how would you respond to this question

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I got a scenario which i need help with:

Mrs J has a stroke and her right-side is paralysis. The doctor said her full recovery is a low chance, but Mrs J is very eager to recover and exercises regularly.

She asked a nurse "Will my right sided recovers like before?"

how would you respond to this question

This is a really complex question. i really don't know how to answer to this question. Should i answer the question directly or tangentially?

If i've answered "No you will not gain full recover like before" therefore I think i would affect the patient's mood to become depress. But if i answered with a "maybe" then i haven't truly answer the question.

Could you please help me with this scenario how can i came about this.

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Specializes in NICU, Psych, Education.

Would it be possible to truthfully answer her question by saying that she won't recover? It sounds like her doctor can't even offer that, since he has simply told her that recovery is "low chance."

Since you can't directly look into the future and give her an answer, what can you do? Think about the principles of active listening and therapeutic communication. What emotions are coming across when the patient asks about her future? How could you best open up dialogue and allow the patient to express her concerns?

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Specializes in Nursing Home ,Dementia Care,Neurology..

I can tell you that many stroke patients become depressed because they are told that they will recover fully and do not!It is better to try and explain,very simply ,that probably she will nor regain full use of that side but that ,with work and exercise she will regain some of it.If she is eager to exercise then that shows determination to recover but it takes a long time so false hopes of a full recovery do not help.

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Specializes in MPCU.

Nothing is wrong with encouraging her. You can point to the realistic possible progress. With hard work many people are able to walk again. Just to state the obvious, most if not all recovery happens within six months. Redirecting her to the positive improvements made will help. If she asks a direct question as you stated in the original post, you must tell her that it is not likely that "everything will be just as it was before the stroke." I've had patients ask similiar questions and when I answered truthfully, they (in one way or another) told me that they already knew, and just wanted to see what I would say. Truthfully, I personally, would rather hear a hurtful truth than a less painful lie from someone who is giving me my medications.

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Specializes in LTC, case mgmt, agency.
Would it be possible to truthfully answer her question by saying that she won't recover? It sounds like her doctor can't even offer that, since he has simply told her that recovery is "low chance."

Since you can't directly look into the future and give her an answer, what can you do? Think about the principles of active listening and therapeutic communication. What emotions are coming across when the patient asks about her future? How could you best open up dialogue and allow the patient to express her concerns?

Very well put Eric, I would also add to leave the patient feeling like there is some hope. It is a delicate situation, but active listening and theraputic dialog are a great start.:D

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Specializes in med/surg, telemetry, IV therapy, mgmt.

remember that you always have the nursing process to help you of any jam (problem) and you will never go wrong if you follow the steps in sequence because they keep you thinking rationally. i am a med/surg nurse and would approach this as a med/surg nurse.

  1. assessment
    (collect data from medical record, do a physical assessment of the patient, assess adl's, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology)

    • a physical assessment of the patient

    • assessment of the patient's ability and any assistance they need to accomplish their adls (activities of daily living) with the disease

    • data collected from the medical record (information in the doctor's history and physical, information in the doctor's progress notes, test result information, notes by ancillary healthcare providers such as physical therapists and dietitians

    • knowing the pathophysiology, signs/symptoms, usual tests ordered, and medical treatment for the medical disease or condition that the patient has. this includes knowing about any medical procedures that have been performed on the patient, their expected consequences during the healing phase, and potential complications. if this information is not known, then you need to research and find it.

[*]
determination of the patient's problem(s)/nursing diagnosis
(make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use)

  • it helps to have a book with nursing diagnosis reference information in it. there are a number of ways to acquire this information.

[*]
planning
(write measurable goals/outcomes and nursing interventions)

  • goals/outcomes are the predicted results of the nursing interventions you will be ordering and performing. they have the following overall effect on the problem:
    • improve the problem or remedy/cure it

    • stabilize it

    • support its deterioration

    [*]interventions are of four types

    • assess/monitor/evaluate/observe (to evaluate the patient's condition)

    • care/perform/provide/assist (performing actual patient care)

    • teach/educate/instruct/supervise (educating patient or caregiver)

    • manage/refer/contact/notify (managing the care on behalf of the patient or caregiver)

[*]
implementation
(initiate the care plan)

[*]
evaluation
(determine if goals/outcomes have been met)

even though you might inherently figure out that this has some psychosocial components to it there is still nursing care involved. step #1 of the nursing process directs you to assess. so, collect data. the patient wants to know about recovery. this involves knowledge of recovery and rehab. step #2 is going to lead you to a conclusion that she is looking for is information and some hope (the problem is most likely deficient knowledge, prognosis and/or a risk of hopelessness). before saying anything, however, find out what she already knows--assess her. ask, "what have you been told?" get her to talk specifically about what the doctor and any of the therapists have told her. get her to repeat to you what goals they have set. look at their documentation. read up on the type of stroke mrs. j has had, it's treatment and rehabilitation and what recovery can be expected. then move on to step #3 planning and intervention, where you might decide to explore mrs. j's feelings about recovery, but do not give her any specific "yes" or "no" answers because it really isn't possible to know. some patients respond well to stories of recovery by others if you know of any. part of giving the patient hope is educating them about their recovery process and what they will be experiencing, how long it will take, etc. the website of the national stroke association (http://www.stroke.org/site/pagenavigator/home) has some terrific information you can utilize to help you answer this scenario. btw, stroke is one of the biggest reasons people are hospitalized and enter acute hospitals for initial treatment, so you are likely to see a lot of mrs. j's in the coming years if you work in an acute hospital. so, there are important issues to learn about here.

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