Jamie, 20 year old female, visits the outpatient healthcare provider for a consultation. As the nurse...

Jamie, 20 year old female, visits the outpatient healthcare provider for a consultation. As the nurse gathers data prior to the healthcare provider appointment, the client reveals that she feels that she has been drinking too much recently, has tried to quit unsuccessfully several times, but is not comfortable abstaining from drinking when she is around her friends who are socially drinking alcohol. She notes that alcohol helps her relax as she is taking college classes and feels very stressed with deadlines and workload in addition to her part-time job. She wants to talk with someone about how to modify her drinking but not give it up altogether.

The nurse responds to this by saying, “I don’t think cutting down on your drinking will help when you have not been able to quit before. Do you really think anything other than totally quitting will work? I have never seen that to be successful in our patients.”

Is the nurse’s communication with the patient appropriate? Why not?

What communication technique (block) did the nurse use?

How should the nurse communicate with this patient? Provide an example of a therapeutic response and name which therapeutic technique you are using.

Jamie tells the nurse that she thinks she can control her drinking if she does not have so much stress. It was her only way to deal with her problems and that going out with her friends caused her to drink too much.

What defense mechanism(s) is Jamie using?

Expert Solution

No, the nurse’s communication with the patient is not at all appropriate. I am saying this because in her statement “I don’t think cutting down on your drinking will help when you have not been able to quit before" she is totally demotivating the patient by highlighting that she was not successful in that in the past and assuming that she would not be able to do it in the future too. Secondly, in her statement "I have never seen that to be successful in our patients”, she is highlighting the fact that quitting alcohol is not the solution to her problem at all and this idea is not successful for her other patients too. The whole information provided by the nurse to the patient is inappropriate and not fully correct. Yes, looking for other options is a good therapeutic response but still, alcohol makes a big deal for any individual and a nursing professional must motivate if someone is trying to quit it rather than asking them for alternative options available.

In my opinion nurse's statement " Do you really think anything other than totally quitting will work? " indicates that she is trying to encourage comparison through her communication so as to make the client recall past coping strategies that could be effective in their condition.

After looking at the situation of this patient, I think the nurse should be more open, encourage the description of the perception, motivating, focused on the core problem and encourage the patient to held herself accountable for her own actions and not putting them onto her friends and try to help her to come up with mutual solutions.

She can probably say something like," I completely follow what you just said and really appreciate your will to modify your drinking habit. Have you thought of something else that could probably release your stress? I would also like to know what do you think might be the reason for not successfully quiting alcohal on the previous attempts so that we can make a better plan for you this time."

In this statement, I have used "acceptance" and "appreciation" in the first part. In the second part of the statement I have tried to "formulate a plan of action" by taking her intakes which is also know as "reflecting" In the last part I have tried to "offer-self" and tried to "focus" on her past habits.

Through this statement, Jamie is using "Rationalization" as her defense mechanism since he using her workload stress and friends as an excuse to justify her behavior.

Nightingale answered 2 years ago

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