A man was brought to the emergency room for treatment of minor injuries after an accident in which his life partner, a transvestite, was killed
He refuses care, paces, screams, "Why, why, why!" repeatedly, and scratches at his arms as if trying to tear the flesh. A nurse says, "Geez, he's going to hurt himself. We'd better admit him to psych.". Which explanation for the nurse's response is most likely? a. The nurse's experience tells her that the patient is developing a psychotic reaction to the stress of the accident and death.
b. She is stigmatizing the patient due to his sexuality, dramatic grief response, and connection to a transvestite person.
c. The nurse is unsure how to handle a person presenting in this manner, is anxious as a result, and copes by wanting to shift the patient to another unit.
d. Medical nurses usually have less skill in managing emotional problems, and psychiatric staff are more appropriate to deal with persons who are grieving.
B
The patient's sexuality and romantic involvement with a transvestite person subject him to stigma, even from health care providers who, as professionals, should be self-aware enough to recognize and intercept such inappropriate and nontherapeutic responses. The patient's grief response, unusual from the cultural perspective of many persons, perhaps, also is stigmatizing and as a result is incorrectly attributed to a mental illness. There are no data to suggest that the patient is not in touch with reality; he is simply expressing his acute grief in a dramatic fashion (which may be a culturally-mediated response). The nurse may be anxious, unsure how to help the patient, or believe that medical nurses have less skill in managing emotional problems, but all nurses should be capable of helping patients with both emotional and physical health needs and should consult with other staff if they are not. This nurse's exclamation of "Geez" suggests that the primary issue underlying the response is countertransference related to stigma.
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Fill in the blank(s) with correct word