The nurse is caring for a client who has been diagnosed with terminal pancreatic cancer. The family is asking what to expect when the end draws near. Which response by the nurse is most appropriate?

  1. “I will have the doctor talk to you about that.”
  2. “The hospice nurse is the best person to answer your questions. I can put in a consult for you.”
  3. “Don’t worry about that right now. You don’t know if there is another treatment option that will work.”
  4. “I can tell you what to look for when the time comes. In the meantime, what are your wishes and goals for care?”
Number 4 is correct.
Rationale: The nurse can explain to the client and the family the signs that indicate death is near. The nurse should allow the client and family to discuss goals for care, such as pain relief. The client may wish to have heroic measures taken, or he may prefer to be kept comfortable without heroic interventions. The nurse should respect the client’s wishes, even if they differ from what she thinks is right. Telling the family that she will have the doctor come talk to them passes off responsibility, and may make the family more anxious if they have to wait to talk to the doctor. The nurse knows the information to share, and should take the opportunity to establish rapport with the family and reassure them that their wishes will be respected. Telling the family not to worry and that other treatments may be effective belittles their feelings and offers false hope.