Rubric For Process Recording – N420 Student Name ✓ Solved

Rubric for Process Recording – N420 STUDENT NAME ______________________________________SEMESTER____________

Describe the core components that should be included in a process recording for nursing students, including pre-interaction planning, during interaction behaviors, technical communication methods used, and post-interaction analysis highlighting cultural considerations, effectiveness, and personal reflection. The description should outline expectations for completeness, appropriateness, clarity, and analytical depth in each section, emphasizing the importance of therapeutic communication, accurate documentation, cultural sensitivity, and critical reflection aimed at professional development. The process recording must demonstrate understanding of verbal and non-verbal cues, correct application of communication techniques with alternatives where appropriate, and insightful evaluation of the interaction, including personal thoughts and feelings, cultural variables, and goal achievement. The necessity of legible presentation and high-quality writing standards is also stressed to ensure clarity and professional standards in documentation.

Sample Paper For Above instruction

Pre-Interaction Phase

In preparing for the interaction, I reviewed the client's medical diagnosis, which was a diagnosis of Type 2 diabetes mellitus. Recognizing the importance of cultural considerations, I noted that the client belongs to a Hispanic cultural background, which influences health beliefs and practices related to diet and medication adherence. The setting for the interaction was the outpatient clinic's consultation room, providing a private and comfortable environment conducive to open communication. Based on this assessment, I established two goals: first, to gather the client's understanding of their health condition and current management practices; second, to educate the client about lifestyle modifications, emphasizing culturally relevant dietary advice.

Interactive Phase

During the interaction, I approached the client with a warm greeting, maintaining eye contact and a friendly demeanor to foster trust. I began by asking open-ended questions about their daily routines and understanding of diabetes, which encouraged the client to share openly. The client expressed some misconceptions about medication and diet, providing an opportunity to address these concerns empathetically.

Verbal communication centered on active listening, affirmations, and clarifying questions, while non-verbal cues included nodding, maintaining appropriate eye contact, and a caring facial expression. I reflected on my personal thoughts—feeling confident in my communication skills but also aware of the need to remain culturally sensitive when explaining dietary modifications.

The transcript details an ongoing dialogue where I utilized various techniques: open-ended questions, reflective listening, summarization, and empathetic responses. For example, I asked, "Can you tell me what you understand about your medication?" and responded with, "It sounds like you’re concerned about how medication fits into your daily routine," which helped validate the client’s feelings and promote understanding.

Communication Techniques Used

I incorporated at least four communication techniques, including open-ended questions, reflective listening, therapeutic silences, and normalization of concerns. When the client hesitated or expressed worries about medication side effects, I acknowledged those feelings: "It’s understandable to be worried about side effects," providing a supportive environment and discussing strategies to manage concerns. When my responses were effective, the client appeared more relaxed and engaged, demonstrating the value of proper technique. If a technique was less effective, I would have rephrased or chosen alternative approaches, such as using humor or visual aids, but in this instance, the methods applied were appropriate.

Post-Interactive Phase

Following the interaction, I reflected on how well the conversation met its goals. The client displayed increased understanding of medication management and expressed willingness to make some dietary changes, indicating that the goals were partially achieved. I noted that my cultural sensitivity was crucial in discussing dietary modifications, avoiding generic advice, and instead tailoring recommendations to the client’s cultural preferences.

My personal feelings during the interaction were positive; I felt empathetic and confident but remained aware of the importance of continued cultural competence. I identified that my verbal techniques helped build rapport, although I recognized the need to improve non-verbal cues, such as ensuring my posture was open and encouraging throughout.

The interaction highlighted cultural variables, such as traditional dietary habits, and the importance of integrating cultural considerations into nursing care plans. Overall, I believe the interaction was successful, and the established goals were met, with the client demonstrating increased engagement and understanding.

In summary, this process recording reinforced the significance of empathetic, culturally sensitive communication in nursing practice. Through careful analysis and reflection, I identified strengths and areas for improvement, such as enhancing non-verbal communication and ensuring ongoing cultural competence to foster patient-centered care effectively.

References

• Beck, C. T. (2012). Nursing Research: Generating and Assessing Evidence for Nursing Practice. Lippincott Williams & Wilkins.
• Leininger, M. M. (2002). Culture care diversity and universality: A theory of nursing. Nursing Science Quarterly, 15(4), 333–338.
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• Peplau, H. E. (1992). Interpersonal relations in nursing: A conceptual framework. Springer Publishing Company.
• Gerrish, K., & Lacey, A. (2010). The research process in nursing. John Wiley & Sons.
• Johnson, M., & Webber, S. (2015). Therapeutic communication in nursing practice. Nursing Standard, 30(07), 49-55.
• Cockerham, W. C. (2017). Health lifestyle theory. Social Theory & Health, 15(4), 371-388.
• Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice. Wolters Kluwer.
• Street, R. L., Makoul, G., Arora, N. K., & Epstein, R. M. (2009). How does communication heal? Patient education and counseling, 74(3), 295-301.
• Australian Nursing & Midwifery Federation. (2014). Cultural awareness and safety in nursing practice. Australian Journal of Advanced Nursing, 31(3), 16-23.