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Difficulty: MediumGrief and Loss

A practical nurse (PN) is collecting data from a client at a primary care clinic. The client's adult child died unexpectedly eight months ago. The client tearfully states, 'I was functioning okay for a while, but this week I am just so angry and I can't stop crying. I feel like I am not making any progress.' Which response by the PN is the most appropriate?

  1. Grieving does not always follow a straight line, and it is normal to experience returning waves of intense emotion.Answer
  2. B
    You have moved backward from the acceptance stage to the anger stage, which means you need more time.
  3. C
    Why do you think you suddenly started feeling angry again after doing well for so long?
  4. D
    You should try to focus on the positive memories of your child instead of dwelling on these negative feelings.

Answer

The most appropriate response is to validate the client's feelings by explaining that grief is an individualized, non-linear process and that experiencing returning waves of emotion is a normal expectation.
The correct answer provides validation and reassurance by acknowledging that grief is a dynamic, individualized journey. It avoids placing the client's experience into a rigid framework and normalizes the fluctuating emotions the client is experiencing, which is a key component of therapeutic communication.

Step-by-Step Solution

1
Analyze the client's statement.
The client is expressing distress over feeling angry and tearful again after a period of functioning well.
Identifying the client's core concern (feeling like they are failing at the grieving process) is necessary to formulate a supportive response.
2
Evaluate the principles of normal grief.
Grief is a highly individualized, dynamic process that does not follow a strict linear timeline; regressions or 'waves' of grief are expected.
Understanding normal versus complicated grief helps the nurse provide accurate reassurance.
3
Select the most therapeutic communication technique.
The response that normalizes the non-linear nature of grief without giving advice, asking 'why', or imposing rigid stages is the best choice.
Therapeutic communication focuses on validating the client's experience and encouraging expression without judgment.

Key Concept

Normal grief is a dynamic, fluctuating process rather than a linear progression of stages, and therapeutic communication requires validating the client's individualized experience.
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Topics

Grief and Loss

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