ALERT: Please read the instructions thoroughly, read the uploaded file, and ask many additional questions as needed to complete this paper. 

INTRODUCTION: Describe the setting, in which you had interaction with the med surg patient. Describe the setting, in which you had interaction with the psych patient, then describe each patient and your interactions and reactions with the patient. Include the Med Surg patient and background information for the diagnosis and clinical setting and the Psychiatric patient background and information for the diagnosis and clinical setting. The paragraph closes with a clear purpose statement for the paper.
Medical Surgical Diagnosis
Describe the Medical Surgical patient’s behavior and how your therapeutic
communication techniques changed to meet the needs of the patient.
Discuss what approaches, by you, were effective and what was not effective with
each patient.
Describe the Med-Surg Patients: Nurse-Patient Relationship, Feelings, Phases
When discussing communication techniques make sure to describe them verbally
communication, nonverbal communication, and phases of the nurse-patient
relationship experienced.
It is important to include your own feelings and how they may affect the relationship
with that particular patient.
Psychiatric Diagnosis
Describe the Psychiatric patient’s behavior and how your therapeutic communication
techniques changed to meet the needs of the patient.
Discuss what approaches, by you, were effective and what was not effective with
The patient. Describe the Nurse Patient Relationship, Feelings, and the different phases of the nurse patient relationship you went through with the psych patient. Discuss communication techniques and describe verbal communication, nonverbal communication, and phases of the nurse-patient relationship experienced. Include your own feelings and how they may affect the relationship with that particular
patient.
Conclusion
Conclude your paper with your overall impression of both nurse-patient relationships.
Include your perceptions of how both you and each patient would benefit from the
relationship and what you learned.
Summarize the paper without the introduction of new material.

APA Format with References: APA 7th edition
The Main Body (narrative portion) of the paper must be at least five pages
Use Level I and II headings. Minimum 7 references published within the last 7 years, peer reviewed scholarly.

Please reach out as often as needed and share progress on the paper, so that we are on the same page regarding the content of the paper.

The basis of this paper is to discuss how therapeutic communication changes to meet the patient’s needs. For this paper, the focus should be on how the communication techniques changes to meet patients need who are admitted to the medical surgical unit but have a psychiatric diagnosis, and how communication technique changes for the patient who is admitted to a psych ward.

Back Ground information about the patient that I can provide. In order to write the paper the writer must do some research regarding therapeutic communication with psych patients. The writer must also be able to familiarize themselves with the nurse-patient relationship, and the different phases of the nurse patient relationship.

Psych Patient Background 

The patient is a 79-year-old female patient with a medical diagnosis of hypothyroidism, she is also diagnosed with Major Depressive Disorder and Anxiety.  When I first interacted with the patient, she was sitting in the day room wearing grey sweatpants and a grey sweatshirt with a big stain in the center. The patient was in the Geriatric ward of the psych room. Other patients were in the area eating, but she was not. She was sitting by herself holding a Steven King novel.

The patient was crying and saying “I want to kill myself, why won’t you let me kill myself? The patient refused medication, stating why do you want to drug me up”? I refuse to be bullied.

Feelings I had before interacted with the patient.

I was optimistic, but after my first interaction, I felt sadness, annoyance at one point, empathy, and sympathy, after a solution was found to help the patient, I felt relief and joy. 

What communication skills were used, and which skills worked and which didn’t?

How did you as the nurse feel,

Background on the  pschy patient

This patient is a 76-year-old male who is admitted to the drug unit for aggressive behavior. The patient was in a senior living facility but was displaced due to aggressive behavior towards staff and other residents. The patient has a diagnosis of schizophrenia.  When I first interacted with the patient he was in his assigned room on the medical surgical floor, the patient was wearing a hospital gown with his own pants on. The patient was placed in a single room close to the nursing station. He had a flat affect, a very monotone voice. He looked stated age. The patient is not a reliable historian he would forget about eating breakfast or having a bowel movement. The patient was calm and cooperative, and follow commands when given very simple commands

These are some of the approaches I would suggest for this patient. Lead with hope, and approach the patient in a calm and caring manner.  Do not overstimulate the patient with lengthy conversations keep communication short and to the point, and be consistent with how you communicate with the patient. Keep promises. A perfect example is that this patient loves chocolate ice cream. The patient saw me walking in the hallway, and he asked me for ice, cream it was a busy day so I told him I would return with the ice cream as soon as I can. I kept my promise and returned with the ice cream as promised.  I also use validation with this patient, the patient stated that clowns were telling him what to do and clowns were in his room. I validated that it must be scary for him, I asked about his sleep, however, I did not confirm that there were clowns in the room because that is not therapeutic communication. I also used redirection along with simple commands to complete my assessment.

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