Emotional Intelligence Reflection About The Patient Free Writing Sample

Client (first initial only) D Client’s age __ 52_____

Client diagnosis bipolar disorder characterized by manic state and disorganized thoughts.

Setting/context (describe)

My interaction with the client took place in the psychiatric clinic. During my first day in the psychiatric clinic, the client approached me and I welcomed her to sit down before I engaged her in a conversation. The client responded well by taking a seat and talking freely with me throughout the period of the conversation.

Goal of Interaction: The goal of interacting with the client was to establish experiences that made her exhibit manic moods of bipolar disorder using therapeutic communication. Given that it was my first day in the psychiatric clinic, I was really scared and nervous since I did not know how to apply therapeutic communication. Therefore, to overcome nervousness, I created a rapport with the client and cautiously thought about the questions that I formulated and used in the therapeutic communication. Overall, I wanted to gain empirical experience in the use of therapeutic communication since I have never interacted with any client in a psychiatric clinic.

Student Interaction Client Interaction Self-Awareness


Social Awareness/Client Analysis
1. Hi, My name is S. (smiling and shaking hands with eye contact)

2. How are you feeling today? (eye contact)

3. Can you tell me more about it? (eye contact, and fingers interlocked)

4. (I said “Why” I murmured but she did not hear me, so I moved on to the next question). Can you please elaborate more on what you mean by seeing so many cops?

5. What was your reaction? (I was constantly thinking about what to ask next, legs started shaking). And I almost asked why question and then took it back.

6. How does it help you? Any specific music to hear? (Asked with curiosity in my tone and nodded my head).

7. Do you feel any difference since you came here? (eye contact).

8. Can you please tell me more about it? (I maintained my eye contact, and asked with a little smile)

9. Kill through air? (and used my hands to communicate, Eye contact)

1. I am D (while pulling the chair to sit)

2. I am crying a lot(clearing her right eye and started choking)

3. My neighbor killed himself and I was horrified, thinking this never happened to me before. I started panicking and talking constantly without a pause. Seeing so many cops was terrifying (started smiling).

4. There were about 10 police cars and it is scary to see it happen in your neighborhood (munching on chips and rolling her pants until her knees with one knee against her chest).

5. Nobody was telling me anything, until my nephew who lives down my street came over and told me what happened. Then I put on the high music and started dancing. Music was loud and I was dancing to console myself (Rubbing her watery eyes).

6. Just any music, I love to dance so I become overly hyperactive and my husband could not control me, and I was brought her. (PCA was checking her blood sugar, she told her to prick in the middle because sideways hurt). And then she maintained eye contact with me.

7. Doctor had not come to see my since I have been here. It has been three days, and he is giving orders over the phone and nurse is following them. I talk a lot and cannot stop talking. (smiling and her eyes were brightening)

8. I was shocked to find him killed. You never know what’s going on may be somebody is cooking some chemicals and trying to kill us through the air (while pulling her hair back and maintain her posture)

9. You know chemicals can go in the air and kill me.

1. I started the interaction by welcoming the client and introducing myself usingself-offer technique. I informed the client my name and shook her hand while smiling and maintaining eye contact. Since I felt nervous, I decided to create a rapport to dispel fears so that I could converse freely with client.

2. I used broad opening questionin trying to ascertain how the client felt. I think the choice of the words used in broad opening question, “how are you feeling today?” was appropriate because it prompted the client to express her feelings freely without any restrictions. However, I was shocked when the client started chocking because the question elicited her emotions. I think a better question could have been, “how are you fairing today?

3. As the client stated that she has been crying a lot, I pitied her and used exploring techniquein questioning her to give more information about her condition. For I wanted the client to describe her situation extensively, I thought that I should let her expound on issues that she has been grappling with in her life.

4. Owing to anxiety, I wondered what made her panic and became terrified, and I requested an explanationby asking “Why?” I realized that requesting an explanation using the words “Why?” was nontherapeutic technique. For I felt out of context, I decided to rephrase my question using more specific words and context. I changed my tact thoughtfully and sought clarification about the effect of seeing many cops in the neighborhood.

5. I asked evaluation questionin a bid to understand how she reacted to the sight of police cars and cops in the neighborhood. However, I became confused for I struggled to think about appropriate question while my legs kept shaking. Eventually, I perceived that the evaluation question was appropriate because it captured the context and mood of the conversation.

