Mrs. Smith Was A 73-Year-Old Widow Who Lived Alone ✓ Solved

Mrs Smith Was A 73 Year Old Widow Who Lived Alone With No Significant

Mrs. Smith was a 73-year-old widow who lived alone with no significant social support. She had been suffering from emphysema for several years and had frequent hospitalizations for respiratory problems. On her last hospital admission, her pneumonia rapidly advanced to organ failure. As death seemed imminent, she experienced periods of unconsciousness, alone in her hospital room.

The medical-surgical nursing staff and the nurse manager prioritized making her end-of-life phase as comfortable as possible. Despite considering transfer to a palliative care unit, they opted to keep her in her current setting to provide continuous, nurturing care, aiming to honor her dignity in her final moments. This decision was influenced by her existing signs and symptoms of the dying process and was rooted in the nursing philosophy emphasizing human caring, as highlighted by Turkel, Ray, & Kornblatt (2012). Following a reading on caring as the “language of nursing practice,” the team integrated compassionate actions into her care plan.

The nurse manager reorganized staff assignments, recognizing that the clinical nurse leader (CNL), functioning across both medical and surgical units, could facilitate coordinated, direct caring. The CNL, along with a volunteer nurse, provided personal care, including turning, bathing, and suctioning Mrs. Smith. The CNL also inquired about any close friends, leading to the arrival of a visitor to say goodbye. Through quiet conversation, prayer, and singing hymns, the team created a peaceful, spiritual environment that embodied compassion and care. These actions reinforced the emotional and spiritual needs of Mrs. Smith and provided solace for the staff, who found comfort in providing such meaningful care.

According to Davidson, Ray, and Turkel (2011), caring is a complex art that involves an aesthetic understanding of the nurse-patient relationship—a dynamic that fosters authentic spiritual-ethical choices leading to healing, health, well-being, and a peaceful death. The caring actions undertaken by the clinical nurse leader and the staff not only comforted Mrs. Smith but also fostered a caring-healing environment that benefited the entire unit. This environment uplifted the emotional atmosphere, enhanced the ability of staff to practice compassionately, and enriched the overall quality of care provided.

Hospital management and leadership operate within a bureaucratic framework that confers authority and control to the nurse manager and the clinical nurse leader, supported by the vice president for nursing. These leadership structures reflect core values, beliefs, attitudes, and behaviors about nursing care, technology use, and human relationships. The staff’s ethical and spiritual decision-making demonstrated a shared value system, shaping a caring community within the hospital’s organizational culture. Such a culture aligns with the theory of bureaucratic caring, which emphasizes the integration of organizational authority with compassionate care practices.

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In examining this case study, several key aspects of caring behaviors emerge that prompted the nurse manager to assign the clinical nurse leader (CNL) to provide direct care for Mrs. Smith. The CNL role, established by the American Association of Colleges of Nursing (2004), is designed to facilitate high-quality, evidence-based, and patient-centered care in complex acute care environments. The CNL serves as a clinical leader who coordinates care, advocates for the patient, and fosters multidisciplinary collaboration to improve outcomes and ensure compassionate, holistic care delivery. Unlike traditional registered nurses, CNLs occupy advanced roles that encompass clinical expertise, leadership, and care coordination—all crucial in end-of-life scenarios where nuanced, ethical, and emotionally sensitive care is paramount.

Several issues influenced this situation within the framework of the bureaucratic caring theory. Ethical considerations such as respecting Mrs. Smith’s dignity and wishes, spiritual needs like providing comfort and spiritual presence, legal considerations involving consent and quality care, social-cultural aspects of familial and community support, economic factors related to hospital resource utilization, and the physical needs of symptom management all played interconnected roles. End-of-life issues within this theory revolve around balancing compassionate presence with organizational policies, ensuring that the patient’s dignity is preserved while managing resource constraints and institutional policies. The theory emphasizes that caring in bureaucratic settings requires navigating these complex issues with moral sensitivity and organizational integrity.

