A new nurse asks the mentor, "How can I be sure I'm developing a therapeutic environ-ment for my unit?" The mentor uses as a basis for the response the fact that a therapeutic milieu is characterized by:
a. Rigid adherence to timelines and unit routine
b. Relaxation of boundaries when doing so is accepted by all
c. The focus of the staff is directed to the most critically disturbed patients
d. Specific patient-centered goals are established mutually by patient and staff
ANS: D
Factors that determine the therapeutic effectiveness of the social environment includes the presence of two-way communication between the patients and the members of the multidis-ciplinary team for purposes of goal setting. In a therapeutic relationship, boundaries are estab-lished early and maintained throughout and although adherence to routine is important, there is room for adjustment when it benefits the therapeutic nature of the milieu. Although short-term attention may require focus on the patient in crisis, attention of the staff is equally shared.
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