Which remark by a patient indicates passage from the orientation phase to the working phase of a nurse-patient relationship?
a. "I don't have any problems."
b. "It is so difficult for me to talk about my problems."
c. "I don't know how talking about things twice a week can help."
d. "I want to find a way to deal with my anger without becoming violent."
ANS: D
Thinking about a more constructive approach to dealing with anger indicates a readiness to make a behavioral change. Behavioral change is associated with the working phase of the relationship. Denial is often seen in the orientation phase. It is common early in the relationship, before rapport and trust are firmly established, for a patient to express difficulty in talking about problems. Stating skepticism about the effectiveness of the nurse-patient relationship is more typically a reaction during the orientation phase.
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