can anyone help

[misty177]

which would you choose.... a girl goes into a clinic after being sexually assaulted and states " i should have fought back and this wouldnt have happened to me". the nurses INITIAL response would be

1. you know self defense techniques

2. i need to get a detailed description of what happened

3. would you like me to send you to the clinic clergy

4. it seems what you did kept you from any further harm

[GingerSue]

4 because you're acknowledging what she's just said

[misty177]

it wouldnt be considered a nurses opinion??????

[GingerSue]

instead of interpreting #4 as an opinion, hear it as an observation that

finds success in this patient's actions (instead of scolding herself for not fighting back - because actually that might have made things worse, and the perpetrator might have killed her)

[NurseCard, ADN]

I'm going to say 2. It seems like a little insensitive, but I'm thinking that at that moment, finding out what happened, gathering evidence, all of that, is the most important thing right then.

[misty177]

thank you for your input.

[NurseCard, ADN]

To me, answer 4 doesn't make enough sense. She DID suffer "more harm". I don't know, I can see acknowledging the patient's feelings or verbalizing them or whatever, but that doesn't seem like something I would say. I might have said "You are feeling like this is partly your fault; like you could have prevented it" or something like that. To make the statement in 4; it's just a false statement to me. She DID suffer harm. Maybe she COULD have fought back, maybe not. She's not in the wrong because she didn't fight back.

I'm probably not making any sense... but in 4, she's not verbalizing the pt's feelings; she's just making a statement that has no basis in reality.

[misty177]

that makes sense......i wish there was a way for me to find the real answer:bugeyes:

[PeteyPie]

which would you choose.... a girl goes into a clinic after being sexually assaulted and states " i should have fought back and this wouldnt have happened to me". the nurses INITIAL response would be

1. you know self defense techniques

2. i need to get a detailed description of what happened

3. would you like me to send you to the clinic clergy

4. it seems what you did kept you from any further harm

I had a lot of trouble with the therapeutic nursing communication for a while, until a classmate explained an easier way to answer these questions. First, reword the question to, "What initial therapeutic response would a nurse say to a victim of sexually assault?"

1. "You know self defense techniques." This response implies the nurse is making a decision for the patient. With therapeutic communication, the nurse is supposed to be focusing on the patient, and the patients feelings. So this one is OUT.

2. "I need to get a detailed description of what happened." Again, doesn't focus on the patient or the patient's feelings, so its OUT.

3. "Would you like me to send you to the clinic clergy." This is a favorite type of wrong answer on NCLEX questions. The answer is almost never, "have someone else do it." I always throw these out immediately, along with, "Can I call a family member for you?" and "Call the physician." 95% of the time, they are wrong.

4. "It seems what you did kept you from further harm." This is the best answer, although it's missing the patients feelings, it is a response centered around the patient, that doesn't imply a judgment.

[misty177]

wow that was great. thank you for the time spent in explaining that. very helpful.:nuke:

[RN4NICU, LPN, LVN]

To me, answer 4 doesn't make enough sense. She DID suffer "more harm". I don't know, I can see acknowledging the patient's feelings or verbalizing them or whatever, but that doesn't seem like something I would say. I might have said "You are feeling like this is partly your fault; like you could have prevented it" or something like that. To make the statement in 4; it's just a false statement to me. She DID suffer harm. Maybe she COULD have fought back, maybe not. She's not in the wrong because she didn't fight back.

I'm probably not making any sense... but in 4, she's not verbalizing the pt's feelings; she's just making a statement that has no basis in reality.

I disagree. She did not suffer MORE harm. She suffered the harm she suffered. The action (or lack thereof) that she took resulted in her not being incapacitated or killed (THAT would be more harm). Statement 4 does not imply that she is in the wrong because she did not fight back. It acknowledges her statement and tells her that, basically, she did the best she could at the time.

I agree with PeteyPie's analysis

#1 doesnt make any sense - it tells the patient that she knows self defense...what does that mean? She should have used it? Doesn't seem helpful.

#2 - totally blows the patient off - way too insensitive to be correct.

#3 - calling someone else might be appropriate for later, but acknowledging her feelings is an appropriate initial response

[core34]

You always acknowledge patients who undergo trauma, that what they did in the situation was the best thing to do. They may have suffered physical/emotional injury, but being able to live through it is the ultimate victory. If you confer that there were better alternatives, patient's will have to deal with added guilt and remorse. Ultimately, any outcome is unpredicatable and if they are safe now, then they did the right thing.