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NURSE-PATIENT INTERACTION ANALYSIS MODIFICATIONS

NURSE CLIENT
Nurse: Hello Angel! (smiles) • Greeting – recognition.
This statement is used to start the conversation with
the client. Smiling will let the patient be at ease with
the student nurse.

Client: Hello Cleng! (smiles back) • Shows that the client is willing to talk with the
student nurse.
• Transactional analysis by Eric Berne-
Because when the student nurse acknowledge the
presence of the client by saying hello it is the
transactional stimulus, and when the client
responded something that is related to the
stimulus then it is transactional response.
Nurse: Sabi mo ito ung time na pwede nating • Giving information- this statement shows the
umpisahan yung counseling session natin. overview of counseling. Student nurse giving
Makikinig at kakausapin kita tungkol sa information that the clients needs to know.
problema mo.

Client: Oo, pwede ngayon bago ko pupuntahan • The statement shows that the client is willing
naman yung patient ko sa Camp Dangwa. Sinabi to accept what the student nurse has to offer
ko naman na mga 4 pa ko pupunta sa kanila. and is willing to cooperate.
Nurse: Ano naman gusto mong pagusapan natin • Giving Broad openings- it shows that the
ngayon? client can take the lead in the conversation
and that she can freely choose the topic of
discussion.

Client: Kahit ano, magtanong ka lang sasagutin • Filipinos are generally passive and lacks
ko naman. Cge magtanong ka lang. initiative. This is shown in the statement use
by the client.
Nurse: Sinabi mo sa akin nung tinanong kita • offering general leads- allows the client to
kung pwede kitang maging client na mayroon take direction in the conversation
kang family problem. Ano ba itong tinutukoy
mo?

• Filipinos are generally passive and lacks


Client: Ahh yun, Tungkol sa family ko. Nahihiya initiative. This is shown in the statement use
ku sayo. (lowers head) by the client.
• The client has great love for the family to
meet her needs for love and belongingness.
This is the third level in Maslow’s hierarchy
of needs.
• Rootedness by Erich Fromm – the need to
attachment or sense to family to fulfill
psychological needs. The client is concerned
with her family problem since she is attached
to the family especially to her mother where
she find the feeling of being loved.
Nurse: Paused (maintained eye contact) • Using Silence- it gives the client time to
collect thoughts or think through a point.

Client: ahhhhmm (thinking) • Thinking (analytical, psychological by Carl


Medyo magulo kasi yung family ko, childhood Jung)- means evaluating thoughts or ideas
experience ko, ahhh ganito yon dati kasi rationally and logically
sinasaktan ako ng mommy ko. • The client has great love for the family to
meet her needs for love and belongingness.
This is the third level in Maslow’s hierarchy
of needs.
• Rootedness by Erich Fromm – the need to
attachment or sense to family to fulfill
psychological needs. The client is concerned
with her family problem since she is attached
to the family especially to her mother where
she find the feeling of being loved.
Nurse: ha? Bakit? Pano? (shocked) • Untherapeutic – belittling feelings expressed Nurse: Ikwento mo nga
by client sakin kung ano at pano
nagyari?
Client: Kasi lalo na nung bata ako, sinasaktan • Instinct by Freud– to keep the body free of
niya ko physically. Konting bagay lang pag tension or hurt. The statement that said that
nagagalit siya yun sinasaktan niya na ako. “Kasi sinasangga ko alangan naman ung
Minsan pa nga pumapasok me sa school may muka ku db?” Justify this theory.
mga naiwang marks sa katawan ko, nung high • The client has the need for safety and security,
school pa ko nun, lalo na sa mga legs at kamay.
Kasi sinasangga ko, alangan naman ung muka ku so by blocking her hands to stop her mom to
db? Pero pag tinatanung nila sa school kung san hit her means she protects herself. This is the
ko nakuha snsabi ko nalng na nauntog ako ganun in the second level of Maslow’s hierarchy of
o nascratch, basta di ko sinasabi yong totoo. needs.
• Neglect and Rejection by Alfred Alder-
children whose parents are hostile go through
infancy and childhood as characterized by a
lack of love and security. Because of this
theory we can relate why the client does not
tell others what really happened to her since
as a result of this she view others with
distrust.

