A 35 years old fireman called Mr. Wu who is a breadwinner of his family. He is married and having a son called Tim. One day during an industrial building blaze, Mr. Wu was found unconscious by his teammates on the building’s fourth floor as firefighters were changing shifts to leave the site. I am the nurse who is responsible to take care of Mr. Wu after he had admitted to my ward. Unfortunately, Mr. Wu passes away one week after his hospitalization.
The following will select a nursing theory and discuss its application when taking care of Mr. Wu and his family during the hospitalization of himself. The study will also figure out how the death of Mr. Wu would affect Mrs. Wu and her son, what the strategies of therapeutic communication should be applied by the nurse and identify the resources to help Mrs. Wu and her son to go through the grief and bereavement process after the death of Mr. Wu.
During the hospitalization of the client
I am going to select the Strobe and Shut’s dual process model to discuss its application when taking care of Mr. Wu and his family. Strobe and Shut’s dual process model is an oscillation processes in which the bereaved would confront and avoid the two types of stressors, which are loss-oriented coping and restoration–orientation (Stroebe, Schut, & Boerner, 2010).
Mr. Wu was found unconscious while he is admitted to my ward. Therefore, there is no application of Strobe and Shut’s dual process model when taking care of Mr. Wu. According to the condition of Mrs. Wu, she was experienced the loss-oriented of everyday life. The components of loss-oriented are grief work, the intrusion of grief, letting go-continuing-relocating bonds and denial of restoration stage (Stroebe, Schut, & Boerner, 2010). It is shown that Mr. Wu is a breadwinner of his family. After he was found unconscious by his teammates on the building’s fourth floor during an industrial building blaze, Mrs. Wu and Tim may felt sorrowful and confused owing to they were concerning the dangerous condition of Mr. Wu. They may not have the mood to do the things which are necessary for the daily life. In addition, they may feel worthless or guilty of self-blame due to they did not have any actions that can wake Mr. Wu up.
There are some applications that I need to take care of Mrs. Wu and Tim, which is the restoration-oriented. The components of restoration-oriented are attending to life changes, inspire them to do new things, the distraction of grief, denial of grief and the new roles (Selby, S., Clark, S., Braunack-Mayer, A., Jones, A., Moulding, N., & Beilby, J. 2011). While Mrs. Wu and Tim were facing the of the hospitalization of Mr. Wu, they may felt puzzled and helpless owing to they did not have any actions that can wake Mr. Wu up. I would suggest them to think positively and listen to them for helping them to cope with unpleasant situation and feeling of being cared for and understood. Moreover, the information of Mr. Wu should be given to Mrs. Wu and Tim for reducing their concern about Mr. Wu.
After the death of the client
1.1 The death of Mr. Wu would affect Mrs. Wu and her son in psychological and social aspects.
The death of Mr. Wu is affecting Mrs. Wu and her son in psychological and social aspects after the death of Mr. Wu, Mrs. Wu and her son need to face the bereavement. Form the aspect of psychological, they are facing the ‘Five Stages of Grief’ according to the Kübler-Ross model. The five stages are denial, anger, bargaining, depression, and acceptance, which are a part of the framework that makes up our learning to live with the one we lost (Kübler- Ross, 2005). The five stages can show the key emotional reactions to the experience of the dying (Kellehear, 2017). The first stage of grief is denial and shock. Mrs. Wu may feel lonely owing to the living environment has become desolated and the emotions were tormented herself and lead to may be in denial was grieving the loss of a loved one after she has received the information of Mr. Wu was passes away after his hospitalization (Kübler-Ross, 2005). Moreover, she may feel depressed due to the death of her husband. The second stage is anger which is a necessary stage of the healing process (Kübler-Ross, 2005). Mrs. Wu blamed that Mr. Wu was taken so cruelly from her lead to no longer attended church and stated that whatever faith she had was squashed. She cried often and became angry when Tim asked if she wanted to go on a trip with him. Now, the condition of Tim is in the phase of anger, he cried and told me that he needed his father back, he became angry and told you that his life was empty. When the anger turns toward self, the person may experience the culpability (Kübler-Ross, 2005). From the guilt, Tim had found her sitting on Mr. Wu’s favorite chair one night and she blamed herself that she refused her husband and went to play tennis instead of cook breakfast for her husband at that fateful day. The third stage is bargaining which Guilt is often bargaining’s companion (Kübler-Ross, 2005). Mr. Wu may want to go back to the past and change the fault with herself which can reverse the event. Now, Mrs. Wu is now in the fourth phase of Kübler-Ross model which is depression. She had lost 10 pounds and previously well-groomed due to depression of the hospitalization of her husband. Moreover, she had shown the position that she didn’t know what to do with herself and that she no longer had a purpose without Mr. Wu. The last stage is acceptance. In the future, although Mrs. Wu and Tim will never like this reality, they will accept it at last.
