ORIENTATION PHASE

Description of Phase:

• Problem defining phase

• Starts when client meets nurse as stranger

• Defining problem and deciding type of service needed

• Client seeks assistance ,conveys needs ,asks questions, shares preconceptions and
expectations of past experiences

• Nurse responds, explains roles to client, helps to identify problems and to use available
resources and services

Objectives:

After the orientation phase, the nurse will be able to:

 Determine why the patient sought help

 Establish trust, acceptance, and open communication
 Mutually formulate a contract with the patient
 Explore patient’s thoughts, feelings, and actions
 Identify patient’s problems
 Define goals with the patient

Date/ Time/ Venue: November 25, 2009 at National Center for Mental Health, Pavilion 1
Ward 9
 RATIONALE OF THE
NURSE’S ANALYSIS OF THE
NURSE-PATIENT PATIENT’S RESPONSE
COMMUNICATION
INTERACTION
TECHNIQUE

Nurse: Magandang umaga J. Therapeutic:

Ako si Ran. Estudyante ako
Giving Information
mula sa Centro Escolar
University, Manila. Student  Making available the facts
nurse mo ako ngayon. that the client needs
Magkikita at mag-uusap tayo Use names
simula Miyerkules hanggang
 Using a person's name
Biyernes sa susunod na
makes her feel more
linggo, mula alas-siyete
valued, and introducing
hanggang alas-tres ng hapon.
yourself is a basic step in
Mag-uusap ulit tayo bukas ha.
establishing a therapeutic
interaction.

Patient: Opo…Opo…Opo
(with nodding)

Nurse: Puwede ko bang

malaman ang buong pangalan  Patient is conscious and
Therapeutic:
mo? comprehending
Exploring

 Encourages the speaker to

expand upon their
Patient: (stated the name) remarks/ question
Nurse: Ano ulit ang pangalan
ko J?

 Patient is responsive
Patient: Ran po. (somnolence)

Nurse: Sige. Ako ang student

nurse mo tapos ikaw ang
pasyente. Therapeutic:
 Patient is drowsy and
Help to orient
comprehending
 Illness and hospitalization  According to Jung,
can be very disorienting perception involves all the
Patient: Opo.
for patients, especially the ways of becoming aware
elderly. of things, people,

Nurse: Mag-uusap tayo J ha. happenings, or ideas.

Magkukwentuhan lang tayo. Judgment involves all the

ways of coming to
conclusions about what

Patient: Opo. Opo. has been perceived. If

people differ
systematically in what they

Nurse: Alam mo ba kung perceive and in how they

anong petsa at araw ngayon? reach conclusions, then it

Therapeutic: is only reasonable for them

Help to orient to differ correspondingly

in their interests, reactions,
 Illness and hospitalization values, motivations, and
can be very disorienting skills.
Patient: Sabado
Nurse: J Huwebes ngayon.
November 26, 2009.
Patient: (stares only)
Nurse: Ano ulit ang petsa
ngayon J?
Patient: Sabado
Nurse: Huwebes ngayon,
November 26, 2009 J.
Patient: Opo
Nurse: Ilang taon ka na pala J?
Patient: Napulo
for patients.  Patient is responsive
Therapeutic:
Presenting Reality
 When it is obvious that the  He is analyzing the
patient is misinterpreting information
reality, the nurse can
indicate that which is real.
 Patient had
He does this not by way of
established/formed fixated
arguing with the patient or
idea with regards
belittling his own
experiences, but rather by
calmly and quietly  Patient is responsive
expressing her own
perceptions or the facts
Therapeutic:  He has a difficulty to recall
personal information and
Asking Direct Questions: is often confused.
 This allows the patient to
try answering a direct
question directly, briefly
and correctly
Therapeutic:  He has a difficulty to recall
Reframing the question: personal information and
is often confused.
 This allows the patient to
try answering a direct
question directly, briefly
Nurse: Anong taon nuong and correctly
ipinanganak ka? Therapeutic:
 Patient has difficulty in
Asking Direct Questions: memory skills

Patient: Marso  This allows the patient to

try answering a direct
question directly, briefly
and correctly
Therapeutic:
Nurse: Ano ang birthday mo?
Kelan ka ipinanganak? Help to orient  Disoriented to place

 Illness and hospitalization

can be very disorienting
Patient: Hulyo, Agosto
for patients.

