The family of an older patient recently diagnosed with cancer reports that the patient seems to be in denial, refusing to choose treatments and planning an extended vacation. What response by the nurse is best?
a. Ask the patient how he or she feels about the diagnosis.
b. Tell the patient treatment started early has the best results.
c. Refer the patient to a licensed mental health professional.
d. Tell the family that the patient will get over it in his own time.
A
This patient may be experiencing a compensatory form of grief and not allowing him- or herself to ponder the enormity of the situation at one time. Rather, the patient may be allowing bits of information to seep into his or her existence slowly in order to make sense of it. This is adaptive and the nurse should ask the patient how he or she feels about the cancer. Telling the patient that treatment must start early may be too harsh and the patient may not be ready to make decisions. The patient probably does not need a mental health professional; rather the patient should be left to come to terms with this diagnosis on her or his own terms. Using phrases like "get over it" are judgmental and imply the patient is doing something wrong.
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