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Difficulty: MediumCoping Mechanisms

A client receives news from the healthcare provider that their physical therapy progress has plateaued and they will not regain full mobility. Shortly after the provider leaves, the client yells at the practical nurse, "This facility is useless, the food is terrible, and none of you know how to do your jobs!" Which response by the practical nurse is most appropriate?

  1. You are experiencing a lot of frustration right now. I have time to sit and listen if you want to talk.Answer
  2. B
    Why are you yelling at me when I am just trying to provide your daily care?
  3. C
    I know this news is upsetting, but you will feel much better once you adapt to your new routine.
  4. D
    Let us focus on the positive fact that you have still made significant progress since you arrived.

Answer

The response that acknowledges the client's frustration and offers to sit and listen.
The correct response utilizes therapeutic communication techniques such as reflecting feelings and offering self. When a client displaces anger onto staff following distressing news, acknowledging their emotional state without judgment provides a safe space for them to process their feelings of loss and frustration.

Step-by-Step Solution

1
Identify the underlying cause of the client's behavior.
The client is using displacement, a defense mechanism, to project their anger and grief about their plateaued physical therapy progress onto the facility and staff.
Recognizing the defense mechanism helps the nurse avoid taking the anger personally and guides a therapeutic response.
2
Evaluate the nurse's role and appropriate interventions.
The practical nurse must maintain a safe, supportive environment using therapeutic communication to help the client process their distress.
Addressing the emotional need rather than the literal words validates the client's feelings.
3
Analyze the provided options against therapeutic communication standards.
Eliminate options that use blocks such as asking 'why', defending the facility, giving false reassurance, or changing the subject.
Non-therapeutic blocks shut down dialogue and can escalate the client's anxiety or anger.
4
Select the most therapeutic response.
The option offering self and reflecting the client's frustration is chosen as the correct action.
This approach builds trust and encourages the client to discuss the true source of their distress.

Key Concept

Therapeutic Communication in Response to Displacement
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Topics

Coping Mechanisms

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