Nurse: Mayroon bang ginagamit yung mommy • offering general leads- allows the client to
mo pag sinasaktan ka? O ung kamay niya lang? take direction in the conversation

Client: Gumagamit siya ng stick minsan sinturon. • Neglect and Rejection by Alfred Alder-
Meron pa ung one time hinawakan niya ung children whose parents are hostile go through
mouth ku (using gestures) nagsusugat ung labi ko infancy and childhood as characterized by a
nun. Natatakot nga ko nung bata ko sa kanya iyak lack of love and security. Because of this
ng iyak sinasabi ku “mama tama na wag na po, theory we can relate why the client does not
huwag niyo napo akong saktan”. tell others what really happened to her since
as a result of this she view others with
distrust, becomes emotional or even feels
anger.
• Neurotic anxiety by Freud- the unconscious
fear of being punished. This was felt by the
patient, she tells her mom to stop hitting her.

Nurse: Hanggang ngayon ba sinasaktan ka pa ng • offering general leads- allows the client to
mommy mo? take direction in the conversation
• Exploring- examining certain ideas,
experiences more fully.

Client: Hindi naman na. pero pinaka last eh • The idea that it is horrible when things are not
malaki nako nun, siguro mga 2nd year college. the way we like them to be by Albert Ellis-
Pero halos lage kame nagaaway. since the client is being hurt physically by the
mother and also they fight together often she
sees this things as bad.
Nurse: Sinabi mong halos lage kayo ngaaway, • Seeking clarification- clarifying unclear
gaano kadalas naman ito? thoughts can help client clarify their own
thoughts ad well as maximizes mutual
understanding between the student nurse and
client.
• Exploring- examining certain ideas,
experiences more fully.

Client: Sa isang week siguro mostly sa araw na • Neglect and Rejection by Alfred Alder-
yon nagaaway kami. Siguro kasalanan ko rin children whose parents are hostile go through
kung minsan kung bakit niya koh nasasaktan. infancy and childhood as characterized by a
lack of love and security. Because of this
theory we can relate why the client does not
tell others what really happened to her since
as a result of this she view others with
distrust.
• The idea that we have virtually no control
over our emotions and we cannot help feeling
disturbed about things. – the patient said that
it is her fault but we really have control over
our emotions and that we can change our
destructive thinking or emotions.
Nurse: Paano mo naman nasabi na kasalanan • Seeking clarification- clarifying unclear
mo? Ano yong mga instances na tinutukoy mo? thoughts can help client clarify their own
thoughts ad well as maximizes mutual
understanding between the student nurse and
client.
• offering general leads- allows the client to
take direction in the conversation
Client: Meron yong isang beses nakatulog ako sa • Faith and Religiosity strength of a Filipino.
salas, di ko napatay ung ilaw at TV, nagulat na Since she want to serve her faith in the means
lang ako nung hinampas niya ko sa muka, as in of YFC, this leads to the fight with her mom.
sa muka talaga. (using gestures) tska meron pa Also this character makes the Filipinos daring
ung one time sa YFC kasi ineexplain ko sa kanya and also develop courage.
na gusto ko tlga magserve doon, eh pinaglalaban
ko yung faith ko eh di nya ata nagustuhan ayun
nasaktan niya ulit ako. Meron din yong nsasagot
ko siya kaya un nasasaktan niya na ako. Yun ung
mga times na nasasaktan niya na ako.
Nurse: Ano naman naramdaman mo tungkol • Exploring- examining certain ideas,
dito? experiences more fully
• Encourages also description

• Rationalization by Freud - interpreting our


own behavior to make it more acceptable and
Client: Di naman ako galit kay mommy sa less threatening to us. The client said she is
katunayan love ko parin siya, kahit matagal na not angry though she is sad.
rin niya ko sinasaktan, kaso syempre nasasad • The preconscious by Freud- storehouse
ako, bakit kelangan pa niyang manakit? Tska pati where it we are unconscious at the moment
sa kapatid ko nagagawa niya na rin yon, naawa but can summon easily. The patient can still
nga aku sa kapatid ko eh. Yong mga ginawa niya picture herself being hurt by her mother.
sakin malaki yong impact hanggang ngayon • Passivity and lack of initiative as a Filipino
siguro kasi, hanggang ngayon fresh parin na trait- because Filipinos are too patient and can
naalala ko at napipicture ko ung sarili ko na endure long suffering they are mostly easily
sinasaktan niya. Dati nga pag kinekwento ko oppressed and exploited.
tong nangyari sakin iyak ako ng iyak ngaun hindi
nmn na.
Nurse: May gusto ka pa bang idagdag? • Exploring- examining certain ideas,
experiences more fully

