If the patient then protests, this is easily interpreted as aggression, and seclusion as
the only remaining alternative. The four phases should be integrated in the care process. After the nurse has
identified a need of the patient, it should be addressed in a responsible and competent way. In this way, a
patient is invited to respond and accept the offered care. In the case of Mrs De Boer, the nurse sitting down
with her acknowledges her fear of the risk of the food and drink being tampered with (attentiveness). Therefore,
he offers sealed juice and a closed package of cookies (responsibility). His action shows competence as
a psychiatric nurse, respecting the patient’s worries and awareness of the context and the specific characteristics
of the situation (competence). The patient accepts the food and drink, being responsive to the care
of the nurse (responsiveness). In this second case, the four phases are in line, showing that the care is
adequate. In the first case, the last phase is not met. Despite the efforts of the nurses, the patient is not
approached in a way that would persuade him to trust the nurses and hand over his stick. As the phases are
intertwined, it could be reflected in retrospect if the strategy of the nurses were attentive, responsive, and
competent enough in this concrete situation.