Community Health Nursing
SZT Task 2
Western Governor’s University
As an RN, with many years of experience in critical care and trauma, I have had to witness death and dying on a regular basis. After leaving the acute care setting, I functioned as case manager and clinical director for Medicare certified home health. Referrals to Hospice were frequently made for many patients. One’s perceptions regarding death and dying tend to be influenced by one’s cultural and religious (if applicable) beliefs, however, working in healthcare has had a significant impact on my own perceptions. Quality of life is of paramount importance as opposed to length; living with unbearable ...view middle of the document...
In addition, the mental health professional could also assist Mrs. Thomas in coping with her situation, her tearfulness and depression, as well as exploring her sadness regarding her children and their non-presence during this time of need. Mental health would also be instrumental in engaging Mrs. Thomas in an honest conversation about her fear of addiction in relationship to her pain management regimen. Home health physical and occupational therapy would evaluate Mrs. Thomas, and provide her with a regimen suited to her abilities that would prevent her from becoming weaker than she currently is and possibly giving her some motivation for getting out of bed, if even for a brief period of time. The cancer support group would be valuable for both Mr. and Mrs. Thomas during the course of her illness, as they have many resources in the community that can be accessed for different levels of help such as transportation to appointments, help with shopping, and even access to financial support agencies like the Susan G. Komen cancer fund.
The holistic nursing action plan would incorporate the three strategies named above and more, integrating the spirit and the mind as a complement to other, more traditional modalities. Physical and occupational therapy will certainly optimize Mrs. Thomas’ functional ability for as long as is possible. A referral to home health nursing will be made. Managing her pain effectively is crucial at this time. With mental health assisting her manage her fear of addiction, her utilization of pain medication will increase, thus providing her with some needed relief. Monitoring her bowel regimen would be implemented with possible obtaining a stool softener to counteract the binding effects of the pain medication. Constructing a pain medication log has been very helpful for many of my previous patients in similar situations since it assuages their fear of possible overdose. An initiation of a discussion about advance directives, if one does not already exist, will occur to prevent family members from possibly directing medical care that Mrs. Thomas does not desire to extend life, such as mechanical ventilation or a feeding tube. The conversation regarding end of life care is crucial to allow Mrs. Thomas to maintain her dignity. In addition, an explanation of hospice and their services will take place. A social worker consultation would allow them...