Which term describes the behavior where a patient demeans one nurse as lazy while praising another?

Which term describes the behavior where a patient demeans one nurse as lazy while praising another?

• A. Narcissistic behaviour
• B. Splitting behaviour
• C. Dependent behaviour
• D. Schizoid behaviour

Answer: (B)

Splitting is a defense mechanism in which a person perceives others in all-or-nothing terms, flipping between seeing people as entirely good or entirely bad. When a patient demeans one nurse as lazy while praising another, that immediate shift illustrates splitting: the patient divides staff into two camps and assigns extreme judgments to each, with little room for nuance. This helps the patient manage anxiety and fear of abandonment by keeping relationships predictable, but it disrupts consistent care and teamwork. In practice, respond with steady, nonreactive communication and maintain consistent care across all staff. Avoid getting drawn into the patient’s shifting views, set clear boundaries, and work with the care team to present a united, fair approach. Acknowledge the patient’s feelings but avoid reinforcing the black-and-white thinking, and document incidents to monitor patterns and guide a collaborative care plan. The other terms don’t fit as well: narcissistic behaviour focuses on self-importance and admiration, not the pattern of alternating positive and negative evaluations of different staff; dependent behaviour centers on clinginess and needing reassurance; schizoid behaviour involves social withdrawal and detachment.

Splitting is a defense mechanism in which a person perceives others in all-or-nothing terms, flipping between seeing people as entirely good or entirely bad. When a patient demeans one nurse as lazy while praising another, that immediate shift illustrates splitting: the patient divides staff into two camps and assigns extreme judgments to each, with little room for nuance. This helps the patient manage anxiety and fear of abandonment by keeping relationships predictable, but it disrupts consistent care and teamwork.

In practice, respond with steady, nonreactive communication and maintain consistent care across all staff. Avoid getting drawn into the patient’s shifting views, set clear boundaries, and work with the care team to present a united, fair approach. Acknowledge the patient’s feelings but avoid reinforcing the black-and-white thinking, and document incidents to monitor patterns and guide a collaborative care plan.

The other terms don’t fit as well: narcissistic behaviour focuses on self-importance and admiration, not the pattern of alternating positive and negative evaluations of different staff; dependent behaviour centers on clinginess and needing reassurance; schizoid behaviour involves social withdrawal and detachment.