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Scenario: You are a nursing student who is assigned to a busy medical-surgical unit that specializes in the care of patients with various respiratory disorders. One of your patients for the day is Mr. Jackson Martinez, or Jackie, a 23 year old Mexican-American male with a primary diagnosis of pulmonary exacerbation secondary to cystic fibrosis. Over the past few days since being admitted, Jackie's condition has been worsening. During your morning rounds with the interdisciplinary healthcare team, you learn that Jackie's prognosis is poor and his physician believes that respiratory failure is imminent. After your meeting with the team, it is time for you to assess Jackie. Upon assessing, you find that his respiratory status has, in fact, significantly declined from just a few days ago. As you are finishing your assessment, Jackie's mom enters the room and begins to ask you questions about the assessment you just completed and how her son is doing?
1. How do you think you may best navigate this situation? Should you state that Jackie's prognosis is poor?
2. Family members are often present in the room during nursing assessments. Is it okay to discuss your assessment with them?
3. We often have no issue stating that a patient is "doing well." However, Is it within the nursing scope to state that a patient is not doing well? Can the nurse share a patient's prognosis, particularly when the outcomes are likely negative/undesirable?
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