The activity room is severely damaged while the nurse is addressing an emergency on the inpatient unit. Which communication by the nurse to the entire milieu would be the most therapeutic when the destruction is first discovered?
a. "This room is off-limits for 2 weeks. I am struggling with this intolerable behavior and sorely disappointed in everyone involved.".
b. "This behavior is representative of a real problem with the unit's milieu. Let's discuss it as you all help put the room back in its original order.".
c. "People must be really angry. Everyone who was involved must help undo the damage immediately and then discuss the reasons for the behavior.".
d. "It seems that there is a great deal of negative feelings in this group today. We need to share feelings regarding the problem while we all clean up the room.".
D
Physically destructive behavior is a response that is derived from an unspoken anger or fear. The most therapeutic communication for the situation is the one that validates and supports the underlying feeling but sets limits on the maladaptive action taken. The nurse's task is to help the destructive patients learn more adaptive ways to deal with anger, such as verbalization. Disparagement reflects the nurse's anger, and humiliation is aggressive to patients and nontherapeutic. Enlisting everyone to help clean up is the most therapeutic option, because it promotes cohesion and may encourage patients who did not do the damage to speak up and voice their anger at the offenders for spoiling their activity room. Peer input is always very effective.
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