Schizoaffective Disorder Template

INTERPERSONAL PROCESS ANALYSIS TEMPLATE Multiaxial Diagnostic System: Axis I (Clinical Disorder): Schizoaffective Disorder Axis II (Personality Disorder/Mental Retardation): NA Axis III (General Medical Conditions): NA Axis IV (Psychosocial and Environmental Problems): Social environment in gaining attention Axis V (Global Assessment of Functioning Scale): 20 since patient has been in danger of hurting herself. 1. Description of the patient: Age? Sex? Ethnicity? Marital Status? What precipitated hospitalization? Number of days in the hospital? Mental Status, etc. Patient is a 23-year-old single Asian Female. She was admitted on 09/06/2020 and is not currently on a 5250 hold as of 09/13/2020, Patient is waiting a hearing for her 5250. Patient is DTS and GD. She was admitted for calling the cops and stating she wanted to jump off the bridge or get hit by a car, She has been off her medication of Risperdal. Patient's medical diagnosis is Schizoaffective disorder. She has been in Unit B for seven days. Patient is A&OX3, She does not fully state her name and asks everyone to call her by another name. She is alert and cooperative. Patient is hyperactive, hypersensitive, and loud. Throughout my time observing and talking to her she was dancing and was also asking inappropriate questions. Patient would dance in front of patient's and would ask girls to be her girlfriend. When she was asked to be respectful, she was annoyed and told the lead nurse. She was dressed appropriately, and hair was not combed out. Her thought process was all over and overly stimulated. 2. Description of environmental setting where interaction took place. Explain the reasons for a supportive or non-supportive environment. (e.g. noise, distractions, light, temperature, etc.) Patient had a supportive environment. She was in a unit were there 27 other patients", but she was inactive with them all. She did prefer music playing and her dancing. The temperature was acceptable and light inside was also acceptable. She was able to go outside three times while I was there. She like talking to both me and my partner and was always asking us personal questions. We would change the direction of the conversation by asking her something about herself. When she was outside, she preferred playing ping pong. She had asked both me and my partner to play ping pong with her. As I observed I realized that all the nurses were familiar with her case. She has been in and out of the facility for a couple of years already. They were all very helpful throughout the process of meeting her. At one point, she was stating vulgar comments and the nurse had to ask her to stop being disrespectful to the nurses. I felt that both myself, my partner, and the patients are in a supportive environment. INTERPERSONAL PROCESS ANALYSIS TEMPLATE INTERPERSONAL PROCESS ANALY NAME: Student Verbal (quotes) und Nonverbal Communication (belurvior, tone of voice, eye contact, mannerisms, etc.) Document at least 5 interactions Goal for each interaction (realistic and measurable) Goal: Patient will talk to me within the first hour of my shift. Verbal: "Hello I'm M.., 1 am a student nurse, Would it be okay if 1 can watch you play your game?" Nonverbal: When we first entered unit B the patients were all outside. I observed for about a minute and then approached the patient. She was playing ping pong with another patient. Patient was wearing pants and a shirt that was provided by the hospital. I stood about 6 to 7 feet from the patient while I asked my question. We both made eye contact as well. Tone was loud enough to hear by mellow. SIS Patient: Verhal (quntes) anıl Nonvertoal Communication (behavior, tone of voice, cyc contact, mannerisms. etc.) Verbal: "Hi!! Yes you can watch me play! My name is Do you know how to play? Nonverbal: Patient was hyperactive, with increased level of energy, and expressional. Her tone was loud and her affect was smiling. Communication Techniques Identify communication technique used then deflue your communication techniques Was the communication therapeutic or non-therapeutice? Which defense and coping mechanisms did the patient use? Rativoale based on your patient. used active listening, Active Listening is an effective communication skill that is providing reassurance that the nurse can hear, observe, and understand what the client communicates and to provide feedback (Helnan et al, 2019). This type of therapeutic commanication was effective. Both myself and the patient were able to commanicate without having to worry about any misunderstandings It seems her coping mechanism was playing her ping pong. It was physical activity was the patient's way of coping. This was my first interaction with her so I can't really give a defense mechanism. She was hitting the ball hand and making sounds so she could have been using sublimation without telling me. Or even displacement by taking anger with the ping pong ball. "Behavioral Technique is physical exercise which causes release of endorphins that lower anxiety, promote relocation within a few minutes" (Holman et al., 2019) Sublimation is a defense mechanism that is dealing with unacceptable feelings or impulses by unconsciously substituting accepting forms of expression" (Holman et al., 2019), DATE: Critique and Analysi teffective or not effec have said...) Docume thoughts and feelings interaction. Was your goal met? The goal was met with active listening. I was effectively communica We both had no issues jour discussion. When I the unit. I was a bit ner soon as I started talking realized she was a hum me, but with a mental c INTERPERSONAL PROCESS ANALYSIS TEMPLATE Goal: Get the patient to tell me the reason why she was admitted within the half hour of my first interaction with the patient. Verbal: "Can you tell me the reason you're here? Nonverbal: I stayed open armed and six feet away from her throughout our conversation. When I asked her the question, she came closer to me again and 1 stepped back. We kept eye contact throughout