NUR2229: Michelle Case Study - Nursing Assignment Help

Assignment Task:

1. Prepare for the discussion

1. The nurse should confirm the patient’s prognosis by reading clinical notes before commencing a discussion (Clayton et al., 2007)

2. If possible, the nurse should ensure a there is a private, quiet environment available and negotiate who should be present.

2. Relate to the person

1. The nurse should show compassion by using compassionate and respectful language. 

2. The nurse should ensure that they are willing to initiate and engage in conversation about what may happen in the future for Michelle.

3. Elicit patient preferences

1.  The nurse should ensure Michelle is provided with an opportunity to clarify her understanding of the prognosis and offer additional knowledge. 

2.  The nurse should explore Michelle’s reason for this consult and actively listen to her expectations of the discussion.

4. Encourage questions

1. The nurse should allow Michelle to explain her own understanding of what has been discussed and ensure her expectations of the discussion are met. 

2. The nurse should encourage further questions and clarification if Michelle requests.

Description

I watched Michelle’s “whole world” be “turned upside down” after she received the news her cancer had returned. In particular, she now has developed metastases in her breasts and liver. Michelle is a 38-year old mother and teacher and was sadly diagnosed with breast cancer two years ago. Her and her husband fought with such “determination” that she was cancer free until today. 

A day after receiving the news that Michelle’s cancer has now returned, she met with Margaret, a local community palliative care nurse to discuss her prognosis and management. I listened Michelle voicing her treatment goal to “improve [her] quality of life.” However, she followed on by stating that however she doesn’t “quite understand” what that means. I observed Margret employing an open body posture and demonstrating active listening skills such as, nodding and making noises of agreement. I listened to Margret’s warm, caring and respectful manner when asking Michelle what the “most difficult things are troubling” her. Michelle began to become emotional as she voiced her “fear of dying” and worry about how her children and husband will manage. In response, Margret seeks permission to explain to Michelle about the in-home support services she can offer. Margret reassures Michelle that there are a “team of people” who are “available to provide support” when “talking to [her] children” about her prognosis and what to expect. Margret provides the option for a psychologist to contact Michelle in the next few days to discuss her concerns and feelings about her recent results.

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