6. As I was curious, I used direct questioningin a bid to understand the importance of music and the nature of music in consolation. I tried to perceive how music could have consoling effect on the client. Although I have felt the soothing effect of music, I wanted to know the nature of music that consoles.

7. I employed evaluation question in trying to assess the progress of the client since she started seeking help from the clinic. I felt nervous when I asked the question: “Do you feel any difference since you came here?” while maintaining the eye contact to get the attention of the client. However, I noted later that I did not formulate the question well because the client did not answer it as I expected.

8. Since the client did not give satisfactory answer about her progress, I posed to her a clarification questionso that she could shed more light on her progress in response to care she received from the clinic. I felt confident and I decided to maintained eye contact and gave her a friendly smile to attract her attention.

9. I voiced doubtby prompting the client to explain how death occurs through the air. The belief that people could cause death by placing chemicals in the air surprised me. I used hands and eye contact to express surprise in a bid to let the client describe how people could cause death through the air using chemicals. I noted that my surprise intimidated the client in that she did not explain well how people could cause death through the air.

1. The client responded affirmatively by telling me her name and comfortably pulled the chair and sat on it. From her responses, the client appeared friendly and felt very comfortable.

2. The client became emotional because the question touched her feelings. I supposed that the emotional aspect indicated that the client’s experiences were very overwhelming. It appears the client thought that crying and choking were best ways to illustrate her trauma. The emotional nature of the client limited her response to the question asked.

3. The client appeared traumatized when she narrated about the death of her neighbor and the sight of cops in the neighborhood. However, the client was emotionally strong this time because she managed to smile at end of her the traumatic narration. I think the client fears death and associates cops with bad omen for she panicked and became terrified. The client clearly indicated that the death of her neighbor and the sight of cops triggered manic state of bipolar disorder because they made her panic and talk continuously.

4. The client seemed terrified because she narrated that police cars and cops looked scary. It seems that the client thought that the cops came kill them in the neighborhood for they looked scary. In this view, the statement of the client shows that scary look of the police cars and cops elicited manic state of bipolar condition. The act of munching chips and rolling her pants deviated the attention of the client from the conversation.

5. The client emotionally explained how she started exhibiting abnormal behavior. However, her explanation was limited because she concentrated on rubbing her watery eyes. The client imagined herself in helpless situation because she started rubbing her watery eyes. From her explanation, it was evident that the sad news about her neighbor killing himself shocked her and made her play loud music and dance to console herself. Hence, it shows that reaction of the client to the traumatic experience triggered manic state of bipolar disorder.

6. The client responded freely that any music could console her because she loves dancing. From her explanation, it was apparent that the traumatic experience, music, and dance are factors that contributed to her hyperactivity. I empathized with the husband for he could not control the client when she was hyperactive. The interaction of the client with PCA showed that the client was able to maintain conversation and talk to other people at the same time.

7. In response to my question, the client was frustrated and confused because she answered it indirectly by avoiding the question and blaming her doctor for being absence. Essentially, the client thought that her doctor had neglected her for she lamented that her doctor had not come to see her for three days since she reported to the clinic. Furthermore, the client responded while smiling and brightening her eyes, which implies that she is strong and hopeful that the doctor has the doctor would heal her. The assertion that the client talks continuously showed that she still suffers from manic state of bipolar disorder.

8. The client was traumatized because of the shocked she received when she learned about the death of her neighbor. From her response, it was evident that the death of her neighbor instilled great fear in her. The client believed that somebody was plotting to kill her by placing deadly chemicals in the air. Her gestures were normal, but her statements indicated that she felt insecure in life.

9. The response of the client shows that she harbored fears of death and she felt very insecure among people. The client imagined how chemicals in the air spread and cause death. Therefore, the conversation showed that the client lived in great fear, which triggers the manic state of bipolar disorder. However, the client has limited understand of death because of her naivety.

