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Difficulty: MediumTherapeutic Communication

A nurse is admitting a young adult client who sustained a severe, permanent spinal cord injury three days ago. While staring at the ceiling, the client says to the nurse, "I don't know why the paramedics even bothered to save me. Being paralyzed is worse than being dead." Which of the following is the most therapeutic response by the nurse?

  1. It sounds like you are experiencing a profound sense of hopelessness regarding your future.Answer
  2. B
    It is completely normal to feel this way now, but many people with this injury go on to live fulfilling lives.
  3. C
    Why do you feel that being paralyzed is worse than not surviving the accident?
  4. D
    You survived a terrible accident, and you should focus your energy on the rehabilitation process ahead.

Answer

The most therapeutic response is the one that reflects the client's feelings, stating that it sounds like they are experiencing a profound sense of hopelessness regarding their future.
The correct response utilizes the therapeutic communication technique of reflecting feelings. By stating that the client sounds hopeless, the nurse accurately identifies the underlying emotion without judgment, validates the client's distress, and leaves the door open for the client to elaborate on their feelings. This builds trust and facilitates the grieving process.

Step-by-Step Solution

1
Analyze the client's statement to determine the underlying emotion.
The client is expressing deep despair, grief, and a feeling that life is no longer worth living due to the recent paralysis.
Understanding the core emotion is necessary to select a response that directly addresses the client's psychosocial needs.
2
Evaluate the provided nursing responses for therapeutic communication techniques.
The statement reflecting hopelessness uses 'reflection of feelings', a proven therapeutic technique.
Therapeutic communication should validate emotions, show empathy, and encourage further expression without judgment or unwanted advice.
3
Identify and eliminate non-therapeutic barriers in the remaining options.
Options containing false reassurance, probing 'why' questions, and unsolicited advice are eliminated.
These techniques block open communication, invalidate the client's experience, and put the client on the defensive.

Key Concept

Therapeutic Communication
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Topics

Therapeutic Communication

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