A woman who is a victim of severe emotional violence tells the nurse that her husband abuses her most often when he is intoxicated, just as his father had beaten him and his mother

Question

The woman is aware of the location of a safe house and has considered leaving home with her two children, but she cites being brought up to believe "you keep quiet and stay together, no matter what happens.". She states the husband is always apologetic and remorseful after an incident. The nurse responds, "You cannot live like this; you have to defend yourself and your children.". Which statement most accurately describes the nurse's response? a. It is an honest and direct response that will help build trust and rapport.
b. It suggests that the nurse herself has been a victim of physical abuse.
c. It is unprofessional, but it will likely help by motivating the patient.
d. It is a human but unprofessional response and is not helpful.

Answer 1

D
It can be difficult to maintain objectivity when facing stories of abuse; anger and frustration are common and understandable responses. However, the nurse, as a professional, is expected to maintain objectivity and respond therapeutically. In this instance, the response reflects countertransference and is not helpful to the patient, who likely already wishes she could live differently and defend herself and her family (but who lacks the knowledge, confidence, or resources to do so). This response does not necessarily indicate that the nurse herself is a victim of abuse. Although it may be an honest, direct response, it reflects the nurse's beliefs, is insensitive to the patient's position or needs, will not build trust or rapport, and will not motivate the patient. It may in fact add to the patient's guilt and helplessness.