The patient shouts at the nurse, "No one answered my call bell all night!" Which response should the nurse use with this patient to restore therapeutic communication?
a. "Shouting is going to disturb other pa-tients.".
b. "I see how that would make you very an-gry.".
c. "Are you sure the nurses were avoiding you?"
d. "The unit has many very sick patients right now.".
B
Regardless of whether the nurses answered the patient's call bell during the night, the patient felt ignored. By empathizing with the patient's distress and reflecting feelings, the nurse displays re-spect and understanding of his or her experience. Reprimanding the patient is humiliating and conveys the nurse's lack of regard for the patient's feelings. Quieting the patient is achievable by displaying empathy, caring, respect, and willingness to hear his or her complaints. Questioning the patient's perception is demeaning and forces the patient to justify feelings, similar to asking a "why" question. Stating that the unit has very sick patients implies that the patient is not as im-portant as the others are, potentially leads to patient feelings of guilt and shame, and is likely to impair therapeutic communication for making an issue of a lack of attention.
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