Download NUR 211 IPR Form Linjia.C

INTERPERSONAL PROCESS RECORDINGS
I. Description
A. A process recording is a written account of the verbal and nonverbal behavior that occurs during a nurse-patient
interaction. Because the nurse relies on her memory to recall what occurred, this recording should be written as
soon as possible after the interaction.
II. Purpose
A. The Student:
1. Observes and records behavior.
2. Identifies covert meaning behind behavior.
3. Demonstrates the use of therapeutic communication techniques.
4. Evaluates his/her own behavior.
III. Guidelines
1. Select a patient with whom you can communicate.
2. Ask the patient for an interview. Select a quiet undisturbed place to conduct the interview.
3. Listen carefully to what he or she says and to your response
4. Do not write notes or take your form into the interview. Rely on your memory. Remember your patients
might be paranoid regarding your writing down what is said.
5. As soon as possible write down some notes to help you when you write your IPR.
6. When you write up the IPR utilize the previous knowledge you gain in your communication classes. For
example: Did you use a "blocking" technique?
IV. Evaluation
A. The process recordings will be graded on a pass/fail. Whether the student said the “right" words is not important
at this time. Your subsequent evaluation of what you did do and say is of importance. Your clinical evaluation
score will reflect your work on these papers.
V. Format for the Student to use: (on 8 1/2 x 11" paper)
A. Student's name:
B. Patient's initials (do not identify patient by full name)
C. Date
D. Time of day
E. Setting
(An initial description of the setting in which the interaction takes place is essential. Environmental factors do
influence the nature of the interaction.)
1. Appearance and motor activity
(The patient's appearance and general demeanor should be described. Be specific and use appropriate
terminology. Many clues to the patient's emotional status will be found here.)
2. Interaction(Use the following format. See attached form).
4. Evaluation -- to examine or judge carefully:
Was this an "interview"? Was this a social chit-chat? Why or why not?
Did you learn anything about this patient that will have implications for nursing care?
**Use the attached template and make as many copies as will be needed.
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Guidelines for Process Recording Form
Setting(or environment). Describe the setting and/or the surrounding in which you and your patient are experiencing at
the time of the IPR interaction. Is the setting the patient’s room, day room, etc. Also describe the environmental factors
which might include, lighting, room ‘mood’, outside, etc.
Appearance and Motor Activity of Client Describe the look of the patient, i.e. sad, frowning, smiling, calm, fidgety,
eyes closed, turning away from nurse, unwilling to make eye contact, etc.
Interaction (verbatim)
Patient Verbatim* - Nurse verbatim*
These sections should include specifically what the nurse and patient say along with significant non-verbal behavior.
Time lapses and silences should be noted, as well as length of silence. Note gestures, facial expression, postures,
eye contact, emotional tone, etc. For example--it should be recorded that the patient's voice dropped to a whisper
when he spoke of his father's death. Record what you are doing for the patient as you converse.
Remarks** What can be said about what you heard and say?
Patient Communication:
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●
●
●
●
Are the statements clear?
Is external stimuli misinterpreted?
Are there any covert expressions of feelings?
Identify defense mechanisms used.
Identify developmental stages when appropriate.
Nurse Communication:
●
●
●
●
What did you feel/think about (e.g. did the patient's language anger you?)
Did you do anything that negatively/positively affected the patient?
Identify the therapeutic/non-therapeutic communication techniques used?
Give your ideas as to what was going on during the interaction. Are there covert messages? Themes?
Identify the communication techniques you use and identify the rationale for your behavior. Identify the
defense mechanisms used for the patient and you. What are they. This column is NOT to be filled with
descriptions of non-verbal behavior.
Alternative response***
This is one of the most important parts of the process recording. This column provides the student with the
opportunity to review the content of the interaction and formulate responses that might have been more effective
than the one used. Each alternative should be accompanied by a rationale as to why it might promote more
effective communication.
● Ask yourself how might you have reacted more effectively?
● Did you respond to overt and/or covert feelings expressed? (affective level)
● Give example of an alternative response--identify it (use exact words).
Evaluation:
● Discuss your general feelings about the interaction.
●
Summarize the psychological content -- what do you think was going on with the patient?
●
What nursing implications did you learn?
Further thoughts about therapeutic communication:
You can be respectful toward the patient and attend to what is said and also set limits and redirect conversation if
necessary.
Be careful of having your own agenda for discussion -- you may then miss other clues (or cues) from patient that
could allow you to learn more from patients.
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Interpersonal Process Recording Form (IPR)
Student’s Name____Linjia
Chen__________________
Date _9/27/2021__________
Patient’s Identification will NOT be on this form
MC
1. Setting (or environment)
We were communicating during the IRT walking activity. We were walking with other clients to the cemetery and then
back to the treatment center. It was a warm day at 10:00 AM.