Form the social aspect as Tim has told me that Mrs. Wu stopped playing tennis, which is an activity that had been a passion of her. She had exaggerated her fault which she thought it lead to the death of her husband. Therefore, she stopped playing tennis as the punishment of herself. Mrs. Wu was previously well groomed, but after the death of her husband, she now always looked untidy and bewildered.
1.2 The strategies of therapeutic communication
There are some strategies of therapeutic communication should be applied by the nurse when communicating with Mrs. Wu and her son. The nurse should make educated guesses. In case, the nurse need to guess their feeling by their expressed emotion, so we can know about their feeling and consequently help them to cope with it (Bramhall, 2014). We can ask Mrs. Wu and Tim to tell about what they are confused. Psychological focus is also a therapeutic communication skill that nurse can use in this case (Bramhall, 2014). The nurse should focus on the emotion, feelings and concern of Mrs. Wu and Tim. While they are expressing their feelings and concern, we should use silence. It can help them engage in the conversation and give them more time to organize what they want to express. Furthermore, we should be active listening. We should answer them for showing response after they have expressed their feelings. This can help them to cope with unpleasant situation and feeling of being cared for and understood. They may break down, depression and crying while they were expressing their concerns. While this situation, we should stop asking them the questions which make them feel distressed.
1.3 The resources to help Mrs. Wu and her son to go through the grief and bereavement process.
There are some resources of local health care system and in the community that can help Mrs. Wu and her son to go through the grief and bereavement process. From the aspect of financial support, Labour and Welfare Bureau of the Government of the Hong Kong Special Administrative Region is the local health care system that can help them by providing the financial aid to them. The Committee on Financial Assistance for Family Members of those who Sacrifice their Lives to Save Others is one of the financial Assistance Scheme of Labour and Welfare Bureau of the Government (Government of Hong Kong, n.d.). This scheme can help Mrs. Wu and Tim to have financial support. It is shown that Mr. Wu is a breadwinner of the whole family. After he has dead, it becomes a burden of the family due to they lost the breadwinner and difficult to support their life in the future.
From the aspect of psychological support, the Hong Kong Red Cross and the Social Welfare Department is a department of the Hong Kong Government can seek help to Mrs. Wu and Tim which provide immediate psychological support services to affected people, their families from the accidents (Hong Kong Red Cross, n.d.) and provide psychological counseling (The Social Welfare Department is a department of the Hong Kong Government, n.d.). While they are facing the bereavement of Mr. Wu death, they may be distressed and have collapsed mood, these two of local health system can help them go through the grief and bereavement process by counseling.
To conclude, Mr. Wu and Tim are facing the grief and bereavement of the death of Mr. Wu. As a nurse, I should take good caring of Mr. Wu and his family during the hospitalization of Mr. Wu and provide support for Mrs. Wu and Tim to go through the grief and bereavement process after the death of Mr. Wu. They may be distressed and confused of the death owing to lost the loved one. Therefore, nurse is playing an important role of coping the stress of clients.