February 11, 2013
The Allen family presented in the simulation has several health issues they deal with individually that contribute to the family unit. Clifford struggles with depression that he does not want to have documented or take medications for out of fear. Pam is the glue of the family; she keeps the home functioning and has not worked outside the family because their son was born with Down’s syndrome. Her time is spent caring for him and the home. She has a history of endometrial cancer and has gone 14 months without a check-up. Gary is an active special needs young man, he holds a job, participates in Special Olympics and Scouting. The family has strong ties to their church that provides support when they need it. In the simulation, Clifford has a transurethral resection of his prostate and Pam has a recurrence of cancer. Two potential dilemmas they face are Clifford’s depression and Pam’s cancer prognosis and the impact on the family, particularly caring for Gary. The Allen family have right to decide what course of treatment they want as it applies to both Clifford’s and Pam’s health. Autonomy, the right to choose what will happen (Guido, 2010, p. 11), is a basic patient right. Clifford experienced discomfort with his benign prostatic hypertrophy (BPH) particularly after bowling with Gary. He did not find relief from the medication and did not want to wait six months as the doctor asked for the medication to relieve symptoms. A follow up visit determined the medication was not working and surgical intervention was necessary, Clifford was anxious about possible complications from surgery particularly impotence and incontinence. The documentation did not indicate nursing interaction prior to surgery. The video interaction between Clifford and the nurse post operatively showed the nurse determining his level of consciousness, acknowledging Clifford’s pain,...