Client: ahhmmm ( thinking) • Thinking (analytical, psychological by Carl


Ai oo pala, after naman naming mag away ni Jung)- means evaluating thoughts or ideas
mommy nagsosorry naman ako eh, example sa rationally and logically
text ganon, minsan binibigyan ko pa nga siya ng • Joy and humor as another Filipino trait-
flower eh. Malambing kasi akong person eh! despite the presence of the problem the client
(laughs) can still laugh and jokes around.
• Undoing by Freud- things that are done to
cancel out unpleasant thoughts or feelings
after they have already occurred. Like saying
sorry and giving flowers.
Nurse: Ano naman nagging reaction ng mommy • offering general leads- allows the client to
mo pag nagsosorry ka? O natry mo na bang take direction in the conversation
kausapin yong mommy mo tungkol sa pananakit • Exploring- examining certain ideas,
niya? experiences more fully

Client: Parang wala lang. no reaction siguro. Oo, • The client expresses desire to solve her
pero hindi talaga yong tinanong kung bakit ka problem by Erich Fromm- man has the ability
nananakit, sinabi ko mama sorry pero hindi to solve problems. The client says sorry and
naman ako lang may kasalanan e, pati ikaw. tries to talk to the mother.
Sasabihin niya, hindi! ikaw lang ang may • The client has great love for the family to
kasalanan wala akong kasalanan ganon. meet her needs for love and belongingness.
This is the third level in Maslow’s hierarchy
of needs.
• Rootedness by Erich Fromm – the need to
attachment or sense to family to fulfill
psychological needs. The client is concerned
with her family problem since she is attached
to the family especially to her mother where
she find the feeling of being loved.
Nurse: Natry mo nabang makipag usap ulit sa • Non therapeutic. Should use open ended Nurse: mayroon ways ka pa
mommy mo? questions. bang nagawa para
makausap mo ung mommy
Client: hndi na, kasi naman baka magalit ulit siya • Filipinos are generally passive and lacks mo tungkol sa siruation
sakin eh. Lagi naman niya sinasabi kasalanan ko initiative. This is shown in the statement use niyo?
lahat. by the client.
• Irrational Belief by Albert Ellis- that one can
not and must not face life difficulties and it is
easier to avoid them.
Nurse: Uhuh… • Accepting- acknowledging client’s statement.
Does not necessarily indicate agreement but it
is non judgemental.

Client: Alam mo ba nun nung kinekwento ko toh • Pychogenic needs by Henry Murray
sa iba iyak ako ng iyak. Pero ngaun medyo hindi (Personology) arise indirectly from primary
na. needs and are concerned with emotional
satisfaction and include psychological eeds
such as affiliation.
Nurse: ahhh.. nasasabi mo sa iba tong experience • Restating- repeating the idea expressed
mo.

Client: Oo, ikaw na siguro ung fourth na group or • Extreme family centeredness as a Filipino
person pero recently lang mga college na ksi dati trait. We tend to cover up for the mistake of
ayaw ko tlgang pagusapan yon. Kasi mabait our family member so as to have a good
naman mommy ko eh.. baka pag nalaman niyang perception or name in the community.
kinekwento ko sa iba baka isipin niya sinisiraan • Denial by Freud- refusal to admit the
ko siya. Tsaka yaw ko ksaing isipin ng ibang existence of an external threat or traumatic
masama siyang tao porket sinasaktan niya ako event.
kasi mabait naman talaga siya.
Nurse: ahmmm may 10 minutes pa tayo may • Giving information regarding the time left for
gusto ka pa bang sabihin? the conversation. This is making available
facts that clients need.

Client: Yan muna sa susunod ko nalang ikkwento • This means that the client is willing to talk to
yong iba sayo. the student nurse again, rapport has been
gained.
Nurse: Ok, napagusapan natin yong mommy mo • Summarizing- collecting all the important
na sinasaktan ka niya physically at di ka namn points of discussion to enhance
galkit sa kanya pero nasasad ka. understanding.

Client: Oo un.. (nods) ahmm set tayo ng date at • Indicates that the client agreed on the
time para sa next meeting natin. summary of discussion given by the student
nurse and is interested for the next counseling.
Nurse: Ok kelan ba bakante mo? Kung kelan ka • Setting the contract so that the client will
pwede kasi db magppc ka rin . para di conflict sa know when to see the student nurse again.
schedule mo.

Client: Oo cge ( smiles) sa Tuesday nalang 11-1 • Shows that the client is willing to talk again
vacant ko. with the student nurse.
Nurse: Sige sabay nalang tayo kain.. salamat ha? • Therapeutic ending or appropriate closure to
Isip ka ng paguusapan natin next time bbye! the counseling session
(smiles, kiss in cheek and waves)

Client: Ok bbye cleng (kiss back smiles and also • Marks the end of the counseling sessioin
waves) • Complementary Transaction by Eric Berne-
two persons are sending and receiving the
same ego state.