Therapeutic:

Nurse: alam mo ba J kung ano Asking Direct Questions:

ang ginagawa mo dito?  Misleading answer
 This allows the patient to
try answering a direct

Patient: (looses eye contact, question directly, briefly

tumingin sa malayo) and correctly

Therapeutic:

Asking Direct Questions:

Nurse: Anong lugar to J?
 This allows the patient to
try answering a direct  Trying to recall personal

Patient: (silence. Spits saliva).. question directly, briefly information

Ambot and correctly

Therapeutic:

Nurse: Saan ka pala nakatira
J?
Patient: sa bahay
Nurse: Saan ka galing na
probinsiya?
Patient: doon
Nurse: Saan yung doon na
sinasabi mo J? Yung lugar
kung saan ka dati nakatira
bago ka napunta dito?
Patient: Bitano
Nurse: Saan yung Bitano J?
Asking Direct Questions:
 This allows the patient to
try answering a direct
 Patient is responsive
question directly, briefly
and correctly
Therapeutic:
Asking Direct Questions:
 This allows the patient to
try answering a direct
question directly, briefly
and correctly
 Patient is responsive
Therapeutic:
Asking Direct Questions:
 This allows the patient to
try answering a direct
question directly, briefly
and correctly
Therapeutic:
 Patient is responsive
Asking Direct Questions:
 This allows the patient to
try answering a direct
question directly, briefly
and correctly
Therapeutic:

Patient: Sorsogon
Nurse: alam mo ba kung
nasaan ang Sorsogon?
Patient: sa Mindanao
Nurse: Naaalala mo pa ba ang
mga nangyari bago ka napunta
dito?
Patient: (looses focus, drowsy)
Nurse: Sino ang kasama mo
pagpunta mo dito?
Patient: (focus returned)
Using Broad Opening
Statements The use of a broad
opening statement allows the
patient to set the direction of
the conversation.
Therapeutic:
Asking Direct Questions:
 This allows the patient to
try answering a direct
question directly, briefly
and correctly
 Somnolence
 The patient can’t justify
Therapeutic: Piaget’s cognitive theory.
Observation:
 According to Piaget, the
 To help with awareness of
formal operational period
feelings, encourage
is the fourth and final of
verbalization of feelings,
the periods of cognitive
conveys concern and
development in Piaget's
interest.
theory. This stage, which
Verbalizing Implied Thoughts
follows the Concrete
and Feelings
Operational stage,
 The nurse voices what the commences at around 11
patient seems to have years of age (puberty) and

Nurse: J mag-usap pa tayo ha?
Patient: Opo.
Nurse: Okay ka pa?
fairly obviously implied,
rather than what he has
actually said.
Therapeutic:
Asking Direct Questions:
 This allows the patient to
try answering a direct
question directly, briefly
and correctly
continues into adulthood.
In this stage, individuals
move beyond concrete
experiences and begin to
think abstractly, reason
logically and draw
conclusions from the
information available, as
well as apply all these
processes to hypothetical
situations.

Therapeutic:
Patient: Opo.
 It is observable that the
Exploring or delving further
patient has an
into a subject or idea:
inappropriate affect
Nurse: Inaantok ka ba J?
 The nurse should
recognize when to delve

Patient: hindi po further. If the patient

chooses not to elaborate,
the nurse should respect

Nurse: Napapagod ka na ba? the patient’s wishes.

