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please formulate a response to this discussion with 5-6 points with explanation and references. This is a master’s level class for nursing. thank you. 
 

 

Case Study
Sarah was diagnosed with pancreatic cancer four months ago.  Due to the quick progression of her disease despite treatment, the medical team informed Sarah and her family last week that there are no longer any curative treatment options and recommended a palliative care focus for her treatment moving forward.  Sarah’s condition has rapidly declined in recent days and Sarah was referred for hospice care.
Sarah’s family is in denial and refuses to accept that there are no further treatment options for Sarah.  They are consumed by calling other medical centers for second opinions and consulting the internet on Sarah’s case.
Sarah feels helpless and lonely during these discussions.  Her family is physically nearby but they are so focused on curing her and any final treatment options that Sarah feels isolated and lonely throughout the realization that her life will be ending soon.  During her most recent hospital admission, Sarah is in pain and frequently calls out for someone to relieve her of the intense physical and emotional pain she is experiencing in tandem.
Her nurse, Elise, recognizes Sarah’s need for care both physically and spiritually.  Sarah trusts her nurse and tells Elise of her loneliness and emotional pain.  Elise offers support and identifies the need for spiritual care.  Elise consults the chaplain to visit Sarah and help guide her in her spiritual journey during the end of her life.  Sarah does not believe in God but believes there is a higher power of some sort.  The chaplain is able to discuss this with Sarah and provides a spiritual connection.  Sarah feels connected after this discussion and requests the chaplain return again the following day.  Sarah enjoys discussing her spirituality with the chaplain and feels less stressed and anxious following these discussions.
Sarah is soon transferred to a residential hospice facility.  The facility has regular group meetings for patients that have similar interests.  Sarah visits the chapel regularly and meets a few other patients during these visits and has fruitful discussions with them daily.  This helps her to feel more connected and less alone.  They discuss their beliefs in a higher power and share experiences.  Some days they say prayers together and hold space for each other and their individual beliefs.
Relational Statements
A 46-year-old male named John, presents to the ICU after suffering from a heart attack and is in emotional distress (antecedent). The nursing staff assures the patient that they will try as much as they can to care for him and to put his faith in them (attribute). This allows John to feel a sense of calmness and be more hopeful for his outcome (consequence).
John has gone through a period of suffering while hospitalized (antecedent). The medical staff, especially the nurses have constantly made an attempt to not only treat him physically but spiritually as well. They ensured he was visited by the chaplain multiple times for daily prayers. This allowed John to feel a connection with a higher self and find more meaning in his life (attribute). With his physical and spiritual needs taken care of, John feels more at ease and an appreciation for life (consequence).
John has been discharged from the hospital after going through a serious life-changing event (antecedent). Before being discharged, the medical staff recommended John join an organization that brings together people who have gone through serious medical issues in their lives. This group allows for discussion of what each individual went through and that they aren’t alone (attribute). This organization helped John feel that he was part of a community, and helped aid in his recovery and in his coping strategies (consequences).
Model Development
Application of Theory
As nurses, it is of utmost importance to have the ability to put aside one’s own beliefs surrounding spirituality in order to effectively assist patients in meeting their spiritual needs, especially during a difficult time such as entering hospice care. Important nursing interventions to apply while caring for patients with spiritual needs consist of utilizing therapeutic communication and active listening, praying with the patient per patient request, seeking additional support from the chaplain, and encouraging family and/or friends to be involved as they know the patient best. Assessment of intervention effectiveness is specific to each patient and their beliefs. Patients entering hospice may feel a sense of connectedness with themselves and their diagnosis. Patients may develop new coping skills or have an easier time coping with their diagnosis and prognosis. Lastly, hospice patients may have a new outlook on life, and a new appreciation for life after engaging in spiritual activities of their choice with their nurses and healthcare providers.

References

Gray, J. (2006). Measuring spirituality: Conceptual and methodological considerations. The

Journal of Theory Construction and Testing, 10(2), 58-64. 

Leh, S. K. (2007). Preconceptions: A concept analysis for nursing. Nursing Forum, 42(3), 109-

122. https://doi.org/10.1111/j.1744-6198.2007.00075.x

McEwen, M., & Wills, E. M. (2023). Theoretical basis for nursing (6th ed.). Wolters Kluwer.

Sessanna, L., Finnell, D., & Jezewski, M. A. (2007). Spirituality in nursing and health-related

            literature: A concept analysis. Journal of Holistic Nursing, 25(4), 252-262.

 https://doi.org/10.1177/0898010107303890

Vachon, M., Fillion, L., & Achille, M. (2009). A conceptual analysis of spirituality at the end of

life. Journal of Palliative Medicine, 12(1), 53-57. https://doi.org/10.1089/jpm.2008.0189

 

SCIENCE
HEALTH SCIENCE
NURSING
NURS MISC