Foundations of mental health nursing.

1. Interpersonal Process Recording (IPR)

   Purpose

   This assignment will help prepare you for conversations with clients with a mental health condition.

   Course Competency

   Describe the foundations of mental health nursing.

   Transferable Skill

   Communication: Displaying capability in writing, reading, and oral communication; understanding of non-verbal language.

   Instructions

   It will be carried out with two students working together. This is a “role play exercise,” in which one student is the student nurse, and the other will role play as a client. In this assignment, the nursing student will be demonstrating the therapeutic nurse-client relationship and analyzing the therapeutic and nontherapeutic techniques used. You will take turns in the roles.
   This is not about always having therapeutic responses. It is about learning from practice and review. It is expected that you will think of other ways to respond or interact with the client that may be more therapeutic after the interaction is terminated. After the conversation is over, you will complete in IPR form.

   The client roles are:

   • Mr. Jones is a 69-year-old retired engineer. He was admitted to the in-patient psychiatric unit the previous day. His daughter had called the police when he locked himself in his bathroom and refused to come out. She thought he was suicidal. He was brought to the hospital by the police and was admitted on involuntary status. He has been reticent since admission but told his daughter he had no reason to live since his wife died.
   • Diagnosis: Major Depressive Disorder
   • Nursing Diagnosis: Risk for suicide.
   • Mrs. Alvarez is a 34-year-old female who has lived in this country for the past 10 yrs. She is a stay at home mom with three small children. Her husband works two jobs to support the family. Lately, she has been extremely anxious and fears that her children will become ill or injured. This seems to be an unrealistic concern, but she has been unable to sleep well and has lost 15 lbs. in the past month. She is a voluntary admission and states she knows she needs help.
   • Diagnosis: Generalized Anxiety Disorder
   • Nursing Diagnosis: Ineffective coping

   You will select the role you wish as a client and take turns switching roles. After the conversation, you will document the interactions using the form provided and following the guidelines instructions for each column.

   IPR Form Explanation

   The IPR is completed with the form to guide you, and the rubric to explain the grading process for content.

IPR Form

1. • The first column is for you, the nursing student’s, comments/ questions, and responses. You may want to include the introduction process. It is understandable if the initial conversation is more superficial to establish rapport. You may not want to include all of this but move on to the more focused interaction. Your nonverbal communication is included here.
   • Then, the conversation will move to a focus on the client’s feelings, concerns, issues as he/she has identified them. After the introduction, it may be beneficial to establish with the client a short- term goal for the interaction.
   • The second column is for the client’s comments, questions, responses. Also, the nonverbal reactions of the client are included in this column.
   • The middle column is for you to write what you are thinking or feeling.
   • The last two columns are for you to document the technique that you used in that portion of the conversation. If it is a non – therapeutic response, you are to write the response and think of how you could revise to more therapeutic response. You can change any response if you think of how you could have responded differently but, identify and change all non – therapeutic responses.

   Remember, this is an assignment that will assist you in all communication with others.

   Explanation of the Rubric Criteria for Interpersonal Process Recording (IPR)

   • Communication (20 verbal entries, ten nonverbal, ten techniques)
   • Criteria 1 Nursing Interaction (verbal and nonverbal) – Nursing statements and questions demonstrate a positive, caring approach and show insight into the client needs. These interchanges will include the introduction process, but not the more superficial interchanges. Nonverbal communication techniques are also recognized. Thoughts and feelings are identified and documented.
   • Criteria 2 – The client verbal statements and questions are documented. Nonverbal communication is also observed and interpreted. You may also identify defense mechanism(s) used by the client.
   • Criteria 3 – All communication techniques used are identified (using titles previously reviewed).
   • Criteria 4 – All non-therapeutic techniques to be identified and changed to a therapeutic method. If in the review of the interaction, a more appropriate or therapeutic approach (verbal or nonverbal) is identified, document how this response/ statement would be changed