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30 Cards in this Set

  • Front
  • Back
who decides the content and direction of the clinical interview
Client decides
What skills you should employ in a clinical interview?
communication skills and active listening (attention to body language, facial expression and vocal tone)
Nurse provides the client the opportunity to reach a specific goal during a clinical interview. List 4?
To feel comfortable and understood
To identify and explore problems relating to others
To discuss healthy ways of meeting emotional needs
To experience a satisfying interpersonal relationship
How does a nurse increase ability to use communiation skill and interviewing skills?
work under supervision or observe more experience clinicial through modeling
what is more important for the success of therapeutic outcome?
strong therapeutic relationhip
Setting of an interview
can be anywhere but ideally in a health care setting, conference room or quiet part of the unit that has relative privacy but is w/in view of others is ideal. Client's home but depends on the degree to w/c the nurse and client feel safe; close to a door and don't position yourself between the door and client should not be position between the nurse and the door
acquired skills and basic ingredients of a therapeutic nurse-client relationship
communication and interviewing techniques
Seating of the Interview
chairs arrange that conversation can be carried in a normal tone of voice, eye contact maintained or avoided, assume same ht in sitting or standing, avoid face to face stance, 90-120 angle position or side to side position is less intense that the nurse/client can look away from each other w/o discomfort; setting is always is close to door access, client should not be position between the nurse and the door
avoid desk barriere between the nurse and the client
Introduction of the clinical interview
follow orientation goals, introduce yourself (name, name of school) , state your purpose, how long and what time is the meeting, discuss confidentialityy and ask the client how they want to be addressed
What is the imporatance of asking a client what they want to be addressed?
conveys respect and gives client direct control over an important ego issue(some like being called by last names/1st)
How to start an interview
offering lead and acceptance statements (uh-huh)
Tactics to Avoid
argue, praise the client or give false reassurance, interpret to the client or speculate teh dynamics of the client's problem, question the client about sensitive areas, try to sell the client on accepting treatment, join in attack with the client on his/her parents, friends, or associates, participate in criticism of another nurse or any other staff members
What can you do instead of arguing with the client?
focus on the facts and clients perceptions
What can you do instead of praising and giving false reassurance to the client?
make observation about the client behavior, change is always possible
What can you do instead of interpreting to the client or speculate on the dynamics of the client problems?
listen attentively, use silence and clarify
What can you instead of questioning the client about sensitive issues?
pay attention to nonverbal communication, strive to keep the clients anxiety decreased
what can you do instead of trying to sell the client on acceptable treatment?
ENC the client to look at the pors and cons
what can you do instead of joining attacks of the client to others?
focus on facts and clien'ts perceptions; be aware of nonverbal communication
what can you do instead of participating in criticism of other staff?
focus on facts and client's perception; check out serious accusations with other staff, have the client meet with the nurse or staff member w/ senior stafff to clarify perception
Helpful guidelines in conducting interview
speak breifly, if you don't know what to say say nothing, when in doubt focus on feelings, avoid advice, avoid relying on questions, pay attention to nonverbal cues and keep the focus on the client
what is the focus in clinical supervision
focus is on the nurse, nurse supervisor and nurse examine & analyze the rn’s feelings and rxn to client and the way they affect the rn-clt relationship; can be a therapeutic process for nurse; can ventilate; examining interactions, obtain insights and device alternative strategies for dealing w/ various clinical issues enhances your clinical & professional growth and minimizes frustration and burnout
What is process recording?
most common method of evaluating nurse-client interactions in academic setting, way to ID patterns in the student’s and clt’s comm. It’s a written record of a segment of rn-clt session that reflects as closely as possible the verbal and nonverbal behaviors of rn &clt
relies on memory and its subject to distortion
Specific client behaviors that may pose a challenge to nurse during a clinical interview?
client, crying, asking the nurse to keep a secret, threatening to commit suicide, client leaves before the session is over, client doesn't want to talk or wants to prolong the interview, giving the nurse a present, and asking personal questions
The client is crying, what are the useful responses?
stay with the client, tell them its ok to cry, this is the time when the client's feelings is closest to the surface and can be identified; offer tissue when appropriate
The client ask you to keep a secret, what are useful responses?
can't make such promise; info may be important to the health and safety of the client or others; tell the client that you can't make that promise and it might be important to me and to other staff
The client stated he wants to kill himself, what can you do?
assess if the client has a plan and lethality of the plan;discuss feelings and circumstances that led to this decision
this is serious Mr.X, I don't want any harm to come to you, I will need to share this information with other staff
The client says he doesn't want to talk?
ask the client if its okay to spend time with him, and that they don't have to talk; spend short frequent periods with the client
the client ask you a personal question?
say nothing or answer with 1 or 2 words then refocuses back on the client
What are the components of communicaton process?
stimulus, messenger, media, receiver, feedback
communication process is complex involving factors such personal and environment that can distort the sending and receiving messages
Factors affecting communication process
personal, environmental and relationship factors