Tom’s daughter has an emotional disturbance

TERMINAL STAGE 1
A PATIENT WITH MULTIPLE METASTASES AND LATE –STAGE LUNG CANCER
The Name of the Class (Course)
Professor (Tutor)
The Name of the School (University)
The City and State where it is located
The Date

TERMINAL STAGE 2
Issues in the case
1. Tom is in pain and agitated
2. There is a dilemma of whether to prevent the patient from dying or ensure comfort
3. Unclear identity of who ought to make medical decisions on Tom’s behalf
4. A non-resuscitation request exists
5. Tom’s daughter has an emotional disturbance
6. Respect of Aborigine culture on healthcare and dying
7. Involvement of family in treatment
8. The choice of medication
9.Medical staff decision on treatment against family preferences(Thomaset al., 2014)
The goals
1. Reduce the suffering of the patient
2. Provide social, spiritual and emotional support
3. Uphold the dignity of the patient
4. Respect the patients and family’s wishes
5. To provide information to the family
6. To give care that is respectful of the culture of the patient

TERMINAL STAGE 3
7. To provide personalized care to the patient (The state of Victoria,2015)
Action plan
Since Tom’s daughter is angry and agitated, I would tell her what she feels is completely
expected. Then I would ask to talk with her outside for a while. It would be preferable to find a
place to sit, in another room or outside the main building of the hospital. I would then let her
calm down for a few minutes. After a while, I would listen to her explain what she wants for her
father. We could then return to the room when she has calmed down. If this technique fails I
would ask help from other staff members such as a fellow nurse. During the whole incident, I
would ask for the assistance of the health worker involved with Aboriginal Liaison to help if the
family permitted it. An interpreter might be important if one of the family members is not fluent
in English. This will require the approval of the family and also if such an individual is not
within the hospital at the time, one of the family members would be called upon to
assist(Carman,2016).
There needs to be a determination of whether Tom can talk or understand what is going on. This
will help assess his capacity to make decisions for himself. It is common for patients at this
period to be agitated or sedated. If this is the case Tom will be unable to decide. However, if he
should be awake and conscious, I will proceed to ask him to tell me his name and then proceed to
ask if he remembers me. Further, I would ask him to nod if he understands or shows me
anywhere he might be feeling pain.