NR 341 Case 5 Complex Adult Health Communicator

Name

Chamberlain University

NR-341 Complex Adult Health

Prof. Name

Date

ATI the Communicator: Case 5 – Ms. Lonely

In this communication case scenario, Nurse Morgan is responsible for the care of Ms. Lonely, a patient who is nearing the end of her life. Ms. Lonely’s family, including her daughters, aunt, and other relatives, gather at her bedside. While watching the video, one particular scene stood out where I would reconsider my clinical practice. The patient displayed signs of pain, and her daughters conveyed to the nurse that their mother did not wish to receive any medication for pain relief. In this situation, it is imperative for the nurse to educate the family on the importance of pain management, explaining how medication could significantly alleviate their mother’s discomfort. Respecting the patient’s autonomy regarding her pain management decisions is crucial, particularly if she is alert and aware of her surroundings.

The daughters should not hold the authority to determine their mother’s pain management unless they possess legal documentation, such as a living will, that grants them the power to make medical decisions on her behalf. Rather than solely relying on pharmacological interventions, the nurse could also explore alternative pain management techniques, such as guided imagery, therapeutic touch, or massage. These non-pharmacological approaches can offer significant comfort and support in managing the patient’s pain.

NR 341 Case 5 Complex Adult Health Communicator

By providing education on various pain management options and involving the patient in decision-making, the nurse can empower Ms. Lonely to have a degree of control over her care. This patient-centered approach not only promotes the patient’s wishes and preferences but also aligns with holistic care principles. Moreover, considering alternative pain management strategies can enhance the overall well-being of the patient, addressing her discomfort in a more comprehensive manner.

Texas Board of Nursing

According to the Texas State Board of Nursing, the nurse’s role in managing a patient’s pain is of utmost importance. Chapter 228 emphasizes that the primary goal of pain management is to effectively address the patient’s pain while considering her overall health. This includes taking into account physical, psychological, and social factors (Texas Administrative Code, 2013).

In addition to these responsibilities, nurses are expected to assess and manage the patient’s pain accurately. This involves documenting the patient’s pain descriptions and evaluating the effectiveness of any prescribed medications or interventions. Proper documentation of the outcomes related to pain relief and the overall condition of the patient is essential. By adhering to these guidelines, Texas nurses contribute to the delivery of optimal pain management and ensure that the treatment plan is tailored to meet the patient’s specific needs.

Incapacitated and Next of Kin

As outlined in the Texas Health and Safety Code §313.004 concerning consent for medical treatment, an incapacitated patient is defined as someone who, based on reasonable medical judgment, is unable to comprehend or appreciate the nature and consequences of a treatment decision. This encompasses understanding the proposed treatment’s potential benefits, risks, and alternatives (Health and Safety Code, 2017). Incapacitated patients may include those who are comatose, mentally or physically incompetent, or unable to articulate their preferences.

Once a physician determines that a patient is incapacitated, an adult surrogate is appointed according to a specific priority order. The first option is the patient’s spouse, followed by an adult child who has the necessary consent from other eligible adult children to act as the sole decision-maker. If there are no eligible adult children or consensus among them cannot be reached, the responsibility falls to the majority of the patient’s available adult children. Lastly, if no adult children are available or in agreement, the patient’s parents are authorized to make healthcare decisions on the patient’s behalf. Texas law permits resolution of any conflicts among potential surrogates through the court system (Health and Safety Code, 2017).

This information is vital for healthcare providers caring for incapacitated patients who lack a living will or do-not-resuscitate (DNR) directive, as it establishes the legal framework for identifying decision-makers. Understanding these guidelines is essential to ensuring that the patient’s best interests and preferences are honored.

References

DeMartino, E. S., Dudzinski, D. M., Doyle, C. K., Sperry, B. P., Gregory, S. E., Siegler, M., Sulmasy, D. P., Mueller, P. S., & Kramer, D. B. (2017). Who Decides When a Patient Can’t? Statutes on Alternate Decision Makers. The New England Journal of Medicine, 376(15), 1478-1482.

Health and Safety Code. (2017). Retrieved November 11, 2018, from https://statutes.capitol.texas.gov/Docs/HS/htm/HS.313.html