A nurse is caring for a client who has a new colostomy. The client refuses to participate in her ostomy care, saying, “I’m not touching that thing.” Which of the following actions should the nurse take?
A.
Tell the client that it is safe to touch her ostomy.
B.
Request that someone from the client’s family participate in the care.
C.
Ask the client to explain her feelings.
D.
Explain why her participation is important.
The Correct Answer and Explanation is:
The correct answer is C. Ask the client to explain her feelings.
Explanation:
When a client with a new colostomy refuses to participate in their ostomy care, it’s crucial to address the emotional and psychological aspects of their response. The refusal often stems from anxiety, fear, or a lack of understanding about the ostomy. Here’s why asking the client to explain their feelings is the most appropriate initial action:
- Understanding the Client’s Perspective: By asking the client to explain her feelings, the nurse opens a dialogue that allows the client to express her concerns and fears. This is a vital first step in addressing the root cause of her refusal. It might reveal underlying anxieties such as fear of touching the stoma, concerns about hygiene, or embarrassment.
- Providing Emotional Support: This approach acknowledges and validates the client’s emotions, which can help in building trust and rapport. It allows the nurse to provide targeted emotional support and reassurance tailored to the client’s specific fears.
- Personalized Education: Understanding the client’s specific concerns enables the nurse to provide personalized education and support. For instance, if the client is fearful of infection or pain, the nurse can offer detailed explanations about the safety and cleanliness of the ostomy care process, and what measures are in place to prevent complications.
- Facilitating Gradual Involvement: Once the client’s feelings are understood, the nurse can work collaboratively with the client to gradually increase their involvement in the care process. This might include demonstrating the steps of ostomy care and allowing the client to practice in a safe and supportive environment.
- Respecting Autonomy: Asking about the client’s feelings respects their autonomy and choices. It’s important to approach the situation with sensitivity and not to force participation, but rather to encourage and support the client in becoming more comfortable with their ostomy care.
Overall, by first addressing the emotional and psychological barriers the client faces, the nurse can more effectively facilitate the client’s involvement in their care, which is essential for promoting self-management and long-term well-being.