Running head: PROCESS RECORDING

Process Recording
Jenna M. Spotts
Cedar Crest College

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3
Process Recording
Introductory Material and Background

The date of the interaction was on September 13, 2013 around 9:30 in the morning. The
patients age wasnt stated during the interaction; patient is an elderly Caucasian female that was
living in the apartments with her husband at Westminster Village until he grew very sick with
Alzheimers disease. The patient was admitted to another nursing home when she had a high
amount of surgeries and then came back to Westminster Village in the past eight months. The
patient was selected for me by my clinical instructor. This interaction took place on the first day
of the student nurses clinical group at Westminster Village, as well as the student nurses first
patient interaction.
Thoughts
The night before the interaction I was more nervous about not hearing my alarm clock
rather than the interactions I was going to have. I woke up a few times during the night fearing
that I was late for school, I even had my mother call me to make sure I was up in the morning.
The drive to Westminster I was nervous about getting stuck in traffic, at this point my hands were
growing clammy while gripping the steering wheel. As I arrived at Westminster I was able to
calm my nervousness since I woke up and made it with time to spare.
Feelings
The night before the interaction I was feeling great, my father and I had a wonderful
night out. As I got home and showered before bed I started to feel nervous about holding a
conversation with a patient. Walking into the conference room was when all those butterflies
started to flutter in my stomach and my hands got really clammy again. I think I was more
nervous about holding a conversation with a patient than starting a conversation.

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4
Goals and Outcomes

The goals that I had for the interaction were to use therapeutic silence, use empathy
instead of sympathy, and focus on the patient and redirect to the patient any time that its needed.
The student nurse will practice the technique of therapeutic silence for at least 1 minute 2
different times during the nurse-patient interaction. The student nurse will practice the technique
of empathy at least 2 different times during the nurse-patient interaction. The student nurse will
practice the technique of having the conversation about the patient more than the student nurse
during the nurse-patient interaction.
Nurses Behavior
(Knocking on the

Inferences
Patients Behavior
I knocked on the door (Patient was moving

Inferences
Patient was moving

door until the patient

out of respect for the

around her room in

around her room

turns to look at the

patient even though

her wheelchair with

getting ready to start

student nurse. Hands

the door was wide

her back to the door.

her day. The patient

were a little shaky

open. I allowed the

Patient was trying to

started out with

and my heart was

patient to know who I get her shoes on

wanting to talk but

beating faster than

was before having a

when she noticed me

told the student nurse

normal. I had a smile

conversation, I was

knocking. She looked

that she had a very

on my face as I dove

opening the

at me with a big

busy day planned out.

into the

opportunity for the

smile on her face.)

The patient was open

conversation.) Good

patient to trust me. I

Why good morning!

and willing to talk for

morning! My name is

was informing the

I know that I said I

a few minutes, this

Jenna, Im a student

patient early in the

was willing to talk

shortened the

nurse with Cedar

interaction of the

but unfortunately I

termination phase.

Crest College. I was

termination that

am running a little

The patient was

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stopping by to see if

would happen. I was

behind, I am about to

informing the student

it is okay to have a

smiling to show the

go eat breakfast and I

nurse about how busy

little chat for about

patient that I am an

have a meeting after

she is, especially with

10-15 minutes.

open and friendly

that with the Kazoo

senior prom around

student nurse.

band that I am in. Its

the corner.

picture day today, so

I was showing the

as well.
(Giggling and

Patient is gathering

towards the patient.)

patient that I was

messing with her

last minute things so

Wow you sound like

actively listening to

walker and a bowtie.)

that way she doesnt

a very busy woman,

how busy she was. I

That sounds lovely,

need to come back to

if you would like I

also wanted to know

you can call me L.E.

her room before her

could walk you down

how to address the

Before we walk tell

meeting. She tells the

to the dining hall and

patient in a way that

me how this bowtie

student nurse what

we can have our little

she was comfortable.

looks. (Patient looks

she would like to be

chat on the way, that

I wanted to still be

at student nurse and

called to show what

way you can keep on

able to talk with the

then smiles.) Well

she is comfortable

with your busy day

patient and I knew

they are lucky I put a

with. The patient

and not be late to

that she was busy, so

bra on today, I

looks to the student

your meeting. How

I wanted to

normally dont wear

nurse for reassurance

would you like me to

compromise with her

one. Okay I think I

on the bowtie to

address you?

and walk her to

have everything, lets

make sure it looked

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(Watching the patient

breakfast so she

go walk to the dining

nice. The patient isnt

move around the

wouldnt lose out on

hall.

afraid to be open and

room, moving to her

the hour that she had

honest with the

walker that is also a

until her meeting.

