00:00
When we're thinking about
nursing interventions,
and when we're looking
at our nursing diagnoses,
we want to be able to be
focused on our patient.
00:11
We need to keep
ourselves observing them.
00:14
We have to see if they are, as I said
before responding to internal stimuli,
which would be their
hallucinations, voices, auditory,
things that are not happening
in the world around them,
but are happening in their mind and
therefore being realized by them
as a real threat to them.
00:36
We want to be able to engage
the person in conversations.
00:40
Rather than arguing with them,
telling them, "No, there's nothing here.
00:45
There's no other person here."
We want to stop and we want to listen,
we want to hear what they're saying.
00:52
We want to find out if they're
having auditory hallucinations.
00:55
What are those voices saying?
We need to know if those
voices are command voices.
01:01
If they're saying to
hurt them or to hurt us.
01:05
It's imperative to ask
what are the voices saying.
01:10
We also want to make sure that we are
contacting with them, we are contacting,
we are able to say, "I'm here for you."
"Is there something that you need?"
And you are going
in and making sure.
01:24
Now if you are working
on a psychiatric floor,
you probably have an
every 15 minute check.
01:31
And so that is mandatory.
01:35
But with someone like this,
you may want to be seeing
them more frequently.
01:40
If they don't want to
come out of their room,
you may want to be
walking by the door.
01:44
You might want to be able to have
a constant observation on them,
if you think they're
going to hurt themselves.
01:53
You also need to
respect boundaries.
01:56
Of course, you don't want
to step in on a person,
you want to recognize
what a personal space is,
especially with somebody who is
paranoid and who has delusions.
02:08
Especially with someone who feels
as though she has been raped,
violated by a cab
driver, by staff members.
02:18
You want to make sure that
you start to be the person
that protective factor who's going to
reestablish those boundaries for her.
02:27
So that she has a sense of a little
bit more control over her environment.
02:32
And speaking about environment,
let's make sure that the environment
is not overwhelming for the person.
02:39
Let's reduce whatever stimuli in the
environment that we possibly can.
02:45
It's important for us also as we make our
therapeutic relationship with our patients,
that we are making sure that we know what
their physical and their safety needs are.
02:57
And to work out with them, how we can
make sure that those are maintained.
03:03
We want to be attentive
to any of their requests,
and whether it's
verbal or nonverbal.
03:09
I mean, if there's somebody who's you
know, scratching their hair,
we might want to go over and say,
"Hey, is it time for a shower?
Would you like to
take a shower?"
Let's see what we
can figure out.
03:21
Not always, people won't
always ask for what they need.
03:25
You may have to ask them.
03:27
"What can I do for you?"
It doesn't hurt and
it goes a long way.
03:33
You want to make sure
that you can be trusted.
03:35
How do you establish trust with a
patient who has a psychiatric disorder?
The same way you establish
trust with anyone else,
you are true to your word,
you don't make promises you can keep,
you listen nonjudgmentally.
03:49
And you provide them information
with hope, not advice.
03:55
Finally, you don't want to
have a threatening stance.
03:59
You don't want to
use aggressive words.
04:01
What do we mean by a
threatening stance?
You do not want to go over
to somebody like this.
04:07
This is terribly
threatening and closed.
04:10
You don't want to do
the the finger thing.
04:12
"I don't know about you, but I don't like
when people start telling me what to do."
We also want to make sure
that our words are delivered
because tone matters,
how loud you're speaking matters,
the facial expression you have.
04:29
So you can say to somebody,
"You're beautiful."
Or you can say,
"You're beautiful."
It's going to be taken
completely different ways.
04:38
And so you have to be
cognizant of your own self
and understand how you
could be threatening.
04:45
If a person is sitting down,
you want to sit with them.
04:48
You don't want to
stand over them.
04:50
You don't want to
rush up to somebody.
04:52
You want to respect
that distance.
04:54
And you want to keep your
hands open and relaxed
when you're talking to
your clients and patients.