‫المملكة العربية السعودية‬
Kingdom of Saudi Arabia
Ministry of Higher Education
Majmaah University
College of Applied Medical
Sciences
Quality & Skills Development
Center
‫وزارة التعليم العالي‬
‫جامعة المجمعة‬
‫كلية العلوم الطبية التطبيقية‬
‫مركز الجودة و تطوير المهارات‬
PSYCHIATRIC MENTAL HEALTH NURSING COURSE
CLINICAL (NRG 474)
Summer Term
1435 – 1436
COMMUNICATION SKILLS ASSESSMENT
1
Please read the following Communication Skills Scenario thoroughly and then indicate
what therapeutic or non-therapeutic techniques the nurse has used in her interaction
with the patient by filling in the space provided
Mr. Antar Bin Shaddad is an inpatient at Al-Amal Psychiatric Hospital who was admitted
four weeks ago with exacerbation of his psychotic symptoms. Mrs. White is Mr.
Shaddad’d assigned nurse. Mr. Shaddad is much better now, he is taking his
medications, and less delusional than on admission. Mrs. White is continuing to assess
Mr. Shaddad and has been talking to him for two weeks. Mr. Shaddad is starting to
open up to his nurse and they are defining goals and making intervention plans. Staff
has reported to Mrs. White this morning that Mr. Shaddad has been up all night talking
and pacing the room. On few occasions he tried to enter the room of Miss Bond the
newly admitted patient. The staff are worried that Mr. Shaddad is not progressing as he
should be. evident by the recurrence of his delusional thoughts. Mrs. White’s goal for
the next few days is to assess Mr. Shaddad’s symptoms and to start a care plan for him.
Mrs. White agreed with Mr. Shaddad to meet this morning after breakfast and talk for an
hour. They met at the main hall and sat on a table near the window.
2
SCENARIO 1
THERAPEUTIC COMMUNICATION

Mrs. White: Hello Mr. Shaddad, I asked about you and they told me that you were
in the shower, I thought I sit and have a cup of coffee until you finished

Mr. Shaddad: Hi Mrs. White, I had a shower but the water was not warm enough

Mrs. White: I can see you look cold (Anter is wearing his coat over his bathrobe),
and also you look worried too, tell me what is bothering you.

Mr. Shaddad: I couldn’t sleep last night, it is very noisy around this place

Mrs. White: Is it like that all the time, noisy, or do you mean just last night when you
couldn’t sleep?

Mr. Shaddad: No, not all the time, but last night there was a new patient. They
brought her in the middle of the night, and she wouldn’t shut up

Mrs. White: Tell me more about what has happened last night

Mr. Shaddad: Well there is nothing more to tell, except that all nurses and doctors
were in and out of her room all night through, and she was screaming non-stop

Mrs. White: So Mr. Shaddad tell me how do you feel about what has happened last
night

Mr. Shaddad: I was angry and frustrated, I really felt bad about the whole thing. But
I am ok now I am not angry. But I feel tired and sleepy.
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
Mrs. White: Would you rather go and have a nap for a couple of hours, or would you
like to stay and have a chat?

Mr. Shaddad: I would like to rest for a bit if you don’t mind, but we can talk in the
afternoon after lunch if you are not busy.

Mrs. White: No I am won’t be busy, I’ll see you after lunch then.

Mr. Shaddad: Thank you, I’ll see you then.
In the afternoon Mrs. White went to the dining hall and saw Mr. shaddad is still having
his lunch she waved her hand to let him know that she is around and she went and sat
on a bench outside the dining hall in the small garden. Mr. Shaddad saw Mrs. White
through the hall window but he did not go outside even though he finished his lunch.
Mrs. White sat there for fifteen minutes past the time they agreed upon. After twenty
minutes Mr. Shaddad came over and sat next to her but he seemed worried again.

Mrs. White: how was lunch, I saw you busy talking over lunch

Mr. Shaddad: I am not very keen on Mansaf, but it was nice.

Mrs. White: you still look worried the way I saw you in the morning

Mr. Shaddad: I told you it’s that woman in the room next mine, I tell you she is not a
patient, she pretend to be but she is not

Mrs. White: What do you mean by that, I do not understand

Mr. Shaddad: She is a wicked woman
4

Mrs. White: What do you mean by wicked?

Mr. Shaddad: She works for the insurance company who is paying my allowances.
She is here to spy on me, to prove that I am not a patient so they won’t pay out the
money.

Mrs. White: I find that hard to believe, do you think you could be mistaken her for
someone else?

Mr. Shaddad: No, no I cannot be mistaken, she is from the insurance people

Mrs. White: I understand what are you telling me, but Miss Bond is a college student
who is from outside our city, she can’t be the woman you think she is, from the
insurance company

Mr. Shaddad: I was almost certain that she is, I could be wrong, I do not know.
Everything seems unreal to me today, I am going mad

Mrs. White: Do you mean you don’t feel yourself today, that you are a little confused
about things?

Mr. Shaddad: I guess I am. What’s wrong with me Mrs. White?