student nurse even

chair.)

though they just met

(Walking out of the

(Looking at me and

moments ago.
Patient was also

patients room feeling patient so I didnt

smiling as we walked

actively listening to

happy and open for a

hold up her busy

down the hallway, the the student nurse,

conversation.) So

schedule, I was

patient stopped to

L.E. showed this by

L.E. what other

showing the patient

grab a paper out of

looking at the student

committees are you

that I was available

her walker and

nurse while she

apart of? It seems

for anything. I started

handed it to the

talked. Patient is well

nice to keep yourself

off the conversation

student nurse.) Well

aware of the groups

so busy and always

about the patients

these are all the

that she is a part of

having something to

hobbies at the nursing meetings and pictures

but needs to write

do. (Looking at the

home to open the

I have to take part in

them down to

patient while walking

conversation and to

today. I dont always

remember. Loss of

and talking, smiling,

talk about things that

remember all of them

memory could be due

hands folded in front

were important to

which is why I write

to old age. Patient

of my uniform.)

her. I wanted to keep

the times and names

informs the student

eye contact so the

of the groups down.

nurse that she does

patient could see that

Its very important

like to stay busy and

I was actively

for me to stay busy, I

active in the nursing

I walked with the

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listening to

like to be very

everything that she

active.

(Taking the paper and

was saying.
I wanted to change

(Smiling, chuckles a

Patient was happy to

looking at the times,

the topic of

little bit.) Yes I have

talk about her

smiling and handing

conversation to L.E.s 6 children, they are

children. Patient was

the paper back to

life. We only had a

wonderful.

saddened when

L.E.) Wow L.E. that

short time so I

Unfortunately 2 of

talking about her two

is a lot of meetings

wanted to ask her

them passed away.

children that passed

today. So do you

about something else

(L.E. looked down

away. Patient needed

have any children?

that would be

and her eyes got

some time to gather

How many?

important. I wanted

glossy. Didnt speak

her thoughts about

to ask both questions

for about 10

her deceased

right away so the

seconds.) My son

children.

patient could go into

who lived in England

detail about if she

had diabetes and

had any children. I

unfortunately didnt

asked this question to

take care of himself

open up the

and had a stroke.

conversation.

(Still looking away

home.

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8
came down with a
terrible infection, and
I dont remember
how she got it, but it

(Looking down and

I used therapeutic

ended up killing her.

staying silent for a

silence to allow the

to sit at, walking to

sadness when talking

minute.) That

patient to gather her

the back of the dining

about her children

sounds terrible L.E.,

thoughts. I used

hall, turning and

that passed away.

it must have been a

empathy when the

looking at the student

Patient smiling at the

rough time. (Looking

patient talked about

nurse with a smile.)

student nurse to keep

at the patient and

her deceased

It was a very

the conversation

staying silent again

children. I used

difficult time for me

going and open for

for 10 seconds. At

therapeutic silence

to endure. If you

the next topic. Patient

this point we entered

again to allow the

would like to sit with

offers a chair for the

the dining hall.)

patient to gather her

me while I eat you

student nurse so the

thoughts to turn the

may pull up a chair.

conversation didnt

conversation where

Patient showed

have to end.

(Smiling at L.E.,

she wanted it to go.

Did you want

Patient offered drink

grabbing a chair and

of respect for L.E. as

anything to drink or

to make sure I was

listening to what she

well as not wanting

eat? There is coffee

comfortable in the

is ordering for

to tower over her as

or hot tea. (Getting

setting. Patient

breakfast.) I would

she ate her breakfast.

her breakfast together

started to talk about

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love to sit and talk

I sat close to L.E. so I

before she starts to

gardening instead of

with you as long as

could listen actively

eat. Looks at the

talking about how she

its okay with you I

and be engaged in the

plants behind us and

came to be at

dont mind at all. So

conversation. I

smiles.) I did those

Westminster Village,

tell me how you

wanted to make sure

plants, they chose me

patient was avoiding

came to be at

it was okay that I sat

actually, well the

the question. Patient

Westminster Village. with her while she

committee since I

was happy to talk

(Sitting down right

ate, I didnt want the

was always taking

about plants. Patient

next to the patient,

patient to be

care of them. I just

talked about how she

arms folded on my

uncomfortable. I

love plants. (Takes a

took her coffee also

lap, smiling.)

asked about

bite of her food and a

in avoidance of the

Westminster Village

sip of coffee, cutting

question. Patient

to change the topic.

up her raisin toast.) I

seemed nervous

dont take any cream,

about talking about

I just like to dip my

why she is at

toast in my coffee.

