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Difficulty: MediumTherapeutic Communication

A pediatric client is admitted to the intensive care unit with a severe traumatic brain injury following a motor vehicle collision. The client's parent is crying at the bedside and states, 'If only I had taken our usual route to school instead of the shortcut, this never would have happened. It is completely my fault.' Which of the following is the most therapeutic response by the nurse?

  1. A
    Try not to blame yourself; accidents happen, and the most important thing is that you are here now.
  2. B
    Why do you believe that taking a different road would have definitively prevented this collision?
  3. It sounds as though you are carrying a profound sense of responsibility for the accident.Answer
  4. D
    You need to focus your energy on hoping for the best recovery rather than dwelling on the past.

Answer

The most therapeutic response is to reflect the parent's feelings by stating that it sounds like they are carrying a profound sense of responsibility.
The correct answer utilizes reflection, a highly effective therapeutic communication technique. By mirroring the parent's expressed feelings of guilt and self-blame without judging or agreeing with the blame, the nurse validates the parent's emotional experience. This encourages further dialogue and helps build a trusting nurse-client-family relationship.

Step-by-Step Solution

1
Analyze the parent's statement to identify the core emotion being expressed.
The parent is expressing profound guilt and self-blame regarding the accident.
Understanding the underlying emotion is necessary to select a response that validates the parent's current psychosocial state.
2
Evaluate the provided nursing responses against principles of therapeutic communication.
Identify responses that use reflection and empathy versus those that use communication barriers like advising, probing, or minimizing.
Therapeutic communication requires the nurse to facilitate expression of feelings rather than shutting them down.
3
Select the option that best demonstrates an evidence-based therapeutic technique.
The reflective statement acknowledging the parent's burden of responsibility is chosen.
Reflection demonstrates active listening and encourages the parent to explore their feelings without feeling judged or dismissed.

Key Concept

Therapeutic Communication: Reflection and Validation
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Topics

Therapeutic Communication

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