31 Mar NURS 202 case Study GRIEF

Review Scenario. A nurse is caring for a client who has chosen not to be treated for their chronic condition and requests to be given only pain management due to their expectation of pending death due to their condition. The nurse is in the client’s room when the client’s adult children arrive to visit. While the nurse is completing the client assessment, the client informs the son and daughter of their decision not to treat their condition and to use comfort care instead. The client’s son remains quiet and does not respond, other than to walk across the room and sit on the chair. The client’s daughter suddenly bursts into tears and states, “No, no, you can’t give up now!” The son replies, “It’s OK. It’s your decision, and we’ve known this day was coming.” The client states, “I just don’t have the energy to fight anymore. I can’t face any more treatment.”

Respond to the following questions and provide an evidence-based rationale. Use the DON NCSBN Clinical Judgement Model that includes as your guide in responding to the questions. (The related steps of the Nursing Process and Clinical Judgment functions are listed after each question below).

a. Identify relevant information related to the grief response by each of the client’s adult children. (RECOGNIZE CUES/ASSESSMENT)

b. Analyze the current needs for the client and their adult children. (ANALYSIS/ ANALYZE CUES)

c. Identify the expected and any unexpected findings related to grief among the client and their adult children. (ANALYSIS/ANALYZE CUES)

d. Identify the priority concerns for the client and adult children. (ANALYSIS/ PRIORITIZE HYPOTHESIS)

e. Identify the expected outcome if the nurse responds to the daughter by using the NURSE mnemonic. (GENERATE SOLUTIONS/PLANNING)

f. Explain the education the client and their adult children might need related to grief. (TAKE ACTION/IMPLEMENTATION)

g. Using the NURSE mnemonic, write a response on how the nurse could reply to the daughter’s reaction. (TAKE ACTION/IMPLEMENTATION)

h. Describe how you will determine whether the expected outcomes are met regarding the grief process of the client and the adult children. (EVALUATE OUTCOMES/EVALUATION)

Grief Clinical Judgement Case Study Grading Rubric

Criteria Description of points Possible

points Earned Points with comments

Recognize Cues (Assessment)

Identify relevant information related to the grief response by each of the client’s adult children.

Pay attention to all verbal and nonverbal cues/actions of the children.

15

Analyze Cues (Analysis)

Analyze the current needs for the client and their adult children. What does the client need?

What do the children need?

10

Analyze Cues (Analysis) continued

Identify the a) expected and any b) unexpected findings related to grief among the client and their adult children.

Separate the expected and unexpected findings for the client from the children

10

Analysis/Prioritize Hypothesis

Identify the priority concerns for the a) client and b) adult children.

10

Generate Solutions (Planning)

Identify the expected outcome if the nurse responds to the daughter by using the NURSE mnemonic.

15

Explain what you expect the outcome will be of the daughter after your response.

The daughter will……… (SMART criteria)

Name Understand Respect Support Explore

Take Action (Implementation)

Explain the education the a) client and their b) adult children might need related to grief.

Nurse will……..

15

Take Action (Implementation)

Using the N-U-R-S-E mnemonic, write a response on how the nurse could reply to the daughter’s reaction.

(Choose one of the N-U-R-S-E responses to the daughter’s following statement: “No, no, you can’t give up now!”

15

Evaluate Outcomes (Evaluation)

Describe how you will determine whether the expected outcomes are met regarding the grief process of the client and the adult children.

10

Total Possible Points 100