Interaction Analysis Paper - Essay Example

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He was offered a glass of water to drink. Different points on his knees and lower legs were touched and he was asked to respond to queries about the areas…
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Case Scenario I: !. Patient was admitted with CVA stroke 80 year old male lives by himself. He is independent. However he said “How I can I go home with headache and having numbness in both legs?” He asked to me.
Goal of the Interaction: To evaluate the exact status of his ability to go home.
Summary of Content of Interaction: The patient was asked to lie down on the examination table and relax for fifteen minutes. He was offered a glass of water to drink. Different points on his knees and lower legs were touched and he was asked to respond to queries about the areas where he feels the actual numbness. When he responded that he felt the numbness in both legs and not any specific region, he was explained patiently that it could have been to due to the stress he was experiencing within the hospital. During his examination he opened up and expressed his concern about the loneliness he felt at home with nobody to care for him, and how he would be unable to take the medicine in case he dosed off. I promised to visit him at home and call him on phone to remind him of his medication at the precise moments he was supposed to take them. As he had a normal pulse and blood pressure, I applied an ice pack on his forehead to relieve him of the headache, to which he responded positively and confirmed that the headache was gone. I promised to get him examined by the concerned physician before he is allowed to go back to his home, so that he gets reassured psychologically and is not overwhelmed by the task. I watched his expression throughout the procedure and noted the relaxation he felt after being examined and talked to in a friendly manner.
Hidden Messages/Themes: The relaxation revealed by his countenance due to the approach adopted was a cue to the inference that his condition was related more to anxiety rather than actual pathology. His positive reaction to examination on the couch revealed that he sought attention from somebody to sympathize with his condition. On being promised a consultation with the physician, he felt more relieved than before. In my opinion the patient just needed a psychological boost to cheer him up as he was confronted with the prospect of being alone at his home again.
Reflection: In my opinion, at the very outset it was evident that the patient was feeling apprehensive on being discharged from the hospital. Faced with the daunting task of looking after himself at home, his anxiety manifested in his claim that he had a headache and felt numbness in legs. At this critical juncture, he needed a skilful handling by first agreeing to find a medical cause for his complaint, and then providing him with a cure for his symptoms, which he expected of me as a nurse. The therapeutic communication used in this interaction are, the immediate solution offered to him by examining him on the spot, promising to visit him at home and offering to call him up to remind him of his medication. Two instances where communication was blocked are, trying to settle the matter right at the moment and the offer to remind him personally of his dosage schedule. These two situations could have been handled in a better manner. The first, by referring him to expert examination immediately and the second, by calling up his relatives who might have reassured him by promising to visit and taking care of him for a couple of days.

Case Scenario II:
2. Patient is a 78 year old female who was diagnosed with Gastrointestinal Bleeding. She was put on Clear Liquid Diet. However, she said to me “I am losing an appetite to eat my food that they served to me.”
Goal of the Interaction: Convincing the patient for minimal feed intake.
Summary of content of Interaction: I responded to her statement on losing appetite by smiling and suggesting that this was a common feature for all who had suffered from similar conditions and convinced her that all patients recovered their appetite in due course of time. I side tracked her apprehensions by explaining that even I would be reluctant to be on only liquid foods as I would miss my favorite food items, which appealed to me immensely. Upon this, the patient enumerated all the foods she had enjoyed when she was young and I developed the conversation further by talking about recipes of her favorite foods and she responded enthusiastically. I used this juncture as a cue to encourage and convince her about the necessity of taking liquid food for a short period of time, after which she would be able to indulge in some of her favorite delicacies at home. I offered to come to her home when she was better to share a meal together. The patient was immensely relieved after this conversation and said that although she wasn’t particularly hungry, she would take whatever has been recommended by the doctor.
Hidden Messages/Themes: From her initial reaction of losing the appetite, it was evident that the patient was put off by the bland liquid food which she found to be repulsive. At her age, the concepts formed during young age have assumed permanence and it is difficult to induce temperamental and behavioral changes. Such patients have to handled carefully and their behaviors modified by the subtle and consistent power of suggestion. I was able to engage her in a conversation which seemed to attract her attention. She responded enthusiastically when asked to talk about some of her favorite foods and their recipes. An offer to share a meal at her home later served to build trust in me as a caregiver and increased familiarity. Before this, she was looking at me in an impersonal manner and obviously was missing the company of friends and relatives.
Reflection: I feel that the situation with this patient was handled in the most appropriate manner, as the conversation direction was enough to elicit a drastic change in the patient’s attitude. Her reluctance to take the clear liquid diet recommended for her was natural as it is visually unappealing and bland. A person who is used to specific food items in daily life cannot bear to take bland foods, even when suffering from some malady, let alone gastrointestinal bleeding, which is a serious disorder at this age and a natural precursor for poor appetite. The blocks during this interaction can be - unilateral direction of conversation, and not trying to explain the technicalities of the disorder to the patient. I could have listened to her more to set aside her despondence and should have tried to provide her with technical details of her disorder, within her comprehension range, to justify the taking of clear liquid food. Read More
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