Psychiatric Medications Q 34
The nursing assistant tells nurse Ronald that the client is not in the dining room for lunch. Nurse Ronald would direct the nursing assistant to do which of the following?
A. Tell the client he’ll need to wait until supper to eat if he misses lunch.
B. Invite the client to lunch and accompany him to the dining room.
C. Inform the client that he has 10 minutes to get to the dining room for lunch.
D. Take the client a lunch tray and let the client eat in his room.
Correct Answer: B. Invite the client to lunch and accompany him to the dining room.
The nurse instructs the nursing assistant to invite the client to lunch & accompany him to the dining room to decrease manipulation, secondary gain, dependency and reinforcement of negative behavior while maintaining the client’s worth. Staff working with manipulative patients are best prepared when they establish firm rules that are rigidly interpreted and consistently enforced among all members of the health care team. Frequent discussions regarding the patient’s progress can help reduce staff frustration and isolation and minimize the patient’s attempts at staff splitting.
Option A: Discussing realistic expectations of time and resources available with the patient is of paramount importance. This establishes boundaries and forms a solid foundation on which to build future rapport. The patient will learn that you can be trusted because you will practice with integrity. By putting forth realistic expectations, you can mitigate many manipulative behaviors exhibited in the healthcare setting.
Option C: One of the best ways to become accountable for exemplary care is to advocate for the patient’s autonomy. Giving the patient choices regarding his or her care restores a sense of control that is imperative to feeling secure. Many times the lack of a routine or schedule prompts a patient to allege that the nurse is neglectful. Formulating a schedule and faithfully notifying the manipulative patient of changes will demonstrate that you believe he or she is worthy of your time and efforts.
Option D: There are many specific interventions that may be put into place by an interdisciplinary team caring for a patient who exhibits manipulative behavior. For example, designating one caregiver to be the patient’s contact will result in more consistent care. Having two staff members present for all patient interactions will ensure that any claims of misconduct can be evaluated for validity by multiple healthcare professionals.