A nurse is supporting a family meeting where the medical team is discussing transition to comfort-focused care for a client with metastatic cancer and worsening multi-organ failure. Which nursing actions reflect best practice? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
Goals-of-care meetings require a certified interpreter (family interpreters introduce bias and emotional burden), comfort with silence so families can process, clear documentation of decision-maker and symptom goals, and offering culturally-aligned spiritual care. Telling the family that continued treatment is futile or unethical is judgmental and undermines shared decision-making — the team explores values, prognosis, and trade-offs, then recommends a plan.
Use SPIKES or NURSE statements: Name the emotion, Understand, Respect, Support, Explore. Avoid premature reassurance and value-laden labels like futile.
Client unable to participate; designated health care proxy is present with three adult children. Spanish primary language; certified medical interpreter on phone.
goals of care — Patient-centered framework aligning treatment with values and prognosis.
palliative care — Specialty focused on serious-illness symptom management and quality of life at any stage.
health care proxy — Designated decision-maker when the client lacks capacity.