Psych Help

  1. I just started my clinicals and my first rotation was in mental health. My first week was alright but here is my problem. The client I spoke to did not really want to open up. We had to discuss this at the end of the day. At any rate now I have to do a little research to look for how to talk to a patient who does not want to talk to you and present what I find to the class in a 5 minute presentation. The instructor wants it as a care plan. So my question, where do I get started? Where would I find information on how to get people to talk if they don't want to and then how do I make it look like a careplan?
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  2. 3 Comments

  3. by   oneLoneNurse
    Getting someone to talk depends on various variables which may be uncontrollable. Does he/she like sports? Where are they from? Use anything BUT money and sex to get them talking. Then later once you develop a repoire with them then you can talk clinically. Without the repoire you may not have a discussion with them. Your instructor may not realize that the patient won't talk. However, if he/she doesn't, describe his/her body language and eye contact. There is more to this than just verbal talk.

    Quote from NeuChrisRN
    I just started my clinicals and my first rotation was in mental health. My first week was alright but here is my problem. The client I spoke to did not really want to open up. We had to discuss this at the end of the day. At any rate now I have to do a little research to look for how to talk to a patient who does not want to talk to you and present what I find to the class in a 5 minute presentation. The instructor wants it as a care plan. So my question, where do I get started? Where would I find information on how to get people to talk if they don't want to and then how do I make it look like a careplan?
  4. by   MIA-RN1
    Look at a nursing diagnosis book and look up your patients medical diagnosis and the related nursing diagnosis. I can't remember off the top of my head now, but altered thought process might be one. Or maybe its altered perception.
    If the patient is responding to internal stimuli ( a nice way to say hearing/listening/talking to hallucinations) then you can think what can you do to get his attention? With psych, you do not respond to the voices so you don't say "why do ladybugs on the wall make you scared" you instead say "There are no ladybugs on the wall" So some reality orientation is always good for a psych patient. Plus the golden rule is to never ask why. (It further agitates pts) The truth is that some pts w/ mental illnesses--such as schizophrenia with many negative symptoms--will not respond to talking. they can't. So maybe you can implement some therapeutic communication, specifically the use of therapeutic silence. LOL that may not fly.
    Psych nursing uses the therapeutic use of self. Your presence may offer a calming and soothing atmosphere for the patient, and help with reality orientation.
    This all sounds kind of garbled but I hope something in here helps.
  5. by   Daytonite
    Let me understand this. Your assignment is to do some research on how to interact with a patient who doesn't want to talk or interact with you and present what you have discovered in a 5-minute presentation in the style of a careplan. Correct?

    Well, do your research and get your information. A careplan is nothing more than the nursing process. The nursing process is nothing more than the scientific process made over for nursing. The steps, again, are to collect data. You'll be doing that with your research. You want to look for information about therapeutic communication skills. Then, develop goals. This will be the theme of your presentation: how to get information from a non-talkative patient. Plan of action: What are the approaches that you discovered in your research. This will be the time to present them in your talk. Interactions might involve giving an example or two of some of these approaches. The final step is evaluation. If you have the chance to try this new information out on a patient you can report it during your presentation. Otherwise, you might go back to talking about what you didn't do with your patient and you plan to do with the next one.

    Does that give you an idea of how you might proceed with this?

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