A patient with schizophrenia tells the nurse "I don't know,it's just all the same.You never know.It comes,it goes,it blows away.Get it?" The best response for the nurse to make would be:

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When a patient's speech is loosely associated,confused,and disorganized,it is important to inform that patient that you have not understood what he has said.This provides the patient with an opportunity to clarify and be assured that the nurse has understood him and will respond appropriately.Stating,"You are not making sense" places all responsibility for communication on the patient and suggests that the nurse believes the patient is defective;this would likely frustrate and distress the patient and reduce his self-esteem.Pretending to understand is nontherapeutic because it gives the patient the false impression that he is communicating effectively.Asking him to organize his thoughts is asking him to do something that is very difficult for him to do;his cognitive impairment is persistent and broad,not momentary or limited.

A Patient with Schizophrenia Tells the Nurse "I Don't Know,it's