A nurse cared for a terminally ill client for over a month and developed a therapeutic nurse-client relationship. After the client's death, feelings of sadness. sleeping poorly, and feeling mildly depressed were experienced by the nurse. Which is the best action to improve the resolution of grief?
The nurse needs to consider taking a leave of absence to pursue healing.
The nurse needs to seek therapy for dysfunctional grief.
The nurse needs to use stress reduction strategies.
The nurse should seek an informal forum for discussing death
The Correct Answer is B
The nurse's feelings of sadness, poor sleep, and mild depression after the death of the terminally ill client indicate that the nurse is experiencing grief, which is a normal reaction to loss. However, if the nurse is finding it difficult to cope with the grief or if the grief is significantly impacting the nurse's daily life and well-being, seeking therapy is the best action.
Option B suggests seeking therapy for dysfunctional grief, which can provide the nurse with professional support and coping strategies to navigate through the grieving process. Therapeutic interventions can help the nurse process the emotions associated with the loss and provide a safe space to express and explore feelings of grief and loss.
Options A, C, and D may be helpful in certain situations, but they may not directly address the nurse's unresolved grief:
A. Taking a leave of absence to pursue healing can be considered if the nurse's grief is severely impacting their ability to function and provide safe patient care. However, it may not be necessary for everyone, and seeking therapy would be a more specific and targeted approach to address the grief.
C. Using stress reduction strategies can be beneficial for managing stress and promoting overall well-being, but it may not directly address the specific grief experienced by the nurse after the client's death.
D. Seeking an informal forum for discussing death can be helpful in processing feelings and emotions related to death and loss. However, it may not provide the level of support and guidance that therapy can offer in resolving grief.
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Correct Answer is C
Explanation
When dealing with a client who is manipulative and disruptive but not demonstrating behaviors that are a threat to self or others, it is essential for the nurse to set clear and consistent boundaries for behavior. This helps establish a therapeutic environment and maintains the safety and well-being of both the client and others in the milieu.
Allowing the client to refuse medications is an important aspect of respecting their autonomy and right to make decisions about their own care, as long as they are not posing a risk to themselves or others. It is important to communicate with the client about the potential consequences of refusing medications and provide information about the benefits of taking prescribed medications to support their mental health.
The other options are not appropriate for the following reasons:
A- Informing the client that a family member will be called to help: Involving family members can be helpful in some situations, but it should not be used as a way to manipulate the client into compliance with treatment. Calling a family member without the client's consent may also violate the client's privacy and autonomy.
B- Preparing discharge paperwork since the client is refusing assistance: Discharging the client solely because they are refusing medication may not be appropriate or ethical if they are not posing a threat to themselves or others. Discharging the client without addressing the underlying issues may not be in the client's best interest and may not resolve the disruptive behavior.
D- Informing the client that without medications, their mental status will not improve: While it is important to provide the client with information about the benefits of medication, using this information as a threat or coercion tactic may not be therapeutic or effective. The nurse should focus on building a trusting relationship with the client and supporting them in making informed decisions about their care.
Correct Answer is D
Explanation
Explanation: This response demonstrates the use of therapeutic communication, specifically offering the client an opportunity to express their feelings and concerns in a non-confrontational manner. By suggesting a private and quiet area to talk to, the nurse provides a safe and supportive environment for the client to explore and process their emotions. This approach can help the client feel heard, validated, and understood, which may reduce their need to act out or engage in argumentative behaviors to express their feelings.
The other responses are not as effective or therapeutic:
A. Threatening the client with seclusion is an aggressive approach and may escalate the client's behavior or cause them to feel cornered and defensive, leading to further acting out.
B. Telling the client they have to take medication to stop their behavior does not address the underlying issues that may be causing their behavior. It can also come across as dismissive of the client's feelings and concerns.
C. Saying "I don't know what set you off today but you have to get along with others" may be perceived as dismissive and does not offer the client an opportunity to express their emotions or address their concerns.
In summary, offering a private space to talk and explore the client's feelings in a non-judgmental and supportive manner is the most beneficial therapeutic response to help the adolescent client decrease acting out behaviors and promote positive communication and coping skills.
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