the conversation. My tone was. mellow and calm. Verbal: "Well I'm here because I'm crazy. Well can I tell you a secret? I am a psychopath. I think about bad stuff I want to do to others, but I haven't done it yet." Nonverbal: Patient stopped playing the ping pong while she answered the question. She was hyperactive, increased energy, and loud. When she told me she wanted to tell me a secrete she came up into my ear and told me her For this goal I used an open-ended question. Open-ended questions are a great effective communication that facilitates spontaneous responses and interactions between the nurse and the patient (Holman et al., 2019). Open-ended questions allow me to obtain additional information needed to obtain my assessment. An open-ended question was a great therapeutic communication as well. I feel her avoiding the real reason she is here made me think she was using regression to avoid telling me the reason why she is here. She stated she is crazy and then laughs like a child and says can I tell you a secret. She is consciously not telling me the real reason. I did find out in her chart that she wanted to end her life by jumping off a bridge or getting hit by a car. "Cognitive is the use of mental changing directions to cope with a stressor" (Holman et al, 2019). "Regression is a defense mechanism that is sudden use of childlike or primitive behaviors that do not correlate with the person's current developmental level" (Holman et al., 2019). The goal was not met. able to tell me the real was here. Open-end qu effective communicati in cases like this she di comfortable at the time reason. It did seem like to her, but I can see she to tell me. thoughts Kept eye contact. Goal: Get the patient to tell me why she decided to stop taking her Risperdal. Vertal: "I noticed on your chart that you stop taking your medication for Risperdal, can you tell me the reason you decided to stop taking them?" Nonverbal: My tone was calm, and my demeanor was also calm. I kept eye contact with her throughout the conversation, I was standing up at the time while she was standing across from me. Verbal: Thinking....." I don't know. Soooo do you know how to do the wrap dance. Do you want to see me do it? Can you do it with me? Nonverbal: Patient was first really quiet when 1 asked the question, and decided not to answer the question. She didn't keep eye contact with me and turned away. Patient mood normal, but then got excited when she talked about dancing. She was hyperactive, and high in energy. Throughout the conversation I still kept my Active listening. I also was a bit silence while she gathered her thoughts on her answer. Active listening is an effective communication skill that gives the nurse the ability to hear, observe, and understand what the client is stating and making sure I can provide feedback (Holman et al., 2019). did use clarifying technique by exploring when trying to have an effective communication with her. Exploring techniques which is clarifying your information allows a nurse to gather any addition information needed to have a better understanding of her condition (Holman et al., 2019). Patient ignored my question and changed the subject. Her coping mechanism cognitive and in this situation, she is using suppression as a defense mechanism. She suppressed the reason why she didn't want to tell me why she stopped taking her medications. She consciously decided not to tell me the reason why she stops taking the medication. Suppression is a defense mechanism that is voluntarily denying unpleasant thoughts and feeling" (Holman et al., 2019). "Cognitive is the use of mental changing directions to cope with a stressor" (Holman et al., 2019). Goal was not met patie tell me why she stoppe Risperdal. I do feel I ur communication skills, I effective for this patien thought about the quest Ignoring the question a Kind of like a child bei they didn't do their hor she got excited when sl talking about dancing. of energy and was a bit me. INTERPERSONAL PROCESS ANALYSIS TEMPLATE INTERPERSONAL PROCESS ANALYSIS SUMMARY 1. Evaluation: After analyzing the interaction, provide a description on how the intemction progressed. Identify the reasons fo r successful process or unsuccessful process, What did you learn from the interaction with your patient? After our interaction, I did take a break away from her. She affer the last question I asked she got a little too unappro priated with her questions. She started asking sexual questions to myself and my partner. A lead nurse intervenes and asked the patient to be more respectful I can say some of my communication techniques were useful, but I also think they were hard to use on someone who is still on acute state of mind Active listening is one style that I feel can make any patient more comfortable with talking to a nurse. It also shows that we are here to listen and help and not be their enemies. I learned that they don't understand boundaries and they themselves are still trying to figure how to even deal with their mental state. Lhave als o never seen someone so full of energy like she did. Lam also more aware that mental health patient can seem totally nonnal and the next thing you know.ca n flip. It was quite an experience and I look forwant to leaming more about how these patients 2. How did you personally feel about the interaction? What would you change if you had to redo the interaction? This was my first day on the clinical site and I was personally a bit scare, but once I started talking to my patient, I was able to fool a bit more comfortable. I feel the interaction was a good and was also very educational. I learned a lot by having a conversation with he r throughout my shift. Lots of my terminology words that I learned in mental health make so much more sense now. It really helps bring it all together when y ou physically see and interact with these patients. I can't say I would redo anything, but that can change with my next interaction with my next patient. It was a great first day leam experience.