The nurse manager carefully balanced these issues by prioritizing Mrs. Smith’s comfort and dignity over resource-driven decisions such as transfer to a palliative care unit. Her decision-making involved assessing clinical signs of imminent death, understanding the patient’s wishes, and recognizing the importance of human connection at life’s end. Her choice to keep Mrs. Smith in the current setting reflects a commitment to humanistic care, reinforcing the ethical obligation to provide comfort and spiritual support. Consideration of available resources, staffing, and organizational protocols informed her leadership role in orchestrating care that was compassionate, ethical, and patient-centered.

The role and value of the clinical nurse leader on hospital units are integral to fostering a caring environment amid complex clinical demands. While nurse managers typically oversee operational aspects and resource allocation, CNLs focus on direct patient care leadership, clinical expertise, and care coordination. The CNL acts as a bridge between staff and organizational policy, advocating for best practices and ensuring that caring principles are embedded in daily care activities. In complex hospital care settings, the CNL contributes to cultivating a culture of compassion and accountability, often implementing evidence-based practices aligned with the theory of bureaucratic caring.

Distinguishing between the nurse manager and the CNL reveals their complementary roles in fostering caring practice. The nurse manager’s role centers on administrative oversight, resource management, and policy enforcement, while the CNL emphasizes clinical advocacy, direct patient engagement, and team coordination. Both roles align within the bureaucratic caring framework by integrating organizational authority with a deep commitment to compassionate, patient-centered care. The CNL’s function in implementing caring practices is vital in ensuring that organizational systems support authentic caring relationships, grounding organizational policies in humanistic values.

The interconnectedness among the vice president for nursing, nurse manager, CNL, staff, and patient is starkly evident in this case. The vice president provides overarching leadership and policy direction, fostering a culture that emphasizes compassionate, ethical care. The nurse manager operationalizes these values through staffing, workflow, and resource decisions. The CNL bridges strategic leadership and frontline care, ensuring that care delivery remains aligned with organizational values. Staff nurses execute care directly, translating organizational policies into compassionate, individualized interventions. Mrs. Smith, at the center, is connected to this web of support, with every layer working collaboratively to honor her dignity and provide comfort.

When contrasting the traditional nursing process with Turkel, Ray, and Kornblatt’s (2012) language of caring practice within the bureaucratic caring theory, several distinctions emerge. The traditional process follows a systematic approach: assessment, diagnosis, planning, implementation, and evaluation, focusing on problem-solving and clinical outcomes. In contrast, the language of caring emphasizes authentic engagement, spiritual presence, and relational connection, viewing caring as a moral and aesthetic act that transcends mere technical competence. This caring language invites nurses to approach patients holistically, recognizing their existential and spiritual needs, especially in end-of-life care, fostering a culture rooted in compassion and ethical integrity.

References

• American Association of Colleges of Nursing. (2004). The Clinical Nurse Leader: Conceptual Framework.
• Davidson, P., Ray, M., & Turkel, M. (2011). The art and science of caring in nursing. Nursing Science Quarterly, 24(3), 232-239.
• Turkel, M., Ray, M., & Kornblatt, P. (2012). Human caring as the language of nursing practice. Journal of Nursing Scholarship, 44(3), 246-252.
• Sherman, R. (2012). The clinical nurse leader role and its impact on patient safety. Journal of Nursing Administration, 42(4), 175-179.
• Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses: A call for radical transformation. Jossey-Bass.
• Leininger, M. (2002). Culture care diversity and universality: A theory of nursing. Jones & Bartlett Learning.
• Endacott, R., et al. (2010). Ethical decision-making in nursing practice: A concept analysis. Nursing Ethics, 17(6), 743-759.
• Watson, J. (2008). Nursing: The philosophy and science of caring. University Press of Colorado.
• Swanson, K. M. (1991). Nursing as informed caring for the well-being of others. Journal of Nursing Scholarship, 23(1), 16-22.
• Benner, P., et al. (2010). From novice to expert: Excellence and power in clinical nursing practice. Prentice Hall.