NR 341 Case 5 Complex Adult Health Communicator

Student 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 tasked with the care of Ms. Lonely, a patient nearing the end of her life. Ms. Lonely’s family, including her daughters, aunt, and other relatives, are gathered at her bedside. During the video, one particular moment highlighted a situation that made me reconsider my clinical practice. In this scene, the patient displayed clear signs of pain, and her daughters informed the nurse that their mother did not want any medication for pain relief. In such a case, it is crucial for the nurse to provide education to the family regarding the importance of pain management, emphasizing how medication can significantly alleviate the patient’s discomfort. It is essential to respect the patient’s autonomy in decisions regarding pain management, especially if she is alert and aware of her surroundings.

The daughters should not have the authority to make decisions regarding their mother’s pain management unless they have legal documentation, such as a living will, giving them the power to make medical decisions on her behalf. The nurse should not only focus on pharmacological pain management but also consider alternative techniques such as guided imagery, therapeutic touch, or massage. These non-pharmacological approaches can offer substantial comfort and support in managing the patient’s pain.

Pain Management and Patient-Centered Care

Incorporating education on diverse pain management options and involving the patient in decision-making allows the nurse to empower Ms. Lonely, giving her more control over her care. A patient-centered approach supports the patient’s preferences and aligns with holistic care principles. By considering alternative methods of pain management, the nurse enhances the patient’s overall well-being, addressing pain in a comprehensive way.

Nurse’s Role in Pain Management and Legal Considerations

According to the Texas State Board of Nursing, the nurse plays a vital role in managing a patient’s pain. Chapter 228 highlights that the primary goal of pain management is to effectively address the patient’s discomfort while considering the overall health, including physical, psychological, and social factors (Texas Administrative Code, 2013). Nurses must assess and manage pain accurately, documenting the patient’s descriptions of pain and evaluating the effectiveness of prescribed interventions. This proper documentation is essential to ensure that the treatment plan is appropriately tailored to meet the patient’s unique needs.

Incapacitated Patients and Decision-Making

Under the Texas Health and Safety Code, an incapacitated patient is someone who cannot understand the nature and consequences of treatment decisions due to medical conditions, including being comatose or mentally incompetent (Health and Safety Code, 2017). When a patient is deemed incapacitated, a legal surrogate decision-maker is appointed. The first choice is the patient’s spouse, followed by an adult child with the consent of the others, or the majority of available adult children if no single decision-maker is agreed upon. If no adult children are available, the responsibility may fall to the patient’s parents. Texas law allows conflicts among potential decision-makers to be resolved in court (Health and Safety Code, 2017).

Understanding these legal frameworks ensures that healthcare providers can honor the preferences and best interests of incapacitated patients, especially those without a living will or DNR directive.

Table: Pain Management, Legal Framework, and Nursing Responsibilities

Aspect	Description	Relevance to Clinical Practice
Pain Management and Education	Education on pharmacological and non-pharmacological interventions for pain. Involves educating family and patients on pain relief options.	Nurses should provide education to families regarding pain management, emphasizing the importance of respecting the patient’s autonomy and offering alternatives to medication for effective comfort (NR 341 Case 5 Complex Adult Health Communicator).
Nurse’s Role and Documentation	Nurses must assess, manage, and document pain accurately, ensuring a patient-centered approach.	Proper documentation and pain assessments are critical in providing effective care. Nurses must evaluate the efficacy of medications and interventions to ensure patient needs are met (Texas Administrative Code, 2013).
Incapacitated Patients and Decision-Making	Legal framework for decision-making when patients are unable to make medical decisions themselves.	Understanding the legal definitions and guidelines surrounding incapacitated patients helps ensure that the patient’s best interests are honored when they are unable to make decisions themselves (Health and Safety Code, 2017).

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