Patient: Hindi po.
Nurse: Nag-enjoy ka ba knina
J?
 Some questions with
regards to personal
information can be
Therapeutic: answered correctly by the
patient.
Focusing:
 It will help the client
expand on a topic
Therapeutic:
Patient: Opo (flat affect)
Nurse: Nag-exercise ka rin ba?
Patient: Opo
Nurse: Kamusta naman ang
pag-ehersisyo mo kanina J?
Patient: Okay lang po
Nurse: Sino pala ang kasama
no J pagpunta mo dito?
Patient: Suseng
Nurse: Kaano-ano mo si
Suseng J?
Patient: nanay
Nurse: Nanay mo siya?
Sequencing:
 Helps to identify cause and
effect, recurring pattern of
interpersonal difficulties.
Therapeutic:
Exploring or delving further
into a subject or idea:
 The nurse should
 Flight of ideas
recognize when to delve
 a nearly continuous flow
further – she should refrain
of rapid speech that jumps
from probing or prying. If
from topic to topic, usually
the patient chooses not to
based on discernible
elaborate, the nurse should
associations, distractions,
respect the patient’s
or plays on words, but in
wishes. Probing usually
severe cases so rapid as to
occurs when the nurse
be disorganized and
introduces a topic because
incoherent.
she is anxious.
Therapeutic:
 Patient is fixated with
Sequencing:
certain numbers like 5 and
 Helps to identify cause and 10.
effect, recurring pattern of
interpersonal difficulties.
 When we feel safe and
secure in our world then
we begin to seek out
friendships in order to feel
a sense of belonging.
Maslow's third level, the
 Therapeutic: need for belonging and
love, focuses on our desire
Patient: Opo Exploring or delving further
to be accepted, to fit in,
into a subject or idea:
and to feel like we have a
 The nurse should place in the world.
Nurse: Tapos ano ang
recognize when to delve
nangyari?
further – she should refrain  Persons may be called both
from probing or prying. If mentally retarded and
the patient chooses not to learning disabled, meaning
Patient: may red na bag, blue
elaborate, the nurse should that their overall IQ is
respect the patient’s lower than average, but
wishes. Probing usually that they have strengths
Nurse: Tapos?
occurs when the nurse and weaknesses on various
introduces a topic because skills.
she is anxious.
Patient: isang bag lang dala
Therapeutic:
ko, namin

Asking Direct Questions:

Nurse: Ilang taon ka na dito?  This allows the patient to

try answering a direct
 Cognitive development is
question directly, briefly
defined as thinking,
Patient: lima and correctly
problem solving, concept
Therapeutic:
understanding, and

Asking Direct Questions: information processing

Nurse: Si Suseng nasaan?
 This allows the patient to
try answering a direct
Patient: Doon question directly, briefly
and correctly
and overall intelligence.
Many mentally retarded
clients have cognitive
weaknesses. Their overall
potential may be lower
than that of their peers and
siblings. They still have
Nurse: Saan yung nanay mo J?
Patient: sa bahay, dun
Nurse: Sa Bitano?
Patient: Opo (nods)
Nurse: may mga gamot ka ba
na iniinom?
Patient: oo, kanina
Nurse: Ano daw yun J?
Patient: aspilit, isa lang
Patient: gamot, gamot,
(showed both arms)
Nurse: may asawa ka naba J?
Therapeutic:
Sequencing:
 Helps to identify cause and
effect, recurring pattern of
interpersonal difficulties.
Therapeutic:
Sequencing:
Helps to identify cause and
effect, recurring pattern of
interpersonal difficulties
Therapeutic:
Acknowledging the patient’s
Feeling:
 The nurse helps the patient
to know that his feelings
are understood and
accepted and encouraged
patterns of strengths and
weaknesses in their
development and may do
very well with certain
types of learning.
 Adaptive skills are the
skills needed for daily life
and include the ability to
produce and understand
language
(communication); home-
living skills; use of
community resources;
health, safety, leisure, self-
care, and social skills; self-
direction; functional
academic skills (reading,
writing, and arithmetic);
and work skills.
 him to continue expressing
them. If communication is
Patient: wala
to be successful, it is
essential that the nurse
accept the thoughts and
feelings her patient is
expressing.

