Nursing Plan: Health Promotion

Creating a nursing plan is crucial in the development of care for Mrs. Thomas and her family. A family that faces a terminal illness such as cancer at times has difficulty determining what they need to do. By strategizing which areas of concern need to be addressed first, Mrs. Thomas can effectively be cared for. It will be important for the plan to be unique to the needs of Mrs. Thomas (Ackey, 2008). The more individualized a plan is the more it will ensure that Mrs. Thomas and her family will be able to follow the plan. If the plan isn’t individualized to the needs of Mrs. Thomas the plan will be ineffective. Before the plan can be developed the nurse also needs to examine her own strengths and weaknesses in being able to care for and treat Mrs. Thomas.

The nurse’s perceptions about the quality of life and health promotion need to be analyzed to determine how it may affect her care for Mrs. Thomas. Understanding your own values and belief system is essential when providing service to others. The nurse may believe that Mrs. Thomas should feel no pain as she tries to deal with her condition. The nurse may not agree with Mrs. Thomas choice to not take any painkillers. However, she would need to be able to respect her wishes rather than force medicine on her. The nurse may also feel that Mrs. Thomas is in need of more social supports in order to promote her health needs which Mrs. Thomas may also not agree to as she does not want to burden others with her problems although she could use support. The nurse would have to resolve these concerns before beginning to provide services to Mrs. Thomas. 

The first strategy in improving the quality of life for Mrs. Thomas would be addressing the pain she is feeling. By providing education to Mrs. Thomas regarding the use of painkillers and the steps that she could take to prevent becoming addicted to the medication it may influence her to agree to take the medicine. Mrs. Thomas’ fear of the painkillers may be unjustified as she just needs more knowledge about medication and the ways in which it can be taken responsibly with no repercussions. If she continues to refuse the nurse may contact the doctor to see if he would be able to prescribe a painkiller which is not as addictive. Although this medication may not be as effective in resolving the pain Mrs. Thomas is feeling. Therefore more holistic approaches may need to be pursued to address her pain. A referral may need to be made to a holistic physician in order to obtain alternate medicine which would relieve Mrs. Thomas’s pain without medication. Finding alternative sources for pain management would be more beneficial as it would respect Mrs. Thomas wishes while at the same time finding a way to manage her pain.

The second strategy would involve creating a natural support system for Mrs. Thomas. The lack of natural supports in the form of family and friends can not only lead to depression and loneliness but also limits the available people who are able to help her in case she needs a ride to the doctor’s or if she is having an emergency. Having a support system would help Mrs. Thomas mentally as well as she would have someone she could talk to about the pressures of her illness. The nurse could talk to Mrs. Thomas of the importance of having a support system rather than just thinking of herself as a burden. The nurse could discuss various ways in which Mrs. Thomas could build a support system. The nurse could also provide Mrs. Thomas information about support groups she could go to in which there are individuals who are going through the same illness. The nurse would also provide resources so that Mrs. Thomas could have some professional supports in the form of a therapist or social worker she could speak with to process her feelings.

The third strategy would involve ensuring that Mrs. Thomas’ medical insurance coverage will care for her long term care. As Mrs. Thomas will have to face ongoing treatment in the form of medical treatments, palliative care, and eventually hospice care, the nurse will need to determine if her insurance will provide enough coverage. Mrs. Thomas may also need additional support in the form of therapy which the insurance will need to cover as well. Mrs. Thomas will need to make a plan along with her husband in case she passes which will take care of all funeral arrangements. Having a pre-need arrangement with a funeral home setup will not only assist the family after Mrs. Thomas passes away but also at the moment to prepare the family for her eventual passing. 

As Mrs. Thomas is still relatively functioning on her own at this stage in her illness her ability to care for herself needs to be optimized through the development of a holistic nursing plan. The plan will incorporate the physician’s input in developing a medicine regimen which will ease Mrs. Thomas pain without creating a possible addiction. A therapist will be included to ensure that Mrs. Thomas mental health is being addressed and she has someone to talk to about the stress she is undergoing. The plan will also incorporate alternative therapies such as yoga, acupuncture or Ayurvedic medicine to provide relaxation to Mrs. Thomas in order to reduce her stress levels. By creating a plan which incorporates not just medical approaches as was common in earlier nursing practices (Mayers, 1972); Mrs. Thomas cancer can be treated in a comprehensive manner.

Once Mrs. Thomas is not able to care for her self the nursing plan will need to be modified. Hospice care may need to be sought after if Mr. Thomas would not be able to manage the care of his wife. Hospice care would be able to provide 24/7 care to Mrs. Thomas while providing an environment which seeks to make her feel as comfortable as possible. Hospice care would also provide the holistic approach by providing a doctor, social worker, therapist and any other professionals which Mrs. Thomas may need. Hospice care would also be able to ease the pressure from the family by demonstrating that they can provide adequate care and they would be able to just visit her in a calm relaxing setting which won’t be a hospital while she was in care.

The community health nurse could also help Mrs. Thomas by addressing Mr. Thomas’s symptoms of depression. Although the direct patient is Mrs. Thomas as Mr. Thomas cares for her, his symptoms need to be resolved as well. Mr. Thomas’ condition may be exacerbating her illness and treatment. Mr. Thomas should be taken to see his doctor or psychiatrist to manage his stress. Mr. Thomas should also resume taking his medication. The nurse will need to assist Mr. Thomas with managing his medication and ensuring that he is taking it on time and as it is prescribed. If Mr. Thomas is sick he will not be able to care for Mrs. Thomas or be a source of support for her. 

Developing a plan of care for a patient who is facing the end of her life is crucial in ensuring that the last moments of her life are peaceful and pain-free. It may seem pointless to deliver end of life care to someone who is passing away, however, the care that a person receives at the end of their life benefits not only themselves but their whole family. A community health nurse is someone who can ease a patient and their family through the process by being both a medical professional and a counselor of sorts who can see the family through the process of illness and grief. By following a strategic case plan’s success a community health nurse can effectively provide services. Mrs. Thomas will have a peaceful end of life process because of these steps.

References

Ackley, B. J., & Ladwig, G. B. (2008). Nursing diagnosis handbook: an evidence-based guide to planning care. Mosby Elsevier.

Mayers, M. G. (1972). A systematic approach to the nursing care plan. Appleton-Century-Crofts.