When a client expresses fear by shouting about someone watching, what should the nurse's best response include?

The most effective response in this scenario is to ask, "Who are 'they'?" This approach is beneficial because it acknowledges the client’s feelings and allows for further exploration of their experience. When a client expresses fear, particularly in a context that suggests paranoia or hallucinations, drawing out more information encourages them to articulate their thoughts and feelings. This can help establish trust between the nurse and the client, and it also allows the nurse to assess the depth and nature of the client's concerns further.

By asking for clarification, the nurse can gain insight into the client's perception of reality, which is essential for determining the appropriate interventions. This response respects the client’s experience and engages them in a dialogue, which is an essential aspect of psychiatric nursing that promotes therapeutic communication.

Other responses, while well-intentioned, may not address the client's immediate emotional state or provide the necessary support. Dismissing the client's fear as unfounded or changing the subject can lead to feelings of invalidation, potentially exacerbating their anxiety. Simply instructing them to calm down may also come off as dismissive and may not facilitate a productive conversation about their fears. Therefore, inviting the client to share who is causing their fear enables a more supportive and understanding dialogue.