Auburn University

NURS 4231 Mental Health Nursing

Interpersonal Process Recording (IPR)

Student Name: Brittany Thompson
Brief Information about this Client: 32 year old female diagnosed with depression but being evaluated for possible schizophrenia
Student Goals For this interaction: To therapeutically communicate with the patient and build a trusting relationship
Setting/Time: 6South of UAB Psychiatric Ward, mid morning snack

Nurse Communication
(Verbal & Non Verbal)
Client Communication
(Verbal & Non Verbal)
Nurses Thoughts &
Feelings Related to the
Interaction
Analysis of the Interaction
(Effectiveness, Technique,
Name & Rationale)
Alternate or Revised Response
1. (I approach the client when I notice she
has been sitting alone most of the
morning and avoids communication
with others. After asking if I could join
her at their table and introductions, I
started asking questions)

What brought you to the unit?

My husband brought
me here because he is
worried about me
Apprehensive at first
because the patient
seemed so closed off,
but relieved that she
didnt seem to mind
me asking personal
questions.
Therapeutic and effective
because it gave me an
opportunity to see how
the patient came to the
unit from their
prospective, not just what
was written in the chart.
Do you mind if I ask you what
brought you to the hospital?
2.
Why is it that your husband is
worried?

He thinks that I might
try and hurt myself or
one of our sons

(She then breaks eye
contact and stares at
the table)
Interested to learn
about the
relationship with her
husband and what
occurred for him to
bring her to the
hospital
Non-therapeutic because I
think the patient felt
shamed because of the
way I worded the
question. I should have
avoided asking why
What is it that was worrying
your husband?
3. Have you thought about hurting
yourself or your sons?

No but I do need
help, my medications
are not working for my
depression
I believe that she
does not have any
intention to hurt
anyone (including
herself) but she does
seem very depressed.
Therapeutic and effective
because it is direct and
clear, which is the best
way to ask about suicidal
thoughts.
Have you ever thought of
harming yourself in any way?
4. What has been going on that you do
not think your medication has been
working for your depression?

Well, the last time I
was in the hospital
they diagnosed me
with postpartum
depression, but I did
Interested to
continue the
conversation to learn
more about the
patients condition
Therapeutic and effective
because the patient was
able to cognitively
describe why their
previous treatment may
Can you tell me more about
your medication not working
to treat your depression?
Nurse Communication
(Verbal & Non Verbal)
Client Communication
(Verbal & Non Verbal)
Nurses Thoughts &
Feelings Related to the
Interaction
Analysis of the Interaction
(Effectiveness, Technique,
Name & Rationale)
Alternate or Revised Response
not tell them that I was
hearing voices. I
thought the
medication might
make the voices go
away, but they have
gotten worse.
not have been sufficient
5. Are you still hearing voices or seeing
things that are not real?

Yes, I only knew that
you were real because
I saw you talking to my
nurse a minute ago.
I really felt sorry for
her at this point in
the conversation
because I could see
that she was
struggling to
determine reality.
Therapeutic and effective.
The patient was able to
talk about their
hallucinations and I got
some insight to what the
patient must be
experiencing.
How long have you been
hearing voices?
6. What were the voices saying?

The patient described
how the voices were
telling her things in the
middle of the night like
if you go to sleep I will
smother you with your
pillow
I gained a new
understanding of a
story I heard from her
nurse when I arrived
on the unit. The nurse
told me that the
previous night the
patient hid in her
closet because she
was afraid of the
male tech that was
checking on her.
When I first heard
that it sounded crazy,
but after talking to
the patient I can see
how having violent
hallucinations at
night in a strange
place would be
terrifying.
Therapeutic and effective.
I used this open-ended
question to determine the
extent of his hallucinations
and she was able to
elaborate on them.
Can you tell me what the
voices were saying to you?
Nurse Communication
(Verbal & Non Verbal)
Client Communication
(Verbal & Non Verbal)
Nurses Thoughts &
Feelings Related to the
Interaction
Analysis of the Interaction
(Effectiveness, Technique,
Name & Rationale)
Alternate or Revised Response
7. Are you going to tell the doctors about
the voices that you have been
hearing?
Yes, I have never told
them because I
thought they would
keep me here and
away from my sons,
but I just really want
the voices to go away,
and if they can help
me then I will.
Glad to hear that she
is willing to talk to the
doctors about her
hallucinations so that
she can start to get
treatment that can
help her.
Therapeutic because the
patient is moving towards
agreeing to a treatment
plan that can help her.
Have you told the doctors
about the hallucinations you
have experienced?