The nurse is speaking with the spouse of a client following a family discussion with the health care provider about the client's terminal condition and eligibility for hospice care. The spouse states, "I don't think I can make this decision right now. What would you do?" How should the nurse respond?

Question

The nurse is speaking with the spouse of a client following a family discussion with the health care provider about the client's terminal condition and eligibility for hospice care.  The spouse states, "I don't think I can make this decision right now.  What would you do?"  How should the nurse respond?

Quizplus · Accepted Answer

End-of-life decisions (eg, hospice, code status) often overwhelm clients and medical decision-makers due to the magnitude of the choices and feelings of guilt that may accompany decisions. Clients and their families may lean on hospital staff to guide these decisions. These moral and ethical dilemmas require the nurse to have strong therapeutic communication skills. When discussing decisions related to client care, the nurse should facilitate exploration of the client's emotions, values, and beliefs, rather than offer personal opinions. Nurses can promote self-exploration by using open-ended questions and guiding phrases (Option C). (Option A) Providing information is an appropriate response when that is what the client is seeking. However, there is no indication that the spouse seeking advice requires additional information, and this response does not promote further communication. (Option B) The nurse's opinion and personal biases can influence clients/family members and may even push them toward decisions incongruent with their values and beliefs. Giving advice is not therapeutic and does not promote open communication. (Option D) It is within the nurse's scope to discuss moral and ethical decisions with clients. Deferring these conversations to another professional (eg, chaplain) instead of talking with the individual inhibits the therapeutic relationship and does not support client self-exploration. Educational objective: When discussing ethical decisions related to client care, it is important for the nurse to use open-ended questions and guiding phrases to facilitate exploration of clients'/family members' emotions, values, and beliefs regarding the topic. Nurses should avoid giving advice and influencing individuals' decisions.

The Nurse Is Speaking with the Spouse of a Client