Mrs. White: Have you felt like this before Mr. Shaddad, maybe the last time you
were here last year.

Mr. Shaddad: Do you mean it’s all because I am mad, because of the problems in
my head?

Mrs. White: Because you are ill, because you have a mental illness Mr. Shaddad
5

Mr. Shaddad: I know I let my family down, I know I should have handled the
pressure better

Mrs. White: Maybe you and I can discuss this further and talk about some of these
thins troubling you

Mr. Shaddad: I think I’ll need your help, I can’t do it alone all by myself

Mrs. White: Ok then, how about to start off by seeing your psychiatrist so that he
could review your medications, and then we can talk about some issues like the
sleeping and the new patient

Mr. Shaddad: Yes that sounds like a good plan to me.

Mrs. White: Agreed then. I will see you tomorrow in the morning at the clinic

Mr. Shaddad: See you tomorrow Mrs. White and thank you.
6
SCENARIO 2
NON-THERAPEUTIC COMMUNICATION

Mrs. White: Finally Mr. Shaddad, I have been waiting here for ages, late to
arrive, early to leave!

Mr. Shaddad: Hello Mrs. White, I had a shower but the water was not warm
enough, I feel cold.

Mrs. White: I can see you are shivering like a leaf, who takes a cold shower in
the morning.

Mr. Shaddad: I couldn’t sleep last night, it is very noisy around this place

Mrs. White: This is one of the quietest wards in the hospital, are you sure the
noise was coming from the inside?

Mr. Shaddad: It was noisy; there was a new patient this is why. They brought her
in the middle of the night, and she wouldn’t shut up

Mrs. White: I can’t believe you just said that, she is sick she can’t help it.

Mr. Shaddad: she was screaming her head off. All nurses and doctors were in
and out of her room all night through, and she was crying non-stop

Mrs. White: So Mr. Shaddad tell me about your family and your children

Mr. Shaddad: I have not seen them for months, my wife thinks I am crazy and
she won’t let the children come near me. That is not fair
7

Mrs. White: I do not think she meant it that way, she is just worried about the
kids, I would not worry about it.

Mr. Shaddad: I would like to rest for a bit if you don’t mind, but we can talk in the
afternoon after lunch if you are not busy.

Mrs. White: you just woke up; you want to go to sleep nine in the morning.

Mr. Shaddad: Sorry Mrs. White, but I am really tired I had no sleep at all last
night.

Mrs. White: Why are you tired, what makes you all that tired?
In the afternoon Mrs. White went to the dining hall and saw Mr. Shaddad is still having
his lunch she waved her hand to let him know that she is around and she went and sat
on a bench outside the dining hall in the small garden. Mr. Shaddad saw Mrs. White
through the hall window but he did not go outside even though he finished his lunch.
Mrs. White sat there for fifteen minutes past the time they agreed upon. After twenty
minutes Mr. Shaddad came over and sat next to her but he seemed preoccupied and
worried again.

Mrs. White: how was lunch, I saw you busy talking over lunch, what were you
talking about, what was so important talking about that made you late coming
over.

Mr. Shaddad: I am not very keen on Mansaf, but it was nice.
8

Mrs. White: Who doesn’t like Mansaf, of course you do. Anyway how are you
now, are you still worried?

Mr. Shaddad: Yes Mrs. White. I told you it’s that woman in the room next mine, I
tell you she is not a patient, she pretend to be but she is not

Mrs. White: Who do you think she is then?

Mr. Shaddad: She is a wicked woman

Mrs. White: That is not nice to say, how do you know she is wicked?

Mr. Shaddad: She works for the insurance company who is paying my
allowances. She is here to spy on me, to prove that I am not a patient so they
won’t pay out the money.

Mrs. White: I don’t believe that, a spy from the insurance company, I think they
have more important things to worry about than spying on you believe me.

Mr. Shaddad: No, no I cannot be mistaken, she is from the insurance people

Mrs. White: ok have it your way, but what makes you think that, it does not make
sense to me.

Mr. Shaddad: I was almost certain that she is, I could be wrong, I do not know.
Everything seems unreal to me today, I am going mad

Mrs. White: No you are not, you are just sick that is all

Mr. Shaddad: I guess I am. What’s wrong with me Mrs. White?
9

Mrs. White: Oh I would not worry about it, few weeks and you’ll be as new as a
lamp bulb

Mr. Shaddad: Do you promise?

Mrs. White: I promise, now sheer up and don’t be silly

Mr. Shaddad: I know I let my family down, I know I should have handled the
pressure better

Mrs. White: That is non-sense, what else you could have done for them, you are
just ill, that is all

Mr. Shaddad: I think I’ll need your help, I can’t do it alone all by myself

Mrs. White: Let’s talk about something that would cheer you up, how about that
chair you are making at the OT. (occupational therapy)

Mr. Shaddad: I do not know Mrs. White, I think I must go.

Mrs. White: Ok take care and be good

Mr. Shaddad: Did not look back or answer.
10