Nurse: Nakatapos ka na ba ng
elementary o high school J?

Patient: oo, elementary

Include the patient

Nurse: Hanggang anong grade  You must remember that

natapos mo? patient care should be
collaborative and include
the patient in decision
Patient: Grade 1 making whenever
possible. The patient often
feels at the mercy of the
Nurse: ano pala palagi mo system, but you can help
ginagawa dito J? him find ways to feel in
control.

Patient: Toothbrush (acting),

ligo, kain

Nurse: Tuwing umaga?

Patient: kain

Nurse: kapag hapon?

Patient: tulog

Nurse: ano ang gusto mong

pagkain J?

Patient: monggo’

Nurse: ano ang kinain mo

kanina?

Patient: monggo

Nurse: Masarap ba J?

Patient: Opo

Nurse: ano ang mga ayaw mo

kainin?

Patient: monggo, kanin, apple

Nurse: Di ba sabi mo gusto

mo ng monggo knina?

Nurse: Usap ulit tayo bukas

ha!

Patient: Opo.

WORKING PHASE

Description of Phase:

At this point, the client’s problems are identified and solutions are explored,
applied and evaluated. The focus of the assessment and of the relationship is the client’s behavior
and the focus of the interaction is the client’s feelings.

Objective:
 After the working phase, the nurse will be able to:

 Explore relevant stressors for the patient

 Promote patient’s development of insight and use of constructive coping
mechanisms
 Overcome resistance behavior

Date/ Time/ Venue: November 26, 2009 at National Center for Mental Health, Pavilion 1
Ward 9

RATIONALE OF THE
NURSE’S ANALYSIS OF THE
NURSE-PATIENT PATIENT’S RESPONSE
COMMUNICATION
INTERACTION
TECHNIQUE

Nurse: Magandang umaga sa Therapeutic:  Patient is disoriented to

yo J! time, place and person
Use names:

 Using a person's name

Patient: Magandang umaga makes her feel more
din po. valued, and introducing
yourself is a basic step in
establishing a therapeutic
Nurse: Ano ulit ang pangalan interaction.
ko J?
Therapeutic:
Patient: (Kran) Help to orient
 Illness and hospitalization
can be very disorienting
 MEMORY AND
ATTENTION. Memory
deficiencies interfere with
learning rote material such
as days of the week,
months of the year, and
times tables. Basic facts
are hard to remember and
there is a lack in
knowledge of general
Nurse: Ran ako for patients. information. There are
Therapeutic: deficits in attention that
interfere with ability to
Using Broad Opening
Patient: Ran focus and concentrate on
Statements:
tasks.
 The use of a broad
Nurse: Kamusta naman ang opening statement allows
tulog mo J? the patient to set the
direction of the
conversation. Give the
Patient: Maayos patient an opportunity to
begin expressing himself.
In using a broad opening
Nurse: eh ang gising? statement, the nurse
focuses the conversation
directly on the patient and
Patient: ayos communicates to him that
she is interested in him
and his problems. Upon
Nurse: Anong araw pala sensing that the patient
ngayon J? may have a need, the nurse
can use a broad opening
statement to initiate
Patient: Martes discussion, while at the
same time allowing the
patient to determine what
Nurse: J, Biyernes ngayon.
will be discussed.
Ang petsa ay November 27,
Therapeutic:
2009.
Giving Information  The patient can’t justify

