Cultural Competence in End-of-Life Care
Cultural Competence in End-of-Life Care ( 4 Questions)
A nurse is providing end-of-life care to a client who identifies as Jewish. The client's spouse asks the nurse to remove all medical equipment from the room before the client dies, as they believe that this will allow the soul to depart peacefully. How should the nurse respond to this request?
"I'm sorry, but I cannot do that. It is against hospital policy to remove medical equipment without a doctor's order." - This response is insensitive and dismissive of the spouse's request and the client's beliefs. The nurse should not use hospital policy as an excuse to deny or delay culturally competent care.
"I understand your request, but I need to check with the client first. It is their right to decide what kind of care they want to receive." - This response is respectful of the client's autonomy, but it may not be appropriate or feasible in this situation. The client may not be able to communicate their wishes or preferences, or they may have delegated this responsibility to their spouse. The nurse should not assume that the spouse's request is contrary to the client's wishes or best interests.
"I respect your request, but I need to explain the risks and benefits of removing the medical equipment. It may affect the client's comfort and safety." - This response is informative and concerned for the client's well-being, but it may not be necessary or helpful in this situation. The spouse may already be aware of the risks and benefits of removing the medical equipment, or they may value their religious beliefs over their medical outcomes. The nurse should not try to persuade or dissuade the spouse from their request.
The nurse should acknowledge and accommodate the spouse's request, as it is based on the client's cultural and religious beliefs. The nurse should also recognize that the spouse is acting as the client's advocate and surrogate decision-maker, as some Jewish traditions may assign this role to the closest family member. The nurse should collaborate with the interdisciplinary team and follow the ethical principles of beneficence, nonmaleficence, autonomy, and justice.
Rationale: The nurse should acknowledge and accommodate the spouse's request, as it is based on the client's cultural and religious beliefs. The nurse should also recognize that the spouse is acting as the client's advocate and surrogate decision-maker, as some Jewish traditions may assign this role to the closest family member. The nurse should collaborate with the interdisciplinary team and follow the ethical principles of beneficence, nonmaleficence, autonomy, and justice.
Incorrect options:
A) "I'm sorry, but I cannot do that. It is against hospital policy to remove medical equipment without a doctor's order." - This response is insensitive and dismissive of the spouse's request and the client's beliefs. The nurse should not use hospital policy as an excuse to deny or delay culturally competent care.
B) "I understand your request, but I need to check with the client first. It is their right to decide what kind of care they want to receive." - This response is respectful of the client's autonomy, but it may not be appropriate or feasible in this situation. The client may not be able to communicate their wishes or preferences, or they may have delegated this responsibility to their spouse. The nurse should not assume that the spouse's request is contrary to the client's wishes or best interests.
C) "I respect your request, but I need to explain the risks and benefits of removing the medical equipment. It may affect the client's comfort and safety." - This response is informative and
concerned for the client's well-being, but it may not be necessary or helpful in this situation. The spouse may already be aware of the risks and benefits of removing the medical equipment, or they may value their religious beliefs over their medical outcomes. The nurse should not try to persuade or dissuade the spouse from their request.