Auburn University
NURS 4230 Mental Health Nursing
Interpersonal Process Recording (IPR)
Student Name:
Brief Information about this Client:
Student Goals For this interaction:
Setting/Time:
1.
Megan McGahan
15 yr old Male who suffers from depression that is recurrent, severe, possibly with psychotic features.
To therapeutically communicate with the client and get insight as to why the client is at the Bradley Center.
Adolescent Unit of the Bradley Center, mid-afternoon before dinner.
Nurse Communication
(Verbal & Non Verbal)
Client Communication
(Verbal & Non Verbal)
(We are sitting and talking as a
group, I have been talking to the
client previously and there is a pause
in the conversation.)
“I tried to cut my
throat”
(client does not make
direct eye-contact,
and points to his
neck)
Nervous with the
response. I was not
expecting
something like this
at all.
Therapeutic since it is an
open-ended question. I
was trying to give a
general lead for the
client to talk about.
“Can I talk to you about
why you’re at the Bradley
Center”
“It’s a long story.”
(Patient notices I am
still listening)
I’ll tell you if you
want to hear it.”
(makes eye contact
for the first time)
(client chuckles since
there no activities
going on at this time)
I am interested in
the story, I want to
know what
happened. I am glad
the client is willing
to share his story.
Therapeutic and
effective. I allow for
silence, and the client is
willing to share his
story.
“What happened to make
you want to do this?”
Non- therapeutic
response, but it is still
effective through
offering of myself to the
conversation. I
demonstrated active
Client is very
listening throughout his
distressed about the story and this made him
drug comment made give more details since
by the police.
he knew I was engaged.
“I would like to hear your
story if you are willing to
share.”
“So what brought you to the Bradley
Center?”
2.
“Did something happen that made
you want to do that?”
3.
“I’ve got nothing else to do really.”
(I look around and shrug my
shoulders jokingly, I am also trying
to build trust with the client, so he
doesn’t just see me as a “nurse, but
rather someone who wants to listen)
Client tells a story
about how he had an
altercation with his
neighbor in which
the police came. The
police told the
client’s girlfriend’s
Nurse’s Thoughts &
Feelings Related to the
Interaction
I’m trying to make
the patient feel
comfortable at first,
trying to keep it
light.
Analysis of the Interaction
(Effectiveness, Technique,
Name & Rationale)
Alternate or Revised Response
Nurse Communication
(Verbal & Non Verbal)
Client Communication
(Verbal & Non Verbal)
Nurse’s Thoughts &
Feelings Related to the
Interaction
Analysis of the Interaction
(Effectiveness, Technique,
Name & Rationale)
I want to know if
the patient was
trying to kill
himself or just hurt
himself. I am
somewhat
uncomfortable
asking this question.
Non-therapeutic because
it is a closed-ended
question and I could be
making assumptions
about the patient.
Alternate or Revised Response
mother that the client
had a drug charge
and the mother said
he could not see the
girlfriend anymore.
“The drug charge
was over a year ago,
I don’t even know
why he even said
that. I don’t do drugs
anymore since I’m in
drug court and I
don’t feel the need
to. So then I came
home and cut my
neck”
(tells the story in
great detail and uses
hands for
expression.)
4.
“Were you trying to kill yourself?”
(I lean in closer to the patient)
“Yes. I wanted to.”
(looks saddened.
Client touches his
neck)
What were you intending
to do with the knife?
Nurse Communication
(Verbal & Non Verbal)
Client Communication
(Verbal & Non Verbal)
Nurse’s Thoughts &
Feelings Related to the
Interaction
5.
“Did you want to do this because
you couldn’t see your girlfriend
anymore?”
“Yea. I was having
very strong feelings
for her and she was
like my best friend.
And my brother is in
jail now and we just
became close again
and he isn’t here to
talk to, so there’s
nobody now”
I want to know
more about his
brother to see if he
has anything to do
with the situation.
6.
“When did your brother go to jail?”
“The day before all
this happened.”
This makes me
think that not only
was he feeling upset
about not being able
to see his girlfriend,
but also his brother.
7.
“Oh, so this was very recent?”
Patient nods his
head.
(looks at the floor)
8.
“Do you feel like this added to the
situation, like you were loosing your
girlfriend and your brother?
This makes me
realize there is more
going on then the
patient just not
being able to see his
girlfriend. His
brother just went to
jail before the event,
and this probably
added to his
feelings.
“Yea, definitely. My I realize I need to
brother and me used encourage the client
to not like each other, to open up by
and we had just
asking a more direct
started get good
question.
again. He was a
Analysis of the Interaction
(Effectiveness, Technique,
Name & Rationale)
Alternate or Revised Response
Effective, but
nontherapeutic since it
is a close-ended
question. But the patient
does open up about his
brother, someone who
has not been in this
conversation before. I
analyze that there is
something more relating
to the brother.
Nontherapeutic, I am
asking a closed ended
question, but I am trying
to get more information
from the patient. I used
the focusing approach,
focusing on the aspect of
his brother.
Nontherapeutic, asking
another closed-ended
question that does not
get me a lot of
information from the
patient.
“What made you want to
cut yourself with the
knife?”
Therapeutic; although it
was a close-ended
question, it got to the
root of the issue and
what he was feeling.
Here I was trying to
“These events seemed to
have happened very close
together. How did that
make you feel?”
“Tell me more about your
brother.”
“This seems like a lot to
handle at one time.”
Nurse Communication
(Verbal & Non Verbal)
9.
“Are you glad that is wasn’t a sharp
knife?”
10. “Do you feel like being at the
Bradley Center has helped since
you’ve been here?”
Client Communication
(Verbal & Non Verbal)
really good friend.
So after everything I
just didn’t want to
live anymore. I mean
if the knife had been
sharper I probably
wouldn’t be here
right now.”
“I’m still not sure. I
guess we’ll just see
how it goes, you
know?”
“I mean, I guess. I’ve
felt happy since I’ve
been here. And we
all get along (points
to the other boys) so
it’s been good so
far.”
Nurse’s Thoughts &
Feelings Related to the
Interaction
Analysis of the Interaction
(Effectiveness, Technique,
Name & Rationale)
Alternate or Revised Response
verbalize the implied by
the client.
I wanted to know
how the client felt
about not killing
himself.
I wanted to get his
opinion on the
Bradley Center and
if it was helping.
Non-therapeutic. I was
trying to encourage the
patient to reflect on this
aspect, hoping that he
would be happy the
knife wasn’t sharp. I
should have made sure
he still wasn’t having
suicidal feelings.
Therapeutic. I was
exploring the patients
thoughts on his being in
the facility.
“Are you still having
thoughts about killing
yourself?”
“How has the Bradley
Center helped you since
you’ve been here?”