Relationship Management Reflection

Reflection of the client’s responses shows that paranoia was a dominant theme, which I identified. Paranoia was associated with the traumatic experiences of her neighbor’s death, the sight of cops and their cars, and homicide. When I asked her how she felt, the client responded by citing the traumatic events that happened in her neighborhood. The client stated that she cried a lot because “my neighbor killed himself and I was horrified, thinking this never happened to me before. I started panicking and talking constantly without a pause. Seeing so many cops was terrifying.” Since the client experienced such traumatic events for the first time, they traumatized and made her develop obsessive thoughts about death. Using broad questioning, requesting an explanation, seeking clarification, exploring views, and evaluating responses prompted the client to describe her condition effectively.

When I asked her how she reacted to the traumatic events, the client said that people did not inform her about the events until when her nephew narrated to her what transpired. The client stated that she responded to the traumatic events by dancing to a loud music because it consoled her. When I sought to find out the role and the nature of music she played, the client responded that, “just any music, I love to dance so I become overly hyperactive and my husband could not control me.” Her response showed that the client understood her condition of hyperactivity well because she turned on a loud music, danced to it, and talked endlessly.

During the interaction, the client had a tendency of avoiding questions, which I posed to her. When I asked if she felt any difference since she came to the clinic, the client avoided the question by answering that, “doctor had not come to see me since I have been here. It has been three days and he is giving orders over the phone and nurse is following them.” In this view, I could have asked the client how the nurse has helped her so that I could inform her how the orders from the doctor have benefited her. When I prompted her to explain about her progress, she changed the topic to the death of the neighbor and introduced her fears. In response to my question about progress, the client stated that, “I was shocked to find him killed. You never know what is going on may be somebody is cooking some chemicals and trying to kill us through the air.” Moreover, when I ask the client to elaborate how one could kill using chemicals in air, she responded casually by saying that chemicals could spread in the air and kill her. To prevent her from avoiding my questions, I should have used a direct question, which is specific to a certain behavior or action.

Self-Management Reflection

I demonstrated genuineness and empathy in the manner I handled the client from the commencement of the conversation until the end. When I commenced the conversation, I welcomed the client by introducing myself and letting her introduce herself. I questioned the client keenly by formulating therapeutic statements, which enabled her to answer my questions well and interact in a friendly manner. I demonstrated genuineness and empathy when I asked the client “how are you feeling today?” Subsequently, I expressed my concerns emphatically when I questioned her regarding her experiences and progress in response to the therapy she received from the clinic. The use of nonverbal communication such as eye contact, smile, and hand gestures enhanced our conversation because I was able to keep the client engaged throughout the period of the interaction. I created rapport and won the trust of the client because she was able to communicate freely with me without any reservations.

Since the conversation was emotional, I used diverse strategies to manage emotions. At first instance in question #2, when I asked the client about how she progresses with therapy, the client started to cry and choke. I used exploring technique in questioning and expressed empathy by crossing fingers and maintaining eye contact. Evidently, the client stopped crying and choking and resumed our conversation as she narrated her traumatic experiences. At the second instance in question #6, when I asked the client about her reaction to the traumatic experiences, the client started to rub her watery eyes for she felt overwhelmed by the emotions. In the management of these emotions, I used soft tone to ask the next question and nodded my head in approval of her emotions. The outcome was positive as the client stabilized and continued with the conversation.

The interaction enhanced my knowledge of communication style for I was able to realize my strengths and weaknesses. The strengths of my communication style are that I was able to formulate therapeutic questions and create effective rapport for conversation. However, the weaknesses of the interaction are that I was passive and did not alleviate her paranoia. Although the client played an active role in the conversation, I was somehow passive because I did let the client to avoid and guide the course of my questions. In many instances, I found myself seeking clarification, explanation, and exploring what the client narrated. As the client expressed fears, which emanated from the death of her neighbor, the sight of cops, and fear of death, I responded with surprise and shock. During the conversation, I interacted with the client casually for I did not help her to overcome the fears she had.

Knowledge gained regarding self is that the experience of interacting with the client has enabled me to formulate and utilize therapeutic statements effectively. However, I failed to be objective because the client diverted my attention and made me digress from the questions I asked. Throughout the conversation, I did not help the client because I merely listened to her experiences. Moreover, I neither supported nor opposed her feelings, behaviors, and fears. In the end, the client did not gain significant benefits apart from the compassion and empathy I expressed during the conversation. Overall, I have improved in the aspect of applying therapeutic interpersonal techniques in clinical environment.

