A nurse is caring for a group of clients on a mental health unit. Which of the following actions should the nurse implement to establish therapeutic relationships with the clients?

Choice A Reason:

Making an evaluation about the patient's problem is incorrect. Making an evaluation may involve the nurse imposing their judgment on the patient's situation, which can hinder effective communication.

Choice B Reason:

Restating the main feelings or thoughts the patient has expressed is correct. Restating the main feelings or thoughts the patient has expressed is a therapeutic communication technique known as paraphrasing. This technique demonstrates active listening and shows the patient that the nurse is paying attention to their concerns. It allows the nurse to reflect back to the patient what has been said, confirming understanding and encouraging further communication.

Choice C Reason:

Saying "I understand what you're saying" is incorrect. While expressing understanding is important, simply stating "I understand" might be perceived as superficial if not accompanied by concrete examples or restatement of the patient's expressed thoughts and feelings.

Choice D Reason:

Offering a leading question such as "And then what happened?", is incorrect. Asking a leading question can be perceived as directive and may steer the conversation in a particular direction. It might not convey the same level of active listening as restating the patient's own words and feelings.

Choice A Reason:

To provide support for the patient is not appropriate. While providing support is important in therapeutic communication, the nurse's statement is more focused on bringing attention to an inconsistency rather than offering direct emotional support.

Choice B Reason:

To redirect the patient to an important idea is not appropriate. The nurse's statement is not aimed at redirecting the patient to a specific idea. Instead, it's about highlighting a potential incongruence between the patient's verbal and nonverbal expressions.

Choice C Reason:

To provide a suggestion for coping strategies is not appropriate. The nurse's statement is not directly offering suggestions for coping strategies. It is more focused on helping the patient recognize and explore the discrepancy in their expressed emotions.

Choice D Reasons:

To bring inconsistencies into awareness is appropriate. This therapeutic communication technique is aimed at helping the patient recognize and explore any inconsistencies between their verbal and nonverbal expressions. By pointing out the discrepancy between the patient's statement of feeling sad and the observed behavior of smiling, the nurse encourages the patient to reflect on and explore their emotions more deeply. This can contribute to increased self-awareness and a better understanding of the patient's emotional state.