Ms. Manche is asked to join a patient discussion group and says she has nothing to say. How should the practical nurse respond?

Ms. Manche is asked to join a patient discussion group and says she has nothing to say. How should the practical nurse respond?

• A. You must go to the group, but you don't have to talk.
• B. Perhaps you could participate by talking about your grandchildren.
• C. You feel you have nothing to say?
• D. The group will be very therapeutic for you.

Answer: (C)

Therapeutic communication through reflective listening is being tested here. A nurse who acknowledges what the patient is feeling and invites them to share more uses an open, non-threatening approach that encourages participation. Saying, “You feel you have nothing to say?” validates the patient’s experience, preserves autonomy, and invites exploration of any hesitations or barriers. It opens the door for the patient to express fears, privacy concerns, or uncertainty about the group’s purpose, so the nurse can respond with support or information. Other options push in ways that aren’t as helpful: telling the patient she must participate but doesn’t have to speak feels coercive and dismissive. Suggesting a topic like grandchildren shifts the focus away from the patient’s current feelings and can seem patronizing. Claiming the group will be therapeutic imposes an expectation that may not align with the patient’s immediate needs or feelings.

Therapeutic communication through reflective listening is being tested here. A nurse who acknowledges what the patient is feeling and invites them to share more uses an open, non-threatening approach that encourages participation. Saying, “You feel you have nothing to say?” validates the patient’s experience, preserves autonomy, and invites exploration of any hesitations or barriers. It opens the door for the patient to express fears, privacy concerns, or uncertainty about the group’s purpose, so the nurse can respond with support or information.

Other options push in ways that aren’t as helpful: telling the patient she must participate but doesn’t have to speak feels coercive and dismissive. Suggesting a topic like grandchildren shifts the focus away from the patient’s current feelings and can seem patronizing. Claiming the group will be therapeutic imposes an expectation that may not align with the patient’s immediate needs or feelings.