THS IS CRITICAL THINKING: Description: It is

THS IS CRITICAL THINKING: Description: It is lunchtime and you have had a very difficult day. Your last two patients required a great deal of patience. Your next patient is a 79-year-old woman for an abdominal series. The patient is very thin and frail. You look at the order in her chart, which states that she has rectal bleeding. She arrived in the department via stretcher. She has just had a sigmoidoscopy and appears to be very tired. After obtaining the upright abdomen image the patient moves onto the table, she complains about the hardness of the table and the temperature of the room. You bring warm blankets for the patient. The patient begins to cry and asks, “Why are you doing this to me?” You explain that her doctor has ordered this examination. From reading her clinical data, you know that the patient has terminal cancer. You wonder why you are doing this to the poor woman. Why do they not just let her die in peace? You stand next to her and hold her hand. What do you do next? Selection of the Best Option GOAL To give the patient the best care possible and to complete the examination. OBSERVATIONS The patient has terminal cancer and is questioning whether she needs this examination. You are very doubtful that the patient will be able to hold the barium. OPTIONS AND CONSEQUENCES Option 1 You explain to the patient that you have no idea why her doctor has ordered the examination. However, you are certain that there is a good reason. You then explain to her that it is entirely her choice whether to have the examination. You tell her that, if you were the patient, you would not have the procedure. Consequences The patient would probably refuse the examination. Option 2 You explain to the patient that you know this is difficult for her. You also call her doctor and relay the doubts the patient has about this examination. Explain how tired the patient is and ask him if the examination can be performed at another time. You also ask the doctor to please speak with the patient. Consequence Chances are that the examination will be postponed until another time. This will give the patient time to speak with her doctor regarding any concerns she may have. Option 3 You allay her concerns about the difficulty she may have with the procedure. You tell her that her doctor wants her to have the test and that he would be disappointed if she refused. Consequence She will probably have the examination. SCIENCE HEALTH SCIENCE NURSING NURE 212

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