process recording psychiatric nursing

Criterion

Not Satisfactory

Good to Excellent

Grade

Pre-Interaction Phase Description of client, medical diagnosis, cultural considerations, setting for interaction; 2 goals for interaction are identified

Content is incomplete.

Goals not stated or inappropriate

- Content is complete. - 2 Goals are stated and appropriate.

Interactive Phase Description of the student nurse and the client interaction includes verbal and nonverbal communication; student describes personal thoughts & feelings at each point of interaction; transcript records a chronological interaction

-verbal & non-verbal behaviors for student & client not described or inconsistently described -transcript not sequential. -Student’s thoughts, feelings not described at each point

- verbal & non-verbal communication recorded for client & student. - student’s thoughts & feelings described. - transcript is sequential conversation.

Interactive Phase Identifies the communication techniques used, whether it was correct or incorrect. If incorrect, a better response is written. Uses at least 4 different communication techniques.

- Content is incomplete. -Does not identify therapeutic techniques or identifies them incorrectly. -Does not write alternative responses.

Uses too few communication techniques

- Communication techniques are named and are mostly identified correctly. - Note made as to whether techniques were effective. - Alternative responses written when indicated.

Uses at least 4 techniques

Post-Interactive Phase comments include analysis of how interaction went; summary of student’s thought & feelings during interaction; comments on introduction & conclusion; identifies cultural variables noted during interaction; notes if goals were met

- Content is incomplete. -Major points are not clearly stated.

- Content is complete. - Major points are stated clearly.

Grammar, Punctuation & Spelling Paper needs to be legible

- Paper not legible.

- Legible.

FINAL GRADE