Question

CASE STUDY

A 62 year-old inmate is admitted to the hospital from prison with a complain of chest pain. The patient is being worked up for possible myocardial infarction and admitted to the cardiac unit. Because the patient is an inmate, while he is in the hospital a prison guard will be posted outside of the patient’s room and he patient will be hand cuffed to the bed rail. During the initial assessment, the admission nurse finds the patient to be withdrawn. The nurse discovers the patient has a past medical history significant for abuse of multiple substances. . the patient describes how the addictive behaviours led to his incarceration and estrangement from his family. The patient expresses to the nurse interest in meeting with a chaplain while in the hospital.

• QUESTION

Describes examples of the how a nurse can provide care to this patient as guided by each of the 10 caritas processes.

Answer 1

1. First value in Caritas process is : Practicing love,kindness and compassion towards self and others.

Eg: The nurse can patiently listen to the patient showing empathy and compassion. This helps in ventilation of feelings and development of a therapeutic relationship.Enable the patient to accept himself leaving the feelings of guilt and shame. Encourage him to participate in activities that he likes, like yoga,meditation and showing compassion towards himself.

2. Instill faith,hope and honor others: Educate the client about his health status, measures to maximize well being like exercise, quitting addiction etc. This will help to improve the hope to lead a balanced life and enable to practice healthy life style.Allow patient to verbalize his feelings and express his emotions.An authentic caring relationship helps in relieving anxiety and promote spiritual and emotional well being.

3. Be sensitive to self and others: addressing the need of patient to meet a clergy can improve his spiritual and emotional status. Encourage to recite prayers in which  he believes or to do meditation or yoga or to perform religious rituals that he follows, at times of emotional crisis so that it may improve the emotional well being.

4. Developing a trusting and caring relationship: Provide direct patient care including comfort measures, involving patient in care planning and decision making. Enable the client to connect with the nurse or care provider by developing a caring relationship.

5. Promote and accept the patients feelings: Accepting the patient's negative and positive feelings. Instead of being a passive listener, the nurse can interact with the patient, understand his concerns as well as obtain clarification of care related queries that the nurse have like information on medical history. Also encourage the patient to accept his negative feelings and move forward.

6. Using scientific problem solving methods: Applying evidence based practice measures in caring for an elderly patient with MI including cardiac rehabilitation and training may promote the well being of the patient.

7. Teaching and learning addressing individual needs: Educate the client about importance of being physically active, complications of addiction on his health status. Encourage the patient to ask doubts so that nurse can learn the level of understanding and need for further education. Provide materials for reading or watching regarding the issues of concern, either it may be health related or based on emotional needs.

8.Creating a healing environment: Respect the values and beliefs of the patient. Help him to accept the present status and to practice behavioral modifications in order to feel healthy and maintain the health status. Allow patient to decide on his behalf and never force anything.Provide materials or objects like books that the patient would like to have in order to provide a diversion and promote a relaxed mental state.

9.Assist with basic physical,emotional,spiritual needs: Assisting in meeting physical needs like feeding, personal hygiene and grooming as necessary, providing psychological support and counselling to develop a positive attitude, allowing to read or hear spiritual books or recordings,referring to social workers in order to arrange for visit of a chaplain as requested by the client.

10.Open to Mystery and allow miracles to happen: Enable the patient to compare the religious teachings with his beliefs and come to an acceptable compromise. Enable the patient to accept the fact of death and enable to live the present and participate actively in life.