Nursing Interventions: Coping and Social Interactions

by Brenda Marshall, EdD, MSN, RN

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    00:00 Let's think about the nursing diagnosis of ineffective coping.

    00:04 Which, ineffective coping really applies to multiple patients that we see in a psychiatric unit.

    00:13 So, ineffective coping can be reflective of that person's sense of powerlessness or vulnerability.

    00:20 What might we want to do with a person who has ineffective coping? Well, we want to be able to encourage a safe and accepting environment.

    00:31 We want to provide facts related to the situation.

    00:36 We want to educate related to the diagnosis.

    00:39 We want to make sure the - that person is understanding of what treatments are available, as well as other things that might be contributing to why they're feeling powerless and vulnerable.

    00:55 We want to be able to talk to our patients and examine what worked before.

    01:01 Ask. So, were there coping strategies you've engaged in in the past that have been successful? And we want to encourage that person to verbalize, talk about how they're feeling and what they are afraid of.

    01:18 We want to help them identify their own strengths.

    01:23 And by doing so, we can explore those possible methods that they might feel comfortable with in order to deal with their fears.

    01:33 Another nursing diagnosis that we are able to use with multiple patients who come to us is impaired social interactions.

    01:46 We want to assist our patients to be able to identify an alternative way to combat their desire or their need to withdraw.

    01:55 We might be able to tell them, if it's uncomfortable for you to sit so close to people, you might want to move your chair a bit and let's see how that feels.

    02:06 Engage them in assessing new ways to reduce that fear or that need to withdraw.

    02:15 We want to slowly increase their contact with others on the unit.

    02:20 We don't want to throw them right into the community meeting first thing, but maybe let them listen to the community meeting, standing around in the hallway with us, or have them meet with one or two people who went to the community meeting and have them discuss what was stated in the meeting.

    02:41 Also, we want to include them in activities that will focus on increasing social skills.

    02:48 And one of the activities that I most enjoy is having one person turn to the person on their left and simply find something to compliment.

    02:58 Usually, it is I like your smile, or I like your jacket.

    03:03 And so, they say I like your smile, and the other person says, thank you very much.

    03:09 And the first person says you're welcome and can look away.

    03:13 That's it. That's all they have to do.

    03:17 If you are not even at that level yet, and there will be times that you're not even at that level, I sometimes just have the person look, smile, see the other person smile back, and look away.

    03:31 It's a very quick group activity.

    03:34 Most people enjoy it even when they don't like having eye contact.

    03:39 The amount of eye contact and the fact that they smile, and the other person smiles back, that's what the requirements are, and then they look away.

    03:49 What we're doing in that activity is mirror neurons.

    03:53 So, when you see someone smile, you usually want to smile back.

    03:57 For some of our clients, they don't want to smile back.

    04:01 Having smiling back as part of the interaction helps them understand what it feels like.

    04:07 It is called behavioral rehearsal.

    About the Lecture

    The lecture Nursing Interventions: Coping and Social Interactions by Brenda Marshall, EdD, MSN, RN is from the course Psychiatric Assessment (Nursing).

    Included Quiz Questions

    1. Assist the client in identifying their own strengths
    2. Provide opinions on the client’s situation
    3. Focus on previous unsuccessful coping strategies
    4. Encourage client to avoid vocalizing their fears
    1. “I see that you are most comfortable eating lunch alone in your room. How about today you could try and sit at a table by yourself at the edge of the dining room, and see how you feel?”
    2. “Today let’s try and have you lead the morning announcements so you can work on your fear of social interactions.”
    3. “I know that you do not like interacting with others, but if you do not eat with the other clients today you will lose your smoking pass privileges.”
    4. “How about today you practice making eye contact and engaging others in conversation? There is a new client coming today, you can show them around the unit and help them get settled.”

    Author of lecture Nursing Interventions: Coping and Social Interactions

     Brenda Marshall, EdD, MSN, RN

    Brenda Marshall, EdD, MSN, RN

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