Legalization Of Marijuana In Colorado And Washington

Legalization of marijuana in Colorado and Washington has raised a lot of controversy in American society in the recent past. According to Clarke (71), there is a changing perception on the real definition of marijuana in terms of its effect on the body. A section of the society believes that it is a stimulant, just like tea, coffee, or a cigarette. They consider it as a stimulant that is not harmful to its users when taken in regulated quantities. This is the group that has been campaigning for the legalization of this drug. Although this still remains a controversial issue in the society, some states such as those mentioned above have approved its use in regulated measures. Other states such as California have also been discussing this issue, and the possibility of legalizing this drug is very high in this state. This research seeks to challenge the definition that views it as a stimulant that is not harmful to human health.

Marijuana has been an illegal drug in this country for a very long time. Most of the other world nations have also illegalized sale and consumption of this substance within their borders. According to Caulkins (90), Marijuana is known to have direct negative health effects in the body of a person. This puts to question the general belief that some people have held that Marijuana is a stimulant that is harmless to human health. From the medical perspective, it has been categorized as a hard drug. In most countries around the world, including the United States, major stimulants such as tea, coffee, or even cigarette, have not fallen to this category. It is important to understand the effect of this substance on the body before defining it as either a hard drug or a stimulant because many people will rely on the definition given by credible authorities to decide on whether to use it or not. The youth, especially adolescents, are at risk of abusing cannabis once it is categorized as a stimulant that has limited or no health consequences. This audience must therefore, be guided appropriately in order to ensure that they do not expose themselves to harm that is associated with the use of this substance.

The report by Nagle (49) shows that marijuana has short-term and long-term effects on its users. This report further states that the short term effects of using it include increased blood pressure, rapid heart rate, increased breathing rate, and slowed reaction time. Some of its psychological effects include aggressions, depressed mood, anxiety, and decreased or increased appetite. Overuse of this substance may result in hallucinations or one being delusional. The above short term effects of this substance confirm its definition as a hard drug. It has negative health effect on the body, and unless care is taken by the user in regulating its use, the effects mentioned above can become worse. Clarke (56) notes that this substance, when used in regulated doses, is a stimulant that has similar effect to that of a cigarette. However, several medical researches that have been conducted by various researchers have stated otherwise. In the report by Caulkins (117), the main problem with it is that once used, it brings the desire to increase its usage. This leads to addiction. The more one uses cannabis, the more he or she realizes that the smaller doses have no effect on their body. To get the desired effect, they would always try to increase the dosage, and with time, the abuse of the drug becomes unavoidable. As Nagle (89) notes, the more the dosage is increased, the greater its impact would be on the body.

This drug has been associated with some health effects when used for a long time. According to Clarke (96), those who use marijuana have higher chances of developing cancer than non-users. This drug also causes serious irritation in the mouth, throat and in the lungs. Acute chest illness and increased risk of infection of the lungs are other effects that have been associated with the use of this substance. Some researchers have also stated that its prolonged usage causes memory loss, impaired immune system of the body and tumor growth. These are effects that make the substance to be considered more of a hard drug than a stimulant.

Medical practitioners have stated that marijuana has other social effects that make it undesirable as a commonly consumed substance in society. The consumers always tend to be very aggressive once they consume it. Given that it makes them reason irrationally, they can engage in activities that may harm other members of the society. Such vices as robbery, rape, homicide, kidnapping, erratic shootings, are closely associated with the users of this substance. They engage in such acts because of the desire for the substance, but lack money, or because of their impaired judgment. It is therefore, a hard drug, and not a stimulant as some people defines it.

Works Cited

Caulkins, Jonathan. Marijuana Legalization: What Everyone Needs to Know, 2012. Print.

Clarke, Robert. Marijuana Botany: An Advanced Study: the Propagation and Breeding of Distinctive Cannabis. Berkeley: Ronin Publishing, 1981. Print.

Nagle, Jeanne. Marijuana. New York: Rosen Publishers. Group, 2008. Print.

A Critical Analysis Of A Research Study Conducted To Establish The Quality Of Pain Management

Quantitative studies are necessary because they help researchers develop theories and ideas for evidence-based healthcare. Researchers should protect human participants whenever they conduct different studies. This is the best way to ensure that the research is ethically acceptable (Burns & Grove, 2011). This paper offers a critical analysis of a research study conducted to establish the quality of pain management and assessment in critical patient care.