 Studies have shown that a Piaget’s cognitive theory

Nurse: Anong araw ang
sumunod sa Biyernes?
Patient: Martes
Nurse: Kung Biyernes ngayon,
ano ang araw bukas? Bukas
ay?
Patient: Martes
Nurse: Sabado bukas J.
Sundan mo ko ha.
Nurse: Lunes
Patient: Lunes
Nurse: Martes
major cause of anxiety or
discomfort in hospitalized
 According to Piaget, the
patients is lack of
formal operational period
information or
is the fourth and final of
misconceptions about their
the periods of cognitive
condition, treatment, or
development in Piaget's
hospital routines. When
theory. This stage, which
the patient is in need of
follows the Concrete
information to relieve
Operational stage,
anxiety, form realistic
commences at around 11
conclusions, or make
years of age (puberty) and
decisions, this need will
continues into adulthood.
often be revealed during
In this stage, individuals
the interaction by
move beyond concrete
statements he makes. By
experiences and begin to
providing such
think abstractly, reason
information as she
logically and draw
prudently can, admitting
conclusions from the
and finding out what she
information available, as
doesn’t know, or referring
well as apply all these
the patient to someone
processes to hypothetical
who can assist him, the
situations.
nurse can do much to
establish an atmosphere of
helpfulness and trust in her
relationship with the
patient.

Patient: Martes
Nurse: Miyerkules

Patient: Miyerkules Therapeutic:

Using Broad Opening

Statements:
Nurse: Huwebes
 The use of a broad
opening statement allows
Patient: Huwebes the patient to set the
direction of the
conversation. Give the
Nurse: Biyernes patient an opportunity to
begin expressing himself.
 Patient is responsive.
Therapeutic:
Patient: Biyernes
Sequencing:

 Helps to identify cause and

Nurse: Sabado effect, recurring pattern of
interpersonal difficulties.
Patient: Sabado
Nurse: Linggo
Therapeutic:
Patient: Linggo Sharing Observations
 The nurse shares with the
patient observations
Nurse: Anu-ano pala mga
regarding behavior. The
 According to Piaget, the
formal operational period
is the fourth and final of
the periods of cognitive
development in Piaget's
theory. This stage, which
follows the Concrete
Operational stage,
commences at around 11
years of age (puberty) and
continues into adulthood.
In this stage, individuals
ginawa mo ngayong umaga?
Patient: Kain, toothbrush, ligo
Nurse: Ano yung mga kinain
mo?
patient who has a need is
often unaware of the
source of this distress, or
reluctant to communicate
it verbally. However, the
tension or anxiety created
by his need creates energy
which is transformed into
some kind of behavior,
move beyond concrete
experiences and begin to
think abstractly, reason
logically and draw
conclusions from the
information available, as
well as apply all these
processes to hypothetical
situations.

Patient: Spanish Therapeutic:

Sequencing:

Nurse: Spanish bread?  Helps to identify cause and

effect, recurring pattern of
interpersonal difficulties
Patient: Opo

Nurse: masarap ba? Reflecting:

 Patient is responsive and
In reflecting, all or part of answers questions with
the patient’s statement is comprehension.
repeated to encourage him
Patient: Opo to go on. Reflecting can be
overused, and the patient
is likely to become
annoyed if his own words
Nurse: pag-usapan natin ang or statements are
continually repeated to
drawing mo kanina. him

Patient: iskindi (ice candy)

Nurse: ice candy yung
drawing mo?
Patient: Opo.
Nurse: Anong meron sa ice
candy at yun ang dinrawing
mo?
Ang ice candy ay?
Patient: matamis, lamig
Nurse: ano pa?
Patient: tigas, tamis
Nurse: may naalala ka ba sa
ice candy?
Patient: (silence)
Therapeutic:
Exploring or delving further
into a subject or idea:
 The nurse should
recognize when to delve
further – she should refrain
from probing or prying. If
the patient chooses not to
elaborate, the nurse should
respect the patient’s
wishes. Probing usually
occurs when the nurse
introduces a topic because
she is anxious
Therapeutic:
Asking Direct Questions:
 This allows the patient to
try answering a direct
question directly, briefly
and correctly
 MEMORY AND
ATTENTION. Memory
deficiencies interfere with
learning rote material such
as days of the week,
months of the year, and
times tables. Basic facts
are hard to remember and
there is a lack in
knowledge of general
information. There are
deficits in attention that
interfere with ability to
focus and concentrate on
tasks.
 MEMORY AND
ATTENTION. Memory
deficiencies interfere with
learning rote material such
as days of the week,
months of the year, and
times tables. Basic facts
Nurse: paborito mo ba ang ice
candy?
Patient: Opo.
Nurse: ano ang paborito mo na
lasa ng ice candy?
are hard to remember and
there is a lack in
knowledge of general
information. There are
deficits in attention that
interfere with ability to
focus and concentrate on
tasks.

