The nurse is caring for an older adult Native American client who is experiencing severe chest pain

Question

The client is accompanied by a tribesman at the insistence of the client. The tribesman tells the nurse that their culture teaches acceptance of death as part of the natural cycle of life and that treatments must be stopped. The client's son insists that his father be treated, and states he feels the tribe's teachings are antiquated. Which action by the nurse is the most appropriate?
1. Call the social worker to plan a family meeting without the tribesman.
2. Interview the client and ascertain his wishes and beliefs.
3. Convene the hospital ethics committee.
4. Call the nursing supervisor.

Answer 1

Correct Answer: 2

The client is an adult and, if capable of expressing his wishes and beliefs, should be encouraged to do so. Sometimes the client must be interviewed alone to be sure the client is actually stating his own wishes and not those of family members who may be present for the interview. Unless an adult is not competent to make and express his own decisions, or is impaired in some way and cannot express his own wishes, then the adult client's wishes are honored over all others who may try to exert influence. It would be inappropriate to call a family meeting, with or without an interested second party, if the client is competent and has not asked for such a meeting. There is, at the moment, no behavior exhibited that would warrant notifying hospital administration, nor is there enough data to ask the hospital ethics committee to render an opinion.