Question

2. During the first 4 days of hospitalization, Eric, age 18 months, cried inconsolably when his parents left him, and he refused the staff's attention. Now the nurse observes that Eric appears to be "settled in" and unconcerned about seeing his parents. The nurse should interpret this as which statement?

a. He has successfully adjusted to the hospital environment.
b. He has transferred his trust to the nursing staff.
c. He may be experiencing detachment, which is the third stage of separation anxiety.
d. Because he is "at home" in the hospital now, seeing his mother frequently will only start the cycle again.

Answer 1

Eric's behavior of appearing settled and unconcerned about seeing his parents after initial distress may suggest detachment, which is a defense mechanism during the third stage of separation anxiety. This indicates an avoidant attachment style, rather than having adjusted to the hospital or transferred trust to the staff.

Step-by-step explanation:

When considering the behaviors of Eric, an 18-month-old hospitalized child, it appears that he may be experiencing detachment, which is the third stage of separation anxiety. Initially, Eric exhibited signs of distress when his parents left and resisted the staff's attention, a normal reaction during the early phases of hospitalization for many children. The nurse's observation of Eric now appearing settled and unconcerned about seeing his parents does not necessarily mean he has adjusted or transferred trust to the staff. Instead, this behavior suggests a defense mechanism that occurs after prolonged separation, where a child may withdraw emotionally to cope with the stress of the separation.

Understanding attachment theory, including the work done by Ainsworth and Bowlby, is essential in this context. A securely attached child would typically be distressed during separation but relieved upon reunion. Eric's lack of concern may indicate an avoidant attachment style, which could be a response to the hospital environment and the interruptions to his normal caregiving routine. Responsive and sensitive caregiving is critical in helping children develop trust and view the world as a safe place, as discussed by Erikson.