The client asks the nurse if certain changes can be made in the unit milieu. Which action by the nurse indicates understanding of the nursing role in the therapeutic milieu?
1. The nurse refers the client's requests to the psychiatric social worker.
2. The nurse discusses the desired changes with the client.
3. The nurse refers the client's requests to the psychosocial rehabilitation worker.
4. The nurse instructs the client that no changes can be made.
2
Rationale: The psychiatric–mental health nurse has major responsibility for the milieu; therefore, it is appropriate to discuss requested changes in order to gather information regarding the effectiveness of the milieu. The psychiatric social worker identifies community resources and may perform counseling. It is non-therapeutic to instruct the client that no changes can be made before gathering data in relation to the client's requests. The psychosocial rehabilitation worker teaches day-to-day skills for living and may provide case management services.
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