Question

A hospice nurse is caring for a family that is providing end-oflife care for their grandmother, who has terminal breast cancer. The nurse focuses on symptom management for the grandmother and on helping the family with developing coping skills. This approach is an example of which of the following? A. Family as context B. Family as patient C. Family as a system D. Family as structure

Short answer

B. Family as patient

Step-by-step solution

Understanding the Scenario

The exercise presents a situation where a nurse is taking care of both the physical needs of the grandmother with terminal cancer by managing her symptoms, as well as the emotional needs of the family by helping them develop coping skills.

Defining the Options

Each answer choice represents a different perspective on the family's role in healthcare. 'Family as context' focuses on the individual in the context of the family. 'Family as patient' treats the family unit itself as the recipient of healthcare. 'Family as a system' emphasizes the interdependent relationships and dynamics within the family. 'Family as structure' refers to the structural or organizational aspect of the family.

Determining the Correct Approach

Since the nurse is addressing both the grandmother's and the family's needs, the approach is holistic and considers the family as an integral unit in the care process. This aligns with the 'Family as patient' perspective, where the family as a whole is the focus of care.

Key concepts

End-of-Life Care

End-of-life care is a crucial aspect of nursing that involves supporting patients who are nearing the end of their life journey. It extends beyond managing physical symptoms to addressing the psychological, social, spiritual, and cultural needs of the patient and their loved ones. For caregivers, providing end-of-life care requires compassion, sensitivity, and communication skills, with a focus on enhancing the quality of remaining life.

For instance, in the exercise, the hospice nurse's role encompasses both symptom management for the grandmother, ensuring her comfort and dignity in her final days, and emotional support for the family. It's essential that healthcare professionals like nurses are trained in palliative care principles that are key to end-of-life care. This includes pain and symptom control, as well as helping the patient and family navigate the complex emotions and decisions they face during this time. Effective communication is also a vital part of this type of care, helping to clarify goals, expectations, and preferences.

Coping Skills

Developing coping skills is vital for individuals and families facing the challenges of a terminal illness. Coping skills are the strategies used to deal with stress, adversity, and grief, and can significantly affect the emotional well-being of everyone involved. Nurses play a pivotal role in facilitating the development of these skills by providing education, counseling, and support groups.

In the scenario presented, the hospice nurse aids the family in acquiring the tools they need to manage their emotional responses to their grandmother's illness. This may involve teaching stress-relief techniques, providing resources for external support, or simply offering a listening ear. Some effective coping strategies include open communication within the family, creating meaningful rituals, seeking support from friends, community, or faith groups, and even preserving normalcy in day-to-day life as much as possible. By assisting in this way, nurses help maintain the family's mental and emotional health during a profoundly difficult period.

Holistic Approach in Nursing

The holistic approach in nursing is a comprehensive form of care that addresses all facets of a patient's well-being—the physical, emotional, social, and spiritual. Nurses who employ this approach understand that healing is multifaceted and that all elements of a person's life can impact health and recovery. In the context of the exercise, the nurse's holistic approach is demonstrated by addressing not just the grandmother's physical symptoms but also the family's emotional health.

Implementing a holistic approach means assessing and planning care that incorporates the entire person, considering their life experiences, values, beliefs, and preferences. It aligns with the biopsychosocial model of care, positing that health and wellness are affected by a complex interplay of biological, psychological, and socio-environmental factors. A holistic nurse might engage in practices such as therapeutic communication, patient education, referrals to complementary therapies, and facilitating a supportive environment. By considering the family as the 'patient' in this scenario, the nurse ensures that care extends to the interconnected system of individuals who are all experiencing the impact of the grandmother's illness.