Patient: monggo

Nurse: Anu-ano pala ang mga

kulay ng ice candy? Diyan sa
drawing mo J?

Patient: (Points on the lines

while identifying its colors,
with some mistakes)

Nurse: (corrects the mistakes)

Nurse: okay J, very well.

Magaling!
Nurse: Nagtitinda ka ba dati
ng ice candy J?

Patient: Hu..

Nurse: Pagod ka na ba J?

Patient: Opo.

Nurse: Okay sige. Pahinga ka

na J. Hintayin lana muna natin
ang iba na matapos ha.

Patient: Opo.
 TERMINATION PHASE

Description of Phase:

The nurse terminates the relationship when the mutually agreed goals are met, the
patient is discharged or transferred or the rotation is finished. The focus of this stage is the
growth that has occurred in the client and the nurse helps the patient to become independent and
responsible in making his own decisions. The relationship and the growth or change that has
occurred in both the nurse and the patient is summarized.

Objective:

During the termination phase, the nurse will be able to:

 Establish reality of separation

 Review progress of therapy and attainment of goal
 Mutually explore feelings of rejection, loss, sadness, and anger and related
behaviors

Date/ Time/ Venue: December 3, 2009 at National Center for Mental Health, Pavilion 1
Ward 9

Nurse-Patient Interaction Rationale of the Nurse’s Analysis of the Patient’s

Communication Technique Response

Nurse: Magandang umaga sa Therapeutic:  The patient is conscious.

yo J.
Use names
Patient: Gandang umaga din  The patient talks rapidly.
po.  Using a person's name

Nurse: Kumusta ang tulog
mo?
Patient: Ok lang.
Nurse: Maayos ba naman ang
gising?
Patient: Opo.
Nurse: Anu-ano ang mga
ginawa mo kanina?
Patient: toothbrush, ligo, kain
Nurse: Ano ang kinain mo J?
Patient: tinapay
Nurse: masarap ba J?
Patient: Opo.
Nurse: nabusog ka ba?
Patient: (nods)
Nurse: Pag-usapan natin J
yung tungkol sa niyog. Ano
nga ang mga parte ng niyog?
Patient: dahon
makes her feel more
valued, and introducing
yourself is a basic step in
establishing a therapeutic
interaction.
Therapeutic:
Using Broad Opening
Statements:
The use of a broad opening
statement allows the patient to
set the direction of the
conversation. Give the patient
an opportunity to begin
expressing himself.
Therapeutic:
 Cognitive development is
Focusing:
 It will help the client
expand on a topic
Therapeutic:
Exploring or delving further
into a subject or idea:
 The nurse should
recognize when to delve
further – she should refrain
from probing or prying. If
the patient chooses not to
elaborate, the nurse should
respect the patient’s
 Adaptive skills are the
skills needed for daily life
and include the ability to
produce and understand
language
(communication); home-
living skills; use of
community resources;
health, safety, leisure, self-
care, and social skills; self-
direction; functional
academic skills (reading,
writing, and arithmetic);
and work skills.
defined as thinking,
problem solving, concept
understanding, and
information processing
and overall intelligence.
Many mentally retarded
clients have cognitive
weaknesses. Their overall
potential may be lower
than that of their peers and
siblings. They still have
patterns of strengths and
weaknesses in their
development and may do
Nurse: Ahh. Magbigay ka nga wishes. Probing usually very well with certain
ng isang gamit ng dahon. occurs when the nurse types of learning.
Patient: bubong introduces a topic because
she is anxious.

