A schizophrenic client states, “I hear the voice of King Tut.” Which response by the nurse would be most therapeutic?
A. “I don’t hear the voice, but I know you hear what sounds like a voice.”
B. “You shouldn’t focus on that voice.”
C. “Don’t worry about the voice as long as it doesn’t belong to anyone real.”
D. “King Tut has been dead for years.”
Correct Answer: A. “I don’t hear the voice, but I know you hear what sounds like a voice.”
This response states reality about the client’s hallucination. Voicing doubt can be a gentler way to call attention to the incorrect or delusional ideas and perceptions of patients. By expressing doubt, nurses can force patients to examine their assumptions.
Option B: Sometimes during a conversation, patients mention something particularly important. When this happens, nurses can focus on their statement, prompting patients to discuss it further. Patients don’t always have an objective perspective on what is relevant to their case; as impartial observers, nurses can more easily pick out the topics to focus on.
Option C: For patients experiencing sensory issues or hallucinations, it can be helpful to ask about them in an encouraging, non-judgmental way. Phrases like “What do you hear now?” or “What does that look like to you?” give patients a prompt to explain what they’re perceiving without casting their perceptions in a negative light.
Option D: The other options are judgmental, flippant, or dismissive. Similar to active listening, asking patients for clarification when they say something confusing or ambiguous is important. Saying something like “I’m not sure I understand. Can you explain it to me?” helps nurses ensure they understand what’s actually being said and can help patients process their ideas more thoroughly.