The student nurse is assigned to assist the psychiatric nurse with the admission interview of a client at the psychiatric hospital. The nurse explains to the student that the interview is very important in obtaining a total health history of the client

QUESTION

Case Study, Mohr

CHAPTER 9, the Nursing Process in Psychiatric–Mental Health Care

In completing the case study, students will be addressing the following learning objective:

Apply the nursing process to psychiatric–mental health nursing.

1. The student nurse is assigned to assist the psychiatric nurse with the admission interview of a client at the psychiatric hospital. The nurse explains to the student that the interview is very important in obtaining a total health history of the client. The nurse should be courteous and respectful of the client to obtain as much information from the client as possible. Assessment information should include the subjective information from the client with the reason for needing treatment, the cause of the present problem(s), and the client’s expectation of the outcome of treatment regimen. The nurse alerts the student to the need to be sensitive to both verbal and nonverbal behavior of the client and to focus on topics that seem important to the client.

(Learning Objective: 1)

a. How can attention to the client’s nonverbal cues be of value in an interview?

b. Why is the interview the most important aspect of the nursing process?

ANSWER

The Significance of the Interview in Psychiatric-Mental Health Nursing: Understanding Nonverbal Cues and Optimizing the Nursing Process

How can attention to the client’s nonverbal cues be of value in an interview?

Attention to the client’s nonverbal cues can be of great value in an interview in psychiatric-mental health nursing. Nonverbal cues include facial expressions, body language, tone of voice, and gestures, which can provide valuable insights into the client’s emotions, feelings, and overall state of mind (Foley, n.d.). While verbal communication provides important information, nonverbal cues often reveal underlying emotions or experiences that the client may not be able or willing to express verbally.

By observing nonverbal cues, the nurse can gain a deeper understanding of the client’s current mental and emotional state. For example, a client who avoids eye contact, fidgets, or displays tense body language may indicate anxiety or discomfort. Conversely, a client who appears relaxed, maintains eye contact, and engages actively in the conversation may convey a sense of trust and openness. These nonverbal cues can help the nurse establish rapport, tailor the interview approach, and adapt communication strategies to meet the client’s specific needs.

Nonverbal cues can also aid in identifying discrepancies between verbal and nonverbal expressions. A client may verbally express that they are feeling fine but exhibit signs of distress through nonverbal cues. This incongruence can alert the nurse to underlying issues that need further exploration. Additionally, nonverbal cues can serve as prompts for the nurse to ask follow-up questions or delve deeper into specific areas of concern.

In summary, paying attention to the client’s nonverbal cues during an interview enhances the nurse’s ability to establish rapport, understand the client’s emotions and experiences, detect discrepancies, and provide holistic care in psychiatric-mental health nursing.

Why is the interview the most important aspect of the nursing process?

The interview is the most important aspect of the nursing process in psychiatric-mental health care due to several key reasons. The nursing process is a systematic and organized framework that guides nurses in providing individualized care to clients. It consists of five interrelated steps: assessment, diagnosis, planning, implementation, and evaluation. The interview primarily falls under the assessment phase, but it also contributes to subsequent steps in the nursing process.

Gathering comprehensive information: The interview enables the nurse to collect subjective information directly from the client. By actively listening and asking relevant questions, the nurse can obtain a detailed health history, including the client’s current concerns, past psychiatric history, family dynamics, and psychosocial background (Toney-Butler, 2022). This information forms the foundation for developing an accurate diagnosis and care plan.

Establishing rapport and trust: The interview serves as an opportunity for the nurse to establish a therapeutic relationship with the client. Through active listening, empathy, and nonjudgmental attitude, the nurse creates a safe and supportive environment that encourages the client to share sensitive and personal information. Building rapport and trust during the interview promotes client engagement, collaboration, and adherence to the treatment plan.

Assessing mental status and risk factors: The interview allows for the assessment of the client’s mental status, including their cognition, perception, mood, and thought processes. The nurse can evaluate the client’s risk for self-harm, harm to others, or potential psychiatric emergencies (Benner, 2008). By carefully exploring the client’s thoughts, feelings, and behaviors, the nurse can identify signs of mental health disorders, assess their severity, and determine appropriate interventions.

Formulating a nursing diagnosis: Based on the assessment findings from the interview, the nurse can formulate a nursing diagnosis. This involves identifying the client’s actual or potential health problems and their underlying causes. The nursing diagnosis guides the subsequent planning, implementation, and evaluation steps of the nursing process, ensuring that interventions are tailored to meet the client’s specific needs.

Collaborative goal setting: During the interview, the nurse explores the client’s expectations and goals for treatment. This information helps in collaborative goal setting, where the nurse and the client work together to establish realistic and meaningful goals. By aligning the treatment plan with the client’s expectations and preferences, the nurse enhances client engagement and improves the likelihood of successful outcomes.

In conclusion, the interview is the most critical aspect of the nursing process in psychiatric-mental health care. It enables the nurse to gather comprehensive information, establish rapport and trust, assess mental status and risk factors, formulate a nursing diagnosis, and collaboratively set goals. By conducting a thorough and empathetic interview, the nurse lays the foundation for effective and individualized care that addresses the client’s unique needs and promotes their mental well-being.

References

Benner, P. (2008, April 1). Clinical Reasoning, Decisionmaking, and Action: Thinking Critically and Clinically. Patient Safety and Quality – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK2643/ 

Foley, G. N. (n.d.). Nonverbal Communication in Psychotherapy. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2898840/ 

Toney-Butler, T. J. (2022, August 29). Nursing Admission Assessment and Examination. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK493211/