have said I hear you saying that you feel you have to do (name a task or tasks) or the household will not be able to function. I would have probably gotten a better therapeutic flow to the outcome

more about my family, but then I think, thats why Im in nursing school, to help my family. N: Do you feel like taking on all of these tasks may be contributing to your stress? S: I think thats absolutely the stress, Im trying to do too much. Im trying to be superwoman and take on everything and I just cant, its just too much, its just N: What kind of things do you think you could do with changing your schedule and stress levels? S: I think probably the best thing, but I

this way.

Eye contact Eyebrows scrunched Hands in lap I wanted to help her get to the root cause of her stress and help her find a way to alleviate it. #4: Clients Non-verbal: Her nonverbal communication showed me that this helped to shed more light on how her expectations of herself could be contributing to her stress.

Open Clarification Nodding yes Rubbing fingers Smiling

Concerned

Eye contact Hands in lap Eyebrows scrunched Looking to the ceiling, then making eye

Open Ended

Concerned

I was trying to help her to see options on her own terms, to create a plan of action.

#4: Clients Non-verbal: It seemed that she really had to think about this, but after some thought, came up with a plan to ask for help. She seemed to begin to understand that the only way things could get better was to realize she didnt have to do everything.

would still feel guilty about it is have the kids do some chores, you know and have them pick up some things that they need to deal with instead of depending on me . Maybe asking their dad to help them with their homework so that I can work on mine. N: Well, why dont we work on that, why dont you work on that, then we can meet next week and we can talk about it and if you need anything you can call us here at the clinic and we can talk about it. S: Okay, sounds good, sounds like a good plan.

contact. Hands on lap

Smiling Eye contact Some hand gestures to patient

Closing Statement

Relieved

I felt that we came a long way from the intro and wanted to make sure she was in agreement with her plan.

NT

Smiling Nodding yes

#1: Communication Error: Why Questions: I should not have stated why, I should have checked out and clarified better. I could have said, Ok, lets pick this back up next week, but for now, you have come up with the plan to ask your children and husband to help out with household tasks because you feel that your success in nursing school is good for you and your family. You understand that you are not able to do all of these things on your own and will need their teamwork. Correct?

N: Do you need anything else from me today? S: No, it sounds like we have a plan, I like it.

Smiling Eye contact Open Ended Smiling Finished

I was ready to go and wanted out of T the hot seat. Its over, but I know I made a million errors that I will need to T correct before caring for my future clients.

I made sure the client didnt have any other concerns before running out on her, but should have probably stated Do you have any other concerns you would like to discuss today? Might have been more therapeutic.

N: Thank you, Mrs. N.

Smiling Standing to leave

Closing Statement

Happy

#4: Clients non-verbal-My client seemed happy, so I was happy. =)