Critical Appraisal: Quantitative Study

Protection of Human Participation

There are different codes of ethics that guide researchers to protect human participants whenever they undertake their studies (Burns & Grove, 2011). After reading the article “Pain Assessment and Management in Critically Ill Intubated Patients: A Retrospective Study”, it is notable that the authors identify some of the benefits of participating in such a study. Patients and participants can contribute a lot to research and healthcare knowledge whenever they participate in different studies. However, the authors fail to outline the major risks associated with participation in scientific studies. Researchers should have the consent of the participants. During the study, the researchers used different medical files from Quebec to execute their study. The researchers liaised with the relevant authorities for getting a permission to use the files. The article clearly indicates that the institutional review boards and human research committees offered their approval for the study. This was necessary to protect human participants. The nature of the study did not allow the subjects to participate voluntarily in this research.

Data Collection

The researchers used effective data collection methods to have a successful study. After getting permission from the respective authorities, the researchers reviewed different medical files from two healthcare institutions. The files included those of patients whose age was 18 years and above. The major variables included age and intubation resulting from trauma, surgery, or pulmonary disease. The dependent variables included pain management and assessment methods. The authors used “Melzack’s Framework” for the retrospective study. The files used were for patients admitted between 1999 and 2001. The researchers began with the identification of the files for patients whose age was 18 years and above. As well, the patients fulfilled the required criteria (Gelinas, Fortier, Viens, Fillion & Puntillo, 2004). The authors grouped the data into two categories. The first category included the patients’ general information and the second group included nurses’ records and notes. The use of identification codes increased the level of data confidentiality. They also used an effective data collection method.

Data Management and Analysis

After collecting the needed data, the researchers coded information to safeguard the rights of the patients. The authors divided this information into two categories as mentioned earlier. The use of proper documentation made it easier to group the data in a proper manner. The sections included age, gender, diagnosis, surgery type, and complications experienced by the patients. The data was analyzed using SPSS 10.0 software. Throughout the data collection and analysis process, the researchers kept accurate records of the collected information (Gelinas et al., 2004). The approach made it easier to analyse the data. This helped the researchers make appropriate decisions. As well, the researchers used statistical software to ensure that the analysis was accurate. The researchers included a Principal Researcher and an Assistant Researcher to ensure that the data was accurate and without bias. The independent comparisons presented by the researchers made it easier to have a better analysis. The approach helped reduce instances of bias throughout the study.

Interpretation of Findings

After completing the study, the researchers observed that there were inadequate procedures for pain documentation in many healthcare facilities. This occurred due to the lack of appropriate tools for pain assessment in the health care facilities. It is notable that the findings are valid because they offer a reflection of reality in many intensive care units today. Personally, I would state that the findings are valid because they give a clear picture of the situation experienced in many healthcare facilities. There is a more urgent need for new strategies and tools for pain management and assessment today than ever before. The authors also identified some of the study’s limitations. Some of the limitations included the nature of the research design and the use of improper indicators for pain. However, the study was successful and presented new ideas for better practice (Gelinas et al., 2004). It is also notable that the researchers presented the findings in a coherent and logic manner. Nurses and professionals can therefore use these findings to come up with new tools for pain management and assessment. The approach can be helpful for patients in intensive care or for those who are unable to communicate verbally.

As well, physicians and nurses can apply the findings to nursing practice in general. The ideas can help nurses identify and manage pain in a proper manner. With a proper coordination and the use of new tools, it can be easier to provide better health care and manage pain in different patients. The researchers recommended the encouragement for new studies whereby nurses and patients could provide their views and experiences of pain and management procedures. It is necessary to develop new tools that can identify new indicators of pain (Gelinas et al., 2004). This will enhance documentation for non-communicative patients and eventually promote the best pain management practices. Future researchers should consider these recommendations in order to help nurses provide the best care and support to thier patients in healthcare facilities.

Reference List

Burns, N. & Grove, S. (2011). Understanding Nursing Research. New York: Elsevier.

Gelinas, C., Fortier, M., Viens, C., Fillion, L. & Puntillo, K. (2004). Pain Assessment and Management in Critically Ill Intubated Patients: A Retrospective Study. American Journal of Critical Care, 13(2), 126-136.

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