Nurse: Ano pa J? Magsabi ka

pa nga ng isang parte pa ng  MEMORY AND
puno ng niyog? ATTENTION. Memory
Therapeutic: deficiencies interfere with
Patient: puno
learning rote material such
Sequencing:
as days of the week,
Nurse: Anong gamit ng kahoy  Helps to identify cause and months of the year, and
ng niyog J?
effect, recurring pattern of times tables. Basic facts
Patient: bahay. interpersonal difficulties. are hard to remember and
there is a lack in

Nurse: Oo. Ginagamit nga to Therapeutic: knowledge of general

sa paggawa ng bahay. information. There are
Focusing:
deficits in attention that

 It will help the client interfere with ability to

Nurse: Puwede ka bang
expand on a topic focus and concentrate on
magkuwento ng tungkol sa
mga magulang at mga kapatid tasks.
mo J? Therapeutic:

Patient: … Asking Direct Questions:

 This allows the patient to  According to Piaget, the

Nurse: Namimiss mo ba sila try answering a direct formal operational period
J?
question directly, briefly is the fourth and final of
Patient: … and correctly the periods of cognitive
development in Piaget's
Nurse: Ano ulit pangalan nung theory. This stage, which
nanay mo? follows the Concrete
Operational stage,
Patient: Suseng
Nurse: Ano naman ang
pangalan ng tatay mo J?
Patient: Mario
Nurse: Ang mga kapatid mo?
Naaalala mo ba mga pangalan
nila?
Patient: Ricoy, Marichu
Nurse: Nasaan na sila ngayon
J?
Patient: Ambot.
Nurse: Napaano pala yang
mga sugat mo sa kamay J?
Patient: kadena
Nurse: Sino ang nagkadena sa
yo J?
Patient: nanay
Nurse: Ano daw ang dahilan
ni Suseng dahil kinadena ka
nya? May nagawa ka ba na
kasalanan?
Patient: Ambot lang.
Therapeutic:
Acknowledging the patient’s
Feeling:
 The nurse helps the patient
to know that his feelings
are understood and
accepted and encouraged
him to continue expressing
them. If communication is
to be successful, it is
essential that the nurse
accept the thoughts and
feelings her patient is
expressing.
 MEMORY AND
commences at around 11
years of age (puberty) and
continues into adulthood.
In this stage, individuals
move beyond concrete
experiences and begin to
think abstractly, reason
logically and draw
conclusions from the
information available, as
well as apply all these
processes to hypothetical
situations.
ATTENTION. Memory
deficiencies interfere with
learning rote material such
as days of the week,
months of the year, and
times tables. Basic facts
are hard to remember and

Nurse: Ano pa ang mga
nangyari J. Sige magkuwento
ka pa. Makikinig ako.
Patient: Kinulong ako.
Nurse: Kinulong ka J?
Patient: …
Nurse: Ano ang naramdaman
mo?
 According to Piaget, the
Patient: Nagalit.
Nurse: Kanino ka nagalit?
Patient: Suseng
Nurse: Tapos ano na ang
nangyari?
Patient: Ambot.
Nurse: J huling beses na pala
kita makakausap ng ganito.
Patient: …
Nurse: Socialization na bukas
at huling araw na rin na
pupunta ako dito bukas.
there is a lack in
knowledge of general
information. There are
deficits in attention that
interfere with ability to
focus and concentrate on
tasks.
formal operational period
is the fourth and final of
the periods of cognitive
development in Piaget's
theory. This stage, which
follows the Concrete
Operational stage,
commences at around 11
years of age (puberty) and
continues into adulthood.
In this stage, individuals
move beyond concrete
experiences and begin to
think abstractly, reason
logically and draw
conclusions from the
information available, as
well as apply all these
processes to hypothetical
Patient: …. situations.

Nurse: May gusto ka pa ba na

sabihin o ikuwento sa akin?

Patient: Wala na.

Nurse: Sige J. Hintayin na

lang natin ang iba na matapos.