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Case Scenario 2

Cora is a 45-year-old woman with severe COPD who smokes 2.5 packs of cigarettes per day. She has limited income and no health insurance or social support. The nurse at the free clinic tries to persuade Cora to quit smoking, but Cora refuses and says smoking is her only pleasure. The nurse implies Cora is noncompliant, but does not understand Cora's difficult financial situation. Coercing patients can infringe on their autonomy; the nurse should involve Cora in care planning and respect her decision to continue smoking while still providing treatment.

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Jean Win
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83 views2 pages

Case Scenario 2

Cora is a 45-year-old woman with severe COPD who smokes 2.5 packs of cigarettes per day. She has limited income and no health insurance or social support. The nurse at the free clinic tries to persuade Cora to quit smoking, but Cora refuses and says smoking is her only pleasure. The nurse implies Cora is noncompliant, but does not understand Cora's difficult financial situation. Coercing patients can infringe on their autonomy; the nurse should involve Cora in care planning and respect her decision to continue smoking while still providing treatment.

Uploaded by

Jean Win
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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CASE SCENARIO 2

Cora is a 45 year old woman who looks year older than her stated age . She has limited monthly
income and no health insurance. Cora smoked 2 and ½ packs of cigarette per day. She has
severe COPD with constant dyspnea and frequent exacerbations. The nurse who sees her at the
local free clinic is interested in at least preventing further problems , and speak to Cora often
about the importance of quitting smoking. The situation becomes very frustrating for all
involved when Cora returns repeatedly for increasingly sever problems, having failed to quit
smoking . Cora of course , becomes labelled as noncompliant. During a particular severe
exacerbation , the nurse says to Cora, “ You know you are committing suicide by continuing to
smoke .”. Cora’s reply is , “ You don’t understand. I live alone. I have no money , no friends , no
family , and will never be able to work. I know the damage I’m doing , but smoking is the only
pleasure I have in life.’

THINK ABOUT IT
DO NURSES COERCE PATIENTS?
In attempting to persuade Cora to stop smoking , to what degree is the nurse disallowing Cora’s
right to autonomy?

Since the nurse implied that Cora was acting noncompliant, the nurse has in fact infringed
Cora's right to autonomy. First of all, the nurse should have questioned Cora about her health
goals and included her in the planning of any additional therapy rather than erroneously
presuming that all patients, including Cora, have the same objectives as the nurse. Second, the
nurse ought to have evaluated Cora's capacity for adhering to the health instructions and the
action plan she had created. The fact that some seasoned nurses have reached a point where
their profession has become a "routine" or "work" that becomes the main focus without having
to attend to the patient's autonomy, which becomes neglected, is another thing that the nurse
should do. This lies in the fact that some seasoned nurses have come to a point where their
profession has become a "routine" or "work."

However, based on what the nurse had mentioned, the nurse was in the dark about Cora's
financial status and lack of family and friend connections. However, given Cora's response, the
nurse should stop trying to persuade her and instead devise a new plan of action for health care
that can help Cora reach her health goals by asking her more questions, assessing them, and
involving her in the decision-making process. When it happens, the nurse shouldn't mark Cora
as a noncompliant patient. Because it appears from the information the nurse has been given
that Cora cannot receive any therapies that would need Cora to pay excessive costs. The nurse
should then come up with a plan of action that revolves around her health goals without
interfering with Cora's one and only vice, smoking. Cora is already aware of the harm smoking
does to her body. If one keeps telling Cora to stop smoking, as the patient had stated, the only
pleasure she gets is smoking, both parties will simply become frustrated and risk breaching the
patient's autonomy. It is our responsibility as nurses to treat patients with respect. The best
course of action in Cora's situation right now is to respect and carry out her wishes as well as
assist her in achieving her selected health goals.

Does Cora have the right to choose to continue smoking?

Since the Patient's Bill of Rights states that the patient has the right to choose his or her course
of treatment and that, in the event of total inability, as in Cora's case, the patient is still entitled
to alternative acceptable care or services for as long as they so choose, Cora has the right to
continue smoking. Cora's decision to smoke must be respected by the nurse as well. By hastily
presuming that all patients, like Cora, share her beliefs and goals, the nurse risked coming to
the wrong conclusion.

If rights and responsibilities are correlative, how should the clinic respond to Cora’s continuing
to smoke? Would you suggest that the clinic continue to serve Cora , even though she is not
following the plan of care?

Cora lacks resources, is unemployed, and is single. Due to her little social and financial support,
Cora's decision to continue smoking is very certainly influenced by this. Instead, the nurse
should make the appropriate modifications to account for Cora's circumstance so that her
inability to pay does not prohibit her from receiving high-quality medical care.

To what degree is coercion employed in situations such as Cora’s? Is coercion appropriate


strategy?

No matter what the situation, the nurse should only make an effort to convince Cora to quit
smoking by supporting her in counseling sessions and informing her of the dangers of smoking.

What would you do?


The nurse can consider informing the patient that smoking often leads to depression since it
only inhibits negative thoughts without necessarily enabling them to escape. Being depressed is
a fatal mental condition that commonly leads to poor decision-making or even death.

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