2.
Appearance and Motor Activity of Client
Client’s clothes were clean. He was very happy to communicate with me. He was making eye contact with me during the
conversation. He was smiling and calm. He was smoking while we were talking.
Remarks** What can be said about what you heard and say?
3.
Interaction (verbatim)
Patient
Nursing Student
Remarks
Alternative Response
Client asked me how to say
I looked at the client. He was
2. I asked his client's name when I
1. When the patient told me
my name. He asked me, “are
very happy and had a smile
that if I mind him smoking. I
you from China?” Once he
on his face. I told him how to told me I look like 21, 22. I told
think it would be better for
knows my name, he was
say my name and I am from
him that yeah, I did look
me to tell him the truth that
very exciting to tell me that
China. I told him it is okay if
younger than my age, thanks. I
I don’t like someone who
Linjia, I am going to go with
we can walk together. I told
asked about his age.
smokes. I could tell him the
you for the walking activity.
him about my age. I said to 3. When we were talking about
reason that I don’t like it.
He stood close to me. He
the client that I don’t mind if
chinese dishes. I told him I like
Smoking is not good for the
asked me my age.
he is smoking. I told him
sesame chicken too. Some of
lungs. High risks for cancers
told him my name. When he
some Chinese words. I asked the dishes that I like over here.
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and cardiac disease, and
He said he can’t believe my
him what his favorite Chinese
4. I asked what his belief is.
stroke. Because telling him
age. He told me that I look
dishes are. I said I am a
the truth would be more
like 21,22. He is 23. While
buddhist. When he told me
effective to open the
we were walking outside,
that we must have some
communication. Then I can
patient asked me if I mind
connection in prelife. I said
ask him what makes him
him smoking.
Buddhism believes that
want to smoke.
He told me, Linjia, I am
people meet each other in
going to tell you how to say
present life for a reason. It
5. 2. When the patient gets out
hello in spanish. He told me
was because in prelife they
of hand and points out age is
his favorite Chinese dish is
had a lot of connection.
not a problem. I could use
sesame chicken. Client asked
I asked him what brought
redirect. Let the patient know
me about my belief. He told
him to the treatment center. I
that I am here for clinical and
me he is Christian.
responded to him that I won’t
studying. Because by
Client said that he believes
judge him for being here. We
redirecting client and setting
that we must have some
are all here for learning.
boundaries can let him focus
connection in prelife. That’s
on the issues that he is facing
why we met today.
When the client told me that
now. Another thing is to
He put out his hand and I
he would come to find me, it
show the professional as a
assumed that he wanted me
was a little overwhelming for
student nurse.
to hold his hand. I didn’t do
me at that moment. But after
that. Later he held one of
he told me he was just
3. When the patient told me
another client and told me
kidding. I felt much ease. I
that we are not seeing each
that it is like this.
hope I made him feel better
other again. I could use
Client told me that he was
when I told him that we were
reflecting communication
here for probation. He said
all here for learning and I
skills to tell him that it is sad,
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6.
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he hopes that I won’t judge
won’t judge him for being
but I am happy to see that
him. He will be out in one
here. By reflecting what the
you had a great day. I wish
week.
client said about the
you the best luck no matter
Patient told me that he had 5 connection we had before I
where you are. This end
sisters, he is the youngest
think this communication was
communication will make him
one. He knows how to treat
therapeutic. I used a reaction
feel warmth and see the
women well. I told him you
defense mechanism by telling
hope of life.
are like a little brother. He
him I don’t mind him
said age is not a problem. I
smoking. This response was
was with someone who was
totally opposite to the way I
40 years old.
was thinking.
After we finished the walk
activity and went back to the
treatment center. He told
me, “Linjia, I am sad that I
can’t see you anymore. I will
go to find you.” Then he
laughed and told me, I am
kidding. He asked me if I
would come back tomorrow?
Patient’s statement was very
clear. There is nothing
misinterpreted. There is no
convert feeling. Client is in
the intimacy vs isolation
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development stage. Patient
used an undoing defense
mechanism when he told me
that he would go find me.
4.
Evaluation of the Interaction between you and the client
This interview was more like a social chit-chat. Because the conversion had a lot of personal questions involved. I learned
that during this type of interview, I need to know what is my nursing role is. I need to examine my own thoughts and
values when talking with client first. It is important to setting boundaries and redirecting patient when patient points out
too many personal ideas to nurse. Because without clear boundaries will cause the nursing role confusion. Giving an
education to patients when we see patients smoking or something else that might harm his health is also important. First
it will help them realise the issues, second will help them open the communication to find out the root cause of their
addiction to provide better nursing care.
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