Question

Difficulty: MediumStress Management

An occupational health nurse is evaluating an employee who reports chronic headaches, recent-onset insomnia, and frequent irritability. The employee states, 'My workload has doubled over the last three months, and I feel like I am completely failing at my job and my life.' Which action should the nurse take first?

  1. Determine the specific methods the employee is currently using to cope with the increased demands.Answer
  2. B
    Suggest that the employee request a temporary leave of absence to rest and recover from burnout.
  3. C
    Instruct the employee on progressive muscle relaxation exercises to help alleviate the insomnia.
  4. D
    Reassure the employee that it is normal to feel overwhelmed and that the stress will eventually pass.

Answer

Determine the specific methods the employee is currently using to cope with the increased demands.
In any psychosocial crisis or high-stress situation, the first step of the nursing process is assessment. The nurse must determine what coping mechanisms the client is already using to evaluate their effectiveness and identify any maladaptive behaviors. This information is essential before developing a plan of care or implementing stress management interventions.

Step-by-Step Solution

1
Analyze the client's statement and presentation.
The client is experiencing acute occupational stress with physical and emotional manifestations (headaches, insomnia, feeling of failure).
Identifying the core issue is necessary to determine the appropriate nursing response.
2
Apply the nursing process (ADPIE) to prioritize the action.
Assessment is the first step. The nurse needs more information about the client's current state.
Before any interventions (teaching, referrals, advice) can be provided, the nurse must assess existing coping skills to identify strengths and maladaptive behaviors.
3
Evaluate the options based on therapeutic communication guidelines.
Options involving giving advice or false reassurance are non-therapeutic and should be eliminated.
Therapeutic communication focuses on exploring the client's feelings and promoting autonomous problem-solving.

Key Concept

Nursing Process in Psychosocial Care
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