Nursing Assignment: Ethical Dilemmas and Holistic Care Plan

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT
Name of the Student
Name of the university
Author’s note

1NURSING ASSIGNMENT
Part 1: The assessment
1. The physicians and the other health care professions providing care for the patients who are
terminally ill, confront with many ethical dilemma and challenges. In order to provides good
care to the dying patients requires physicians to have potential ethical dilemmas and be aware
of the strategies and the interventions to prevent conflict.
The ethical issues at the end of life care involves principles of autonomy, where the
physicians should encourage dialogue about the end of life care and the utilization of the
advanced directives such that autonomy can be preserved, even if the decision making capacity
of the patient is lost (Butts & Rich, 2019). In this case it is evident that Mac had been suffering
from progressive dementia, which causes personality or behavior changes, disorientation,
inability to recognize common things or inability to do everyday task, delusional thoughts or
disruptive behavior that affects the quality of life of the person and personal relationships. Such
symptoms are common for a patient with dementia and this kind of behavior cannot be related to
the character of a person that he used to be before (Vicensi, 2016). Mac’s wide Dorothy had said
that it would be better if Mac dies quickly as she does not want him to suffer, and that he was not
like before. This had not only taken a toll on the life of the patient but is also affecting Dorothy’s
wellbeing as well. It is evident from Dorothy’s statement, that Mac had been terminally ill and
would not be able to survive a chest infection without a lifesaving support. Considering the
ethical principle of beneficence, the health care professionals should try to do anything that is
good for the patient and should try to save him. Ethical dilemma is bound to occur between
provisions of a life support system or withdraw the intervention to let the patient die faithfully.

2NURSING ASSIGNMENT
Respecting the autonomy of the patients is one of the essential element of nursing (Bischoff et al.,
2013). When the nurse entered the suite of the patient, she /he was welcomed by abusive slangs.
Nurses are in the position to respect the wish of patients, even if sometimes it seems unpleasant.
2. Holistic care plan for Mac and Dorothy
The main clinical priorities that has to be considered for developing a holistic care plan for Mac
are- compromised family coping, activity intolerance and respiratory distress.
In order to assist the patient to cope up with the family a supporting primary person
(family member, wife or a close friend) can be employed, which can provide effective , sufficient
support , assistance, comfort or encouragement that might be required by the individual or master
adaptive tasks related to the health challenge (Giovanni, 2012). It is necessary to assess the level of
the anxiety present in family. Again it is also necessary to determine the level of cognitive
impairment of the perceptual, cognitive and the physical abilities as information about the family
problems will be helpful in determining the options available for the treatment. A number of
psychotherapeutic approaches are there for developing the coping up skills in Mac, like
differential re-enforcement of the other behaviors , contingence management, supported
psychotherapy and recreational therapy can be used by the nurses to provide with the
psychotherapy
Dorothy can be provided psychological support in order to assist her in coping up with
the distress. Dorothy might be having difficulty in coping up with the sudden behavioral change
of Mac. Prevalence of anxiety, depression and PTSD has been found in the caregivers caring for
the patients who are terminally ill (Johnson et al, 2019). Dorothy might suffer from stress, which