The nurse approaches a 33 year old male client who was admitted several days ago to the psychiatric inpatient unit with a diagnosis of severe depression.

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The nurse approaches a 33 year old male client who was admitted several days ago to the psychiatric inpatient unit with a diagnosis of severe depression. The nurse smiles and says, “Hi, Doug. My name is Becca. I’m the evening nurse.” She sits down in a chair near him. The nurse compliments the client on how he’s looking and asks, “How are you feeling today?” The client leans away, maintains a slumped posture, avoids eye contact and shakes his head. The nurse leans back in her chair and sits with the client in silence. After several minutes of silence, she crosses her arms and tells the client that she has about 20 minutes she can spend with the him, and asks “Would you like to talk? Or would you like me to just sit here quietly with you?” Doug shrugs but says nothing. After another 5 minutes, the nurse stands up and says to the client, “Well, you let me know if you change your mind, Doug. I’ll be here until 11.” The client continues to look down. The nurse smiles and says, “I’ll check in on you later” and goes back to the nurse’s station. Approach this scene as if you are a detective, looking for important clues. Take note of everything that happened. Think about how the client might have felt at each moment of this interaction. And, like all good detectives, make some notes to yourself.

Now you’re ready to answer the questions below.

1.Identify what verbal and nonverbal actions by the nurse supported or enhanced therapeutic communication.

2. Identify what verbal and nonverbal actions by the nurse might have blocked therapeutic communication.

3.How might you interpret the client’s body language and silence during this first meeting?

4. What do you think would have made this a more therapeutic conversation?

5. What do you think about the nurse disengaging before twenty minutes? What do you think the nurse was feeling? What do you think the client was feeling?

 
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