Westminster Village.

(Smiling as she dips

I was actively

and bites it.)

Patient wanted to

listening to her talk

listening to the

oatmeal, then looking

answer the question

about her gardening.)

patient talk about her

up at the student

but was sad about the

Oh I love plants! I

gardening. I wanted

nurse a little weary.)

answer she was about

used to work with my

to connect with the

Yes it is a nice

to give. Patient

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10

uncle at his garden

patient about

window. Well I used

started off with a

patch when I was in

gardening so I told

to live in the

happy memory of her

high school. L.E.

her about my high

apartments with my

husband when they

your plants look

school job that I had.

husband for about 10

lived in the

beautiful, and that is

I wanted to show that

years. He then came

apartments, when

the perfect window to

I did know a little

down with

they both still had

have them in, lots of

about plants in the

Alzheimers, I visited

their freedom. Patient

sunlight.

fact that they needed

him every day. I still

was saddened when

sunlight, I didnt

dont know if he

talking about her

want to force the

remembered me.

deceased husband

patient to answer a

(Eyes became glossy,

and stayed silent to

question she was

looking down. Then

gather her thoughts.

uncomfortable

looks up at the

answering.

student nurse
smiling.) I like to
think that he did
remember me and
that we both enjoyed
those visits. (Patient
looks down and stays

(Looking at L.E. and

I used therapeutic

silent for a minute.)

staying silent for a

silence to allow the

last bite of oatmeal

up her breakfast

minute.) It must

patient time to gather

and last sip of coffee.

showing that

Patient was finishing

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11

have been nice to

her thoughts as well

Looks at student

termination was near.

have the apartment

as myself. I showed

nurse and smiles.)

Patient was saddened

with your husband. It

empathy when

Yes it was a difficult

to talk about her late

also must have been

talking about her late

time for me, but like I husband, but was

very difficult to visit

husband. I pointed

said, I like to think

okay with talking

him every day, but

out the patients

that he remembered

about him. The

that shows your

strength to show that

me and liked the

patient liked to think

strength. (Smiling at

she is a strong willed

visits. Unfortunately I happy thoughts of her

L.E.)

elderly woman.

must get going now

husband. Patient was

to my meeting.

ready to terminate the

(Looking at the

I stood up to show

conversation.
(Patient stands up and Patient thanked

patient smiling, and

that I was okay with

chuckles, looking up

student nurse for the

standing up.) Okay

terminating the

at the student nurse,

conversation and

L.E. I really

conversation. I

smiling.) Thank you

stood up to show that

appreciate you taking

wanted to thank the

Jenna for a lovely

termination was here.

the time out of your

patient for allowing

breakfast chat. I had a Patient showed active

busy schedule to talk

me the time to talk

wonderful time as

listening when

with me. It was a

with her. I wanted to

well. Good luck with

wishing the student

wonderful

show her that I did

your studies in

nurse well with her

conversation,

remember about the

nursing. I will make

studies. Patient

brightened my day.

senior prom and

sure to have a great

walked away from

Thank you so much

hoped that she had a

time at the senior

the student nurse to

and I hope you have

wonderful time

prom. Thanks again

terminate the

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12

fun at the senior

playing in the Kazoo

and have a great

prom! Have a great

band.

day! (Patient walks

day L.E.!

away to go to her
meetings.)

conversation.

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Evaluation of Nursing Interventions

Throughout the interaction that took place between the student nurse and the patient,
there were three goals that were set. All three of these goals were met by the student nurse during
the nurse-patient interaction. The first goal was for the student nurse to practice the technique of
therapeutic silence two different times through the interaction for at least one minute. The second
goal was to practice the technique of empathy two different times through the interaction. Lastly
the third goal was to practice the technique of holding the conversation about the patient and not
the student nurse.
When the patient talked about her two deceased children the student nurse stayed silent
for a minute to allow the patient to gather her thoughts about her two children. The patient was
then able to continue the conversation in a happy manner. The second time that the student nurse
was able to practice therapeutic silence was when the patient was talking about her deceased
husband. The student nurse stayed silent for a minute to once again allow the patient to gather
her thoughts. This allows the patient to direct the conversation where she would like it to go and
some time to think.
Again when the patient talked about her deceased children and deceased husband, the
student nurse was able to use empathy. The student nurse stated how difficult it must have been,
this allows the patient to respond to the student nurse.
The last goal was to hold the conversation about the patient and not the student nurse.
This goal was achieved in that the patient was more than willing to talk about her life. The
patient asked the student nurse a few questions about her life but mainly was open to talking
about herself. The student nurse answered the questions for the patient so there could be trust
between the nurse and the patient.