LAGUARDIA COMMUNITY COLLEGE
CITY UNIVERSITY OF NEW YORK
DEPARTMENT OF NATURAL & APPLIED SCIENCE
PRACTICAL NURSING PROGRAM
SCL 105
SPRING II 2006
Interaction Analysis Sheet
Client’s Initials
Age
52
Diagnosis
Sex
LM
Student
MANOLITO GULLA
F
Date
01/23/07
SCHIZOAFFECTIVE DISORDER BIPOLAR TYPE
NURSE-CLIENT INTERACTION
INTROSPECTION
LM was walking about aimlessly, pacing in a circular
fashion, near the lobby. A few other clients were visible in
the area. Her face showed a flat affect. She was wearing
thin, loose, dress and her straight hair flowed down on her
shoulders. I walked towards her:
N -“Hello! I am Manolito, a student nurse.”
C -“Oh, hi! I slipped fell to the floor last night, no this
morning – hurt myself over here. (pointing to her
upper left thigh). (Slurred speech, poor memory)
N -“You hurt yourself?” (Reflection)
C -“Yes, see I got this big bruise”
LM suddenly lifted up her dress to expose the outer
superior part of her right thigh in the greater trochanter
region. I briefly looked away and when I turned my head
back, the dress was down.
N - Silence. (still recovering from the shock) “Have you
told this to any of the nurses?”
C -“Yes, but they haven’t done anything about it. It hurts
on this side.” (pointing to left side but the bruise is
on the right side – disorganized actions).
She excused herself and went briefly to her room. After a
few minutes, she came back wearing a different dress, hair
combed up and tied at the back, face was smiling.
C -“It’s raining outside. I believe John Lennon’s spirit is
everywhere, in the plants, in everything around us.
John’s spirit is inside my body. (Flight of ideas and
Grandiose Delusions). Why are you so easy to talk
to, what’s your name again? (leans forward to see
my ID) You like me, don’t you?”
When I first saw LM, I was a bit apprehensive and
anxious considering that the previous week, she refused to
talk to one of my fellow student nurses. I was afraid that
she would reject me and would also refuse to talk to me.
Seeing her pacing aimlessly and face showing no
emotion, I felt sad and wondered what traumatic event
could have happened to this person that triggered her to
behave as though her life is full of emptiness, as though
her body has lost its soul.
I was so shocked and awed when she lifted up her
dress. I felt indecisive and did not do what to do. I felt that
I was not in control of the situation. I felt embarrassed and
was ashamed to mention the incident during the post
conference with my professor and fellow classmates.
ANALYSIS AND EVALUATION OF
INTERACTION
LM’s lifting of her dress without realizing its
inappropriateness could indicate a problem in
Freud’s Phallic Stage. According to Freud, people
fixated at this stage could become promiscuous and
amoral. This problem also translates to a
corresponding stage in Erikson’s Early Childhood
years. According to Erikson, this Oedipal stage
results in oppressive establishment of a moral sense
restricting the horizon of the permissible. A residual
conflict over initiative may cause overcompensation
and showing off.
LM may have gotten the message that I did not
approve of her behavior when I turned my head away
instead of looking closely at the blackened spot of
the bruise. But I think I could have been more
therapeutic if I had verbally but politely told her that
her behavior was inappropriate at that point.
I felt good when I saw her put on a neat dress and
groomed her hair.
When LM said “You like me, don’t you?”, she
seemed to be using the defense mechanism of
Projection. She is unable to acknowledge her own
feelings and attributed them to me instead.
I felt happy when I realized that I seem to be
influencing her to behave in a less anxious and more
positive way even though I was silent most of the time as
she did nearly all of the talking.
During the entire period that I was with her, she
changed her dress and hairstyle four times. This
frequent changing of clothes and hairstyle could be
an indication of an obsessive-compulsive disorder.
LAGUARDIA COMMUNITY COLLEGE
CITY UNIVERSITY OF NEW YORK
DEPARTMENT OF NATURAL & APPLIED SCIENCE
PRACTICAL NURSING PROGRAM