5.3.3: FRAME 3- Prioritize Hypothesis
- Page ID
- 90254
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Question Type: Bow-Tie
Scoring: 0/1
NCSBN Item Type and Scoring: https://www.ncsbn.org/public-files/p...main_stage.pdf
Identify the condition for Rhys, select three findings, and the three appropriate actions for the nurse.
| Finding | Condition | Action |
|---|---|---|
| Altered level of consciousness | Infection | Provide emotional support for family |
| Anxiousness | Poor Pain Management | Administer morphine |
| Diaphoretic | Transitioning to end-of-life | Suction secretions |
| Mottled Skin | Apply cool compresses to neck and forehead | |
| Unmanaged Pain | Raise head of bed |
RATIONALE
The American Nurses Association (ANA) position statement of the Nurses’ Roles and Responsibilities in Providing Care and Support at the End-of-life (2016) states, the proximal reality of a client’s death is typically very difficult for patients and families. Choices about the most appropriate health care at the end of a person’s life often address whether specific treatments are ultimately likely to benefit the client. These choices may have a quality-of-life dimension. Nurses are frequently in a position to provide guidance for clients and families confronting difficult decisions and adapting to painful realities…. Decisions about care at the end of a person’s life often involve quality-of-life considerations. Nurses are obligated to provide care that includes the promotion of comfort, relief of pain and other symptoms, and support for clients, families, and others close to the affected individual (ANA, 2016).
FOCUSED GUIDE
The National Council of State Boards of Nursing (NCSBN) published A Nurse’s Guide to Professional Boundaries (2018). This guide addresses the fact that nursing has been voted the most trusted profession year after year. Read the NCSBN descriptions on incorporates therapeutic communication and professional boundaries below, then ask the students to address and role play different interactions with Rhys’s family.
- Provide examples of how positive nurse-client, nurse-family relationships can be incorporated into the end-oflife care for Rhys?
- Identify potential consequences resulting from poor therapeutic communication and violation of professional boundaries.
A therapeutic relationship is one that allows nurses to apply their professional knowledge, skills, abilities, and experiences towards meeting the health needs of the client. This relationship is dynamic, goal-oriented and patientand family-centered because it is designed to meet the needs of the individual and family. Regardless of the context or length of interaction, the therapeutic nurse–patient relationship protects the patient’s dignity, autonomy and privacy and allows for the development of trust and respect.
Professional boundaries are the spaces between the nurse’s power and the client’s vulnerability. The power of the nurse comes from the nurse’s professional position and access to sensitive personal information. The difference in personal information the nurse knows about the client versus personal information the client knows about the nurse creates an imbalance in the nurse–patient relationship. Nurses should make every effort to respect the power imbalance and ensure a patient-centered relationship (NCSBN, 2018, p.4)