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Questions for Critical Thinking Caps

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Questions for Critical Thinking Caps Worksheet
Read the description of the six caps and the “Case Study for Six Caps” on p. 175 of Professional Nursing. Answer the following questions individually. Then, discuss your answers in your Learning Team forum online. After you have discussed each question and achieved a consensus, compile a group response, which will be submitted as a Learning Team assignment.

White cap: Rachel Skidmore
What pieces of information are needed to assist the family in making a decision regarding Marianne’s care?

In order for the family of Marianne to make an informed decision certain information is needed. The medical staff needs to review the current prognosis without surgery. What type of treatment or surgery is possible along with the risks, benefits, and recovery required. The staff needs to review if any discussion has occurred in the family with Marianne in the past regarding advance directive wishes even though no formal advance directives have been made. Patient rights need to be reviewed and written copy provided to family. Information on DNR, full code, to allow or when to stop ventilation, and if artificial feedings to be started are a few of the topics that the family needs to have information reviewed to make an informed decision on the care of Marianne. Grief is a natural process that is individual process to each person and the staff needs to allow for the various stages.

Red cap: Shirley Palotai
How might family members’ values and morals affect their decision-making process when faced with potential end-of-life decisions for a loved one?

When Marianne and her husband had their wedding, they probably stated their wedding vows, “through sickness and heath.” Marianne’s husband may feel that he is morally bound to that statement and that it is his duty as a man to ensure every avenue is explored for treatment. Marianne and her husband may have been married for a very long time, and he is not ready to accept at this point that his wife will not be at his side. Marianne’s husband may also believe that if every option for treatment is not utilized, he may be depriving his wife with the chance of recovery. He thinks he knows what his wife wants because he is the one that knows her best. Marianne’s husband may have religious view guiding him as well. He may feel that if he lets his wife pass, then it would be the same as killing her himself. Marianne’s children, on the other hand, have very different viewpoints. They are extremely concerned about the quality of life that their mother will endure. They are probably also concerned with their mother being comfortable and possibly the financial burden that extensive lifesaving measures would entail. Being that Marianne did not have an advance directive, it is tough to decipher what Marianne would want, but ultimately the decision for Marianne’s plan of care will rest on her husband.

Black cap:
Discuss ways in which nurses can integrate concepts found within the American Nurses Association’s Code of Nursing Ethics and the Nursing Practice Act when caring for patients and their families.

Yellow cap:
How might the family benefit from conversations with their loved ones’ health care providers and spiritual advisor during their periods of stress?

Green cap:
Describe how ethics committees can provide support to patients’ families during their difficult decision-making process.

Blue cap:
How do you see your own morals and values affecting your feelings regarding difficult decisions for end of life care?

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