Assess patient's and family's understanding of the diagnosis and prognosis, limitations, treatment options; description of their personal values; and their physical expressions of suffering. Assessment factors assist in identifying appropriate interventions.
Establish an environment in which family members can share comfortably and openly their issues and concerns.
Enlist assistance of health care ethics resources such as ethics committee or consultants. Including experts in health care ethics will assist in identifying the patient/family values and reason for the dilemma. By identifying the source of the conflict, the process of resolution may begin, thus leading to better understanding by all parties and partial or full relief from moral suffering.- Enlist assistance of chaplain or personal clergy to assist in the process of resolution through clarification of values related to religious views. Chaplains and personal clergy may provide a more neutral “third party” that can help defuse the situation. Personal trusted clergy might recognize or facilitate patient/family verbal and physical expressions of suffering or relief.
- Educate patient and family about medical diagnosis, treatment regimen, and limitations to help both patient and family understand the limits and read about medical treatment related to medical diagnosis.
- Provide or set aside ample time for patient and family to express their feelings about the current situation. Open, honest communication may clear misconceptions on both sides and facilitate relief from suffering in the midst of dilemma.
- Acknowledge ethical/moral position of patient/family who may feel that their positions or views will go unrecognized in the midst of serious illness and high-tech treatments; they may not want to “bother” nurses and physicians with these concerns. Acknowledging their concerns, values, and moral position allows for holistic care.
- Refer, where requested, for follow-up for a family member who needs exercise, weight management, diet assistance, health screenings, and so forth. Assisting patient in making referrals will help ensure continued efforts on the part of the patient to live a healthier lifestyle.
Suggested NIC Interventions
Active Listening: Anger Control Assistance; Anxiety Reduction; Conflict Mediation; Consultation; Counseling; Documentation; Family Integrity Promotion; Family Support; Multidisciplinary Care Conference; Spiritual Support Family Support; Family Integrity Promotion; Family Maintenance; Truth Telling |