you are the Registered Nurse caring for Tom, you will need to process the information provided to: identify the issues 

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Tom’s Story

 Things you need to know…

Tom was able to discuss his end of life decisions with Uncle Joe, however his condition continued to deteriorate, and he is now receiving end of life care (terminal phase).

Following on from the end of the video, Tom’s daughter Carina arrived at the hospital. Carina is clearly angry (she is raising her voice and she is clenching her fists), she tells you that she has power of attorney for her father and she wants the morphine stopped and changed to ‘something better’. She explains she wants ‘everything done to save her father’ and that only she has the capacity to make decisions for her father.

Jimmy confirms the power of attorney claim however states that his mother Cec is Tom’s enduring guardian and he thinks his father did “some  advanced care  planning with his GP, but he is not sure, but that would override the guardian thing anyway – wouldn’t it?“.

While reviewing the progress notes, you also note an entry from Tom’s last admission, the page is tagged with a red dot and a medical registrar has written “Following discussion with team – NFR, not for CPR, not for ICU admission”. The entry is signed and dated. He current medication order is for Morphine 2.5mg – 5mg SC every 2 hours PRN. All other medications have been ceased.

Carina’s arrival and comments are causing obvious distress to the rest of Tom’s family, who are aware of Tom’s wishes and are supportive of the palliative approach currently being undertaken, however they are concerned about Tom’s increasing agitation and pain. Tom is no longer eating but is taking small sips of fluid, Carina wants the nursing staff ‘make sure Dad drinks or get the doctors to put a drip in’.

You are the Registered Nurse caring for Tom, you will need to process the information provided to:

· identify the issues 

· establish goals (what do you want to happen)

· select a course of action (what are you going to do)

A good starting point is to ensure you research and understand the terms above which are in bold.

Module three will provide you with a range of resources to assist you with your case study.

Attention 

· Please write your paper in the first person.

· You may use headings, images, tables and dot points to convey information.

· For the purpose of this assessment task Tom lives in Tasmania.

· Please read the rubric for this assessment before you start writing.

Just follow Tasmanian legislations.