Plz plz help to this case study

[augie7783]

Mr. Washington is a seventy-seven year old man with metastatic carcinoma. He has been in and out of the hospital for three months. Discharged three times during that period, he has always been readmitted within a week of discharge. The last time he was discharged, he was home for only two days. His wife is the primary caregiver and states that she needs him. This hospital admission is to help regulate his pain with medication.

During your assessment, he states that he is not a Christian. He was brought up in the church and he went on Sundays, but he can't go running to God for answers.

How will you deal with this situation as a nurse from an ethical or christian perspective??

Plz someone help coz i do not even know where to start

[donsterRN, ASN, BSN]

Have you done anything so far? Any research?

I would start with assessing his spiritual needs (once his physiological ones have been attended to), and proceeding from there. Perhaps involve his wife with that conversation.

I'm not sure what is meant by "How will you deal with this situation as a nurse from an ethical or christian perspective??"

[augie7783]

AS in how to explore his feelings futher. Like sample questions because i think this client is hopeless. Also how i can boost his morals and at the same time gather more info on how he feels.

[TakeTwoAspirin, MSN, RN, APRN]

You need to be careful with your wording. I know you are only talking to us, but using phrases like "hopeless" may project a judgmental attitude - whether you are actually judging the patient or not.

Also, be careful not to confuse the terms religion and spiritual. There are people who do not practice a religion per se, but would consider themselves to be spiritual. Look up the definition of these and make sure you are clear on the distinction.

Ethically, however he feels about religion, spirituality, or whatever, you should treat him no differently than any other patient! There should be no ethical conflict that you deal with as a nurse with regard to his religious beliefs.

[donsterRN, ASN, BSN]

I think that anytime you want to further explore someone's feelings, you have to use meticulous communication techniques. Asking open ended questions, clarifying, reflection... all of that will help the patient to express what he's feeling and allow you to have a purposeful and meaningful conversation.

The previous poster has an excellent point about being nonjudgmental, and also about the differences between religion and spirituality.

Good luck!

[Daytonite, BSN, RN]

Well, since you highlighted the part about the patient's religion and ethics regarding it, I guess that is what you are having trouble with? We nurses are supposed to be non-judgmental. He obviously doesn't want anything to do with God or religion, so I wouldn't even address it on the care plan. That would be like shoving religion down his throat and we can't do that. If you feel that part of the care plan should include coping with the cancer, there are other "ethical" ways to do that--cancer support groups, etc.

As to the case study itself, it seems like pain is the main symptom the patient has and so that should be addressed. There are also coping issues with the patient's primary caregiver, the wife, that need to be addressed.