Question

A client has confided to the nurse that she would prefer hospice care to receiving further radical treatment for terminal pancreatic cancer. The nurse observes that the client fails to share her wishes with her family during a discussion regarding future treatment plans. Ethically, the nurse should first:

1. Tell the family of the client's expressed wishes
2. Privately ask the client if her wishes have changed
3. Inform the client's health care provider of her wishes
4. Share with the client the importance of expressing her wishes

Answer 1

The nurse should first privately ask the client if her wishes have changed, respecting her confidentiality and autonomy. After confirming, the nurse can support the client in communicating her wishes to her family and facilitate a discussion if needed.

Step-by-step explanation:

In the scenario where a client expresses a preference for hospice care but does not communicate this wish to her family, ethically, the nurse should first: 2. Privately ask the client if her wishes have changed. This is because patient autonomy and confidentiality are paramount in healthcare. It is important to respect the client's right to make decisions about their own care, and the wishes expressed to the nurse in confidence should not be disclosed to others without the client's consent.

Step-by-Step Explanation:

The nurse should confirm with the client in a private setting if her decision about preferring hospice care remains unchanged.

1. If the client reaffirms her decision, the nurse can explore the reasons why the client has not shared her wishes with her family and offer support.
2. The nurse can discuss the importance of open communication and can encourage the client to share her preference for hospice care with her family when she is ready.
3. If needed, the nurse can facilitate a family conference where the client feels supported to express her wishes regarding her end-of-life care.