The nurse observes a client pacing in the hall. Which statement by the nurse may help the client recognize his anxiety?
A. “I guess you’re worried about something, aren’t you?
B. “Can I get you some medication to help calm you?”
C. “Have you been pacing for a long time?”
D. “I notice that you’re pacing. How are you feeling?”
Correct Answer: D. “I notice that you’re pacing. How are you feeling?”
By acknowledging the observed behavior and asking the client to express his feelings the nurse can best assist the client to become aware of his anxiety. Recognition acknowledges a patient’s behavior and highlights it without giving an overt compliment. A compliment can sometimes be taken as condescending, especially when it concerns a routine task like making the bed. However, saying something like “I noticed you took all of your medications” draws attention to the action and encourages it without requiring a compliment.
Option A: The nurse is offering an interpretation that may or may not be accurate; the nurse is also asking a question that may be answered by a “yes” or “no” response, which is not therapeutic. Therapeutic communication is often most effective when patients direct the flow of conversation and decide what to talk about. To that end, giving patients a broad opening such as “What’s on your mind today?” or “What would you like to talk about?” can be a good way to allow patients an opportunity to discuss what’s on their mind.
Option B: The nurse is intervening before accurately assessing the problem. By using nonverbal and verbal cues such as nodding and saying “I see,” nurses can encourage patients to continue talking. Active listening involves showing interest in what patients have to say, acknowledging that you’re listening and understanding, and engaging with them throughout the conversation. Nurses can offer general leads such as “What happened next?” to guide the conversation or propel it forward.
Option C: This statement encourages a “yes” or “no” response, avoids focusing on the client’s anxiety, which is the reason for his pacing. Observations about the appearance, demeanor, or behavior of patients can help draw attention to areas that might pose a problem for them. Observing that they look tired may prompt patients to explain why they haven’t been getting much sleep lately; making an observation that they haven’t been eating much may lead to the discovery of a new symptom.