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Giving premature advice
- Assumes the nurse knows best and the pt can't think for self. Inhibits problem solving and foster dependency.
- EX: "get out of this situation immediately."
- Encouraging problem solving: "what are the pros and cons of ur situation?", "what were some of the actions u though u might take?", "what are some of the ways you might though to meet ur goals?"
- Indicates that the nurse is unable to understand or emphasize w the pt. Here the pt's feelings and experiences are being belittled, which can cause the pt to feel small or insignificant.
- EX: pt "I wish I were dead." Nurse "Everyone gets down on the dumb""I know what u mean.", "you should feel happy u r getting better.", "things get worse before they get better."
- Empathizing and exploring: "you must be feeling very upset. Are you thinking of hurting yourself?"
- Underrates a person's feelings a belittles a person's concerns.
- May cause the patient to stop sharing feelings if (s)he feels to be ridiculed or not taken seriously.
- EX: "I wouldn't worry abt that", "everything will be alright", "you will do just fine, u'll see"
- Clarifying the pt's msg: "what specifically r u worried abt?", "What do u think could go wrong?","what r u concerned might happen?"
Making value judgments
- Prevents probs solving. Can make the pt feel guilty, angry, misunderstood, not supported, or anxious to leave.
- EX: "how come u still smoke when ur wife has cancer?"
- Making observations: "I notice u r still smoking even though ur wife has lung cancer. Is this a prob?"
Ask "why" questions
- implies criticism; often has the effect of making the pt feel defensive.
- EX: Why did u stop taking ur meds?"
- Asking open-ended questions;giving a broad opening: "tell me some of the reasons that led up to ur not taking ur medications"
Give approval, agreeing
- Implies the pt is doing the right the same height, either B sitting or thing- and that not doing it was wrong.
- May lead the pt to focus on pleasing the nurse or clinician;denies the pt the opportunity to change his or her mind or decision.
- EX: "I'm proud of u for applying for that job" "I agree w ur decision"
- Making observation: "I noticed that u applied for that job. What factors will lead up to ur changing ur mind?"
- Asking open-ended questions; giving a broad opening: "what led to that decision?"
- Can make a person defensive.
- EX: "u really should have shown up for the medication group" "I disagree w that"
- Exploring: "what was going through ur mind when u decided not to come to ur medication group?"
- "that's one point of view. How did u arrive at that conclusion?"
Changing the subject
- May invalidate the pt's feelings and needs.
- Can leave the pt feeling alienated and isolated and increase feelings of hopelessness.
- EX: pt "I'd like to die" N "did u go to AA like we discussed?"
- Validating and exploring: "this sounds serious. have u thought of harming urself?"