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Difficulty: MediumGrief and Loss

A nurse is caring for a client whose spouse died unexpectedly 3 days ago. The client is pacing the room, crying, and states, 'I do not know how I am going to survive without him. Everything is ruined, and it is my fault for not making him go to the hospital sooner.' Which of the following is the most therapeutic response by the nurse?

  1. You are feeling completely overwhelmed and carrying a heavy burden of blame right now.Answer
  2. B
    You must not blame yourself; there was nothing you could have done to prevent this.
  3. C
    Why do you believe you are responsible for a medical emergency that was out of your control?
  4. D
    It is completely normal to feel this way right now, but I promise that time will heal this pain.

Answer

The response that reflects and validates the client's feelings of being overwhelmed and carrying a burden of blame.
The correct response utilizes the therapeutic techniques of reflection and empathy. By restating the client's feelings of being overwhelmed and taking on blame, the nurse validates the client's emotional experience. This supportive approach does not judge the client or attempt to prematurely 'fix' an unfixable situation, thereby encouraging the client to continue expressing their feelings safely.

Step-by-Step Solution

1
Analyze the client's behavior and statement.
The client is in the acute stage of grief, expressing profound helplessness, anxiety (manifested by pacing), and unwarranted guilt over the unexpected loss.
Identifying the client's current emotional state is necessary to select an appropriate therapeutic communication technique.
2
Evaluate the nursing responses based on therapeutic communication principles.
The correct response uses reflection and empathy to validate the client's feelings. The other responses use non-therapeutic blocks such as false reassurance, asking 'why' questions, and relying on clichés.
Therapeutic communication should focus on the client's feelings and encourage emotional expression without judging, minimizing, or prematurely attempting to 'fix' the grief.

Key Concept

Therapeutic Communication in Acute Grief
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Topics

Grief and Loss

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