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Psychiatric Clinical-learning Enrichment: CASE SCENARIO ANALYSIS
(Independent Learning)
Scenario: Client, J.D, an Iraqi war hero was in his room taking a nap… he also complained of
feeling sad and depressed about his life since he returned home from Iraq. He has not eaten his
meals for several days since hospitalization. The student nurse comes into the room and notice
tray of uneaten food in on his bedside table.
Directions: at this point think of what student nurse should say to start a therapeutic
communication dialogue *(you may reference your therapeutic communication techniques
handouts).
Student Nurse:
“_____________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
_____________________________________________________________________________”
Patient: “Oh don’t bother with me. I don’t have much time left in this world…and I don’t have
much time to live for anyway, I should have died in Iraq”
Directions: at this point think of what student nurse should say to start a therapeutic
communication dialogue *(you may reference your therapeutic communication techniques
handouts).
Student Nurse:
“_____________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
_____________________________________________________________________________”
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Scenario: The patient was admitted four (4) days ago with a diagnosis of lung cancer. She was informed
by her doctor that a course of radiation and chemotherapy was her best option. She became very upset,
tearful and frightened about the proposed treatment and stated that she was not sure if she would go
through with it. She admitted to feeling depressed and isolative for the past week, but denied any
suicidal ideations at this time. The student nurse approaches her to discuss how she if feeling today.
Student Nurse: “Good afternoon Mrs. Thomas, I was wondering how you were feeling about undergoing
radiation and chemotherapy?
Client: “I don’t know. I’m not as scared as I was when I got here, but I have a lot of question to ask about
it”.
Student Nurse: “It sounds like you have given it some thought. I’m sure Dr. Harrell will talk with you,
answer some of your questions and help you to feel better. Would you like to do that?”
Client: “I guess what do you think?”
Directions: from this point, think of what the student nurse could say to start a therapeutic conversation
including the appropriate therapeutic techniques.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Case study revised/modified 10/17/2012
Reference: Tamparo, C.T., & Lindh, W. Q. (2008). Therapeutic communication for healthcare
professionals. Retrieved October 15, 2012 from http://www.nelsonbrain.com
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STUDY QUESTIONS-Write in your response. Use as a Study Guide throughout course.
Student Name: ______________________ Date: __________ Clinical: Psychiatric Nursing
Terms
Definitions/Analysis
1. What is the purpose of sharing observations and
perceptions?
2. During which phrase of the nurse-client
relationship an agreement is established?
3. What type of communication technique let the
client know his feelings are understood and
accepted?
4. What are the two (2) main modes of
communication?
5. What is the purpose of offering general leads?
6.Idenitfy this non-therapeutic technique: “ You
should think about re-enlisting in the military if
you want to serve your country more”
7. Identify non-therapeutic technique: The client
complains of feeling nauseated after taking a pill
the nurse gave him.
Nurse:” surely you are not trying to say that I gave
you the wrong pills”!
8.Name at least six (6) universal facial expressions
9. the ability to share or express concern for the
psychological state of another individual
10. Nurse says to client “ You seem upset today”
11. Nurse to Client: “Your money was locked up in
a locker at the nurses’ station with your name on
it. No one has stolen it.”
12. Giving factual information to the client that
she/he needs to know
13.Allowing client time to put thoughts and
feelings into words
14. Which phase of a therapeutic relationship
allows client to verbalize set goals towards
transition to home from the healthcare setting?
15.Why is stereotyping considered a block to
communication
Developed 10/16/2012
Instructor: E. Shaifer MSN, RN
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CASE STUDY CENARIO:
Bessie, student nurse is assigned to the psychiatric unit for her clinical experience. She is nervous and
not sure she will be able to talk with the clients. The first client she approaches, Mrs. Ortiz-Toro, has
been in the hospital for three (3) days. After Bessie introduces herself, she waits for a reply. After a few
second, there is only silence. Janice tells Mrs. Ortiz-Toro that she will be on the unit to see her three (3)
days a week, explains why she is on the unit, and states what year she is in school. Mrs. Ortiz-Toro nods
once during the discussion that lasts for several minutes. Bessie immediately begins to discuss the rain
thunder storms that occurred two (2) days ago and the Halloween Fall Festival parties that are coming
up. Bessie becomes quite animated.
1. What communication techniques/ skills did student nurse Bessie use during her interactions
with Mrs. Ortiz-Toro? (Indicate therapeutic, non-therapeutic, verbal, non-verbal, blocks, etc.)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
2. What communication blocks may have been present during the interaction?
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
3. Student nurse Bessie, asks you for advice prior to her next interaction with Mrs. Ortiz-Toro.
~What advice would you give her to better enhance her interactions?
~Identify therapeutic communication techniques for the above student-client dialogue?
Case study developed/modification: E.Shaifer MSN, RN 10/2012
Reference:
Kneisl, C. R., Wilson, H.S., & Trigoboff, E. (1995-2012). Contemporary psychiatric-mental health
nursing. Retrieved October 15, 2012 from
http://wps.prenhall.com/chet_kneisl_contemporary_1/10/2655/679784.cw/index.htmlon
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