Question

Case Study 4

During a clinical experience in a medical-surgical course, Ray is assigned to care for a patient with end-stage renal failure who is semiconscious. He is told in report that the family members have been present at his bedside the entire hospital stay and hospice has been contacted. As part of his assignment, he must take a complete history, provide total patient care, and educate the patient and family about the medical problems and medications. During his care of the patient, family members comment that this is the most anyone has done for their father the entire time he has been in the hospital. Ray discusses the pathophysiology and medications with the patient and the family members. He explains how the hospice nurses will come to the home to provide care and comfort until the end. Confused, the family members state that they were told that their father's condition would stabilize and possibly improve if he followed the physician's orders. One family member tells Ray that she has never heard of hospice and certainly doesn't want a stranger coming to the home. The family members confront Ray about the lack of communication between the doctors and nurses at this hospital. Ray leaves the room feeling angry at the doctors and other nurses for not communicating with the family, and he is discouraged that his meticulous planning of care for the patient "stirred the pot."

Top of Form

A. What was the first indication that the family was concerned about the quality of care?

Your Answer

B. How could Ray have de-escalated the conflict among the family, patient, and caregivers?

Your Answer

C. Was there an issue regarding treatment decisions that contributed to the conflict?

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D. How could the conflict have been avoided in respect to nursing care?

Answer 1

1.The first indication that the family are concerned is when they are in a confused state that their fathers condition would stabilise or not and would like to follow the physicians order. as they are not in trust factor that some one will come and treat the patient properly at home.

2.The most important factor that ray has to follow is the communication between him and the doctors and nurses.The staff should educate the patient and family members and let them know the state and condition of the patient.Ray was doing his part perefectly by providing patient care and educating them but there is a lack of communication between the family members and nurses,inorder to prevent such conditions he should train the staff and a plan should be followed by them.

3.Yes it is a kind of treatment issue as here in this case quality of patient care is questioned.

4.Nursing staff should be given a good training and a plan with certain policies should be implemented for them so that thay can communicate well with the doctors as well as ray.