'No, not me' reaction of the patient is seen in which stage of death (Terminal Patients)?

Appeared in: AIIMS Bhopal NO - 2018 (Shift-1st)

Explanation

The statement 'No, not me' is a hallmark of the Denial stage, the first stage in the Kübler-Ross model of grief.
In this stage, the individual uses denial as a defense mechanism to cope with the initial shock of a terminal diagnosis.
The person refuses to believe the facts, often seeking other opinions or believing a mistake has been made.
This stage acts as a buffer, allowing the person time to gradually absorb the difficult news.

Option A: Anger is the second stage, characterized by frustration, resentment, and questioning 'Why me?'. It follows the initial denial as the reality of the situation begins to set in.
Option C: Acceptance is the final stage of grief. In this stage, the patient is no longer angry or in denial and has come to terms with their impending death, often feeling a sense of calm.
Option D: Bargaining is the third stage, where the individual tries to negotiate with a higher power or with doctors to postpone death in exchange for something.

Clinical Relevance

Nursing practice connection: Use the key finding related to Kübler-Ross stages of grief and dying to guide bedside assessment, documentation, and the next nursing action.
Understanding the stages of grief helps nurses provide empathetic and appropriate psychosocial support to terminally ill patients and their families.
Nurses should not force a patient out of a stage but rather provide a safe environment for them to express their feelings, whether it's denial, anger, or sadness.
Therapeutic communication is key. For a patient in denial, instead of confronting them, the nurse can use open-ended questions like, 'Tell me more about how you are feeling,' to encourage expression.

How to Approach the Question

First, identify the key phrase in the question: 'No, not me'.
Recognize that this question is asking about a specific psychological reaction to terminal illness.
Recall the Kübler-Ross model of the five stages of grief: Denial, Anger, Bargaining, Depression, and Acceptance (mnemonic: DABDA).
Match the phrase 'No, not me' to the definition of each stage.
The phrase is a clear expression of disbelief and refusal to accept reality, which is the definition of the Denial stage.
Select the option corresponding to Denial.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 p. 102-104

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 2667-2669

E6 Nursing Fundamentals Taylor p. 949-951

Practise the full AIIMS Bhopal NO - 2018 (Shift-1st)

Attempt every question from this paper in a timed mock, then review the full solution for each one.