Background of the topic

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Mr. Wu is a fireman.
He was unconscious and found in an industrial building blaze. Unluckily, he died after hospitalization and left his
wife and son, Tim. Owing to the death of Mr. Wu, Mrs. Wu and Tim had big
changes in life. Mrs. Wu lost passion about playing tennis. She believed that
fate was settled and her original faith was collapsed, so she did not
participated in church anymore. She had lost ten pounds and looked dirty and
bewildered. Her emotion became unstable as she often cry and be angry. She was
regretful that she went to play tennis but she did not cook breakfast for Mr.
Wu on the death day of him. Meanwhile, Tim cried for the return of his father
and he was angry due to empty life.


The flow of discussion of the paper

The paper will
discuss the application of a nursing theory in taking care of Mr. Wu, Mrs. Wu
and Tim during the hospitalization of Mr. Wu. The effect of the death of Mr. Wu
on Mrs. Wu and Tim and the strategies of therapeutic communication for
communicating with them will also be included. Finally, resources in the local
health care system and community will be suggested.



During the hospitalization of the

Application of nursing theory for
taking care of Mr. Wu and his family

Virginia Henderson’s
need theory can be applied in taking care of Mr. Wu and his family. This theory
cover the physiological, psychological, spiritual and moral, and sociological
aspects in order to help the clients to be independent (George, 2011).


For Mr. Wu, he is a
dying person, so the need theory aims to help him die peacefully. The
physiological components are more suitable for him. First, nurse should ensure
Mr. Wu can tolerate dyspnea and breathe normally in the ward. For example,
airway suctioning or oxygen therapy can be used if the client has dyspnea.
Second, Mr. Wu should have a balanced nutrition intake. For instance, the diet
should contain fewer red meat and more vegetables. Third, nurse should ensure
Mr. Wu to have an optimum and regular urinary elimination and bowel elimination
pattern. Forth, nurse should ensure Mr. Wu has a good rest. Fifth, Mr. Wu need
to maintain normal body temperature which is between 36 to 37 degree celsius, so
nurse should observe any signs of hyperthermia or hypothermia. Sixth, Mr. Wu
need to have suitable clothes-dress and look well groomed, so nurse should
change his clothes regularly. Those interventions can increase Mr. Wu’s quality
of life (Ahtisham & Jacoline, 2015).


For Mr. Wu’s family,
the need theory help them live independently without Mr. Wu. First, nurse
should inform Mrs. Wu to keep good hygiene and well-groomed in favor of
protecting the integument. Second, nurse should worship Mrs. Wu’s faith and
encourage her attending the church even if Mr. Wu does not accompany with her.
Third, nurse should cheer Mrs. Wu to regain passion on playing tennis as this
can help her forget the grief. Forth, nurse should inform Mrs. Wu to have an
adequate nutrition intake for body requirement in consideration of preventing
weight loss. Fifth, Mrs. Wu and Tim should learn how to deal with sadness and
anger. For example, they can do exercises and listen to natural music. Sixth,
nurse can encourage Tim taking part in different recreations such as playing
tennis and cycling which helps him release the stress (Ahtisham & Jacoline,


After the death of the client

Effects of the death of Mr. Wu on Mrs.
Wu and Tim

Psychological aspect

Mrs. Wu and Tim will
go through the five stages of grief due to the loss of Mr. Wu. Kubler-Ross
(2014, p. xiv) proposes the five stages of grief which are denial and shock,
anger, bargaining, depression, and acceptance. In the “denial and shock” stage,
both Mrs. Wu and Tim were shock with the death of Mr. Wu. In the “anger” stage,
Mrs. Wu was angry when Tim asked whether she went to travel with him because
she thought that her life was meaningless without husband. Tim also had a sign
of anger after the loss of father. In the “bargaining” stage, Mrs. Wu
showed guilt because she did not cook a breakfast at fateful day for Mr. Wu.
She rejected her husband and went to play tennis. If she could go back to the
past, she would definitely make breakfast for Mr. Wu. Tim used to say that he
wanted his father returned. In the “depression” stage, Mrs. Wu cried often. Tim
also cried and had an empty feeling. In the “acceptance” stage, both of them
are not experience this stage yet. They still try to deny the death of Mr. Wu,
so it is a challenge for them to reach the final stage of grief (Kubler-Ross,
2014, p. 111).


Social aspect

The effect of the
death of Mr. Wu on Mrs. Wu and Tim can be discussed by using Strobe and Schut
dual process model. There are two types of stressors in this model which are
loss-oriented and restoration-oriented. A process of oscillation takes place in
a person who confronts and avoids loss-oriented and restoration-oriented
(Stroebe & Schut, 1999). According to the case scenario, Mrs. Wu is defined
as loss-oriented. Mrs. Wu did not try to do the new things and stop her passion
on playing tennis. She no longer goes to church which shows that she is not
enthusiastic on society and hides herself. Tim was determined as
restoration-oriented because he tried to invite Mrs. Wu to go to travel with
him. He is willing to contact the society because he tried to do new thing.


Strategies of therapeutic communication
for communicating with Mrs. Wu and Tim


Empathy is a
significant strategy for facilitating the conversation between nurses and
clients. Clinical empathy involves in understanding the client’s perception or
feelings, communicating with them to take notice of the accuracy from their
expression, and acting on appreciating them in a therapeutic way (Mercer & Reynolds, 2002). Nurse can make a
statement such as “Everything happened like a rocket, no wonder you think
that it is unacceptable” for Mrs. Wu. Therefore, she may be eager to chat
with nurses as she thinks that nurses are supportive. Apart from some verbal
wordings, nurse can present empathy through nonverbal behaviors. For example,
nurse can change the tone to be friendly and nod when Mrs. Wu or Tim talk with
them (Halpern, 2003). This helps the
client become comfortable and may reduce client’s depression (Mercer & Reynolds, 2002).


Active listening

Active listening can
also be used in communication. The nurses pay attention on what the clients
want to express and listen to them attentively (Jahromi
et al., 2016). The nurse can use questions to encourage clients
expressing thoughts or feelings. Nurses can also show responses during
communicating with Mrs. Wu and Tim. For example, a statement like “I notice
that you are distressed and unsettled about the loss of husband and father” can
be plugged in the conversation. Mrs. Wu and Tim may alleviate their feeling
when someone acknowledges them. Some verbal or nonverbal behaviors including
nodding and saying “go on” are allowed to add in the communication. The
barriers such as interrupting and focusing on other topic should be avoided as
they will disturb the expression of Mrs. Wu and Tim. Active listening can
enhance the interaction between the clients and nurses (Bulechek et al., 2013).


Resources in the local health care
system and community for helping Mrs. Wu and Tim

Psychological support

Social Welfare
Department provides many clinical psychological services for native. The
clinical psychology unit consists of a senior clinical psychologist and eight
to twelve clinical psychologists. The clinical psychologists perform
psychological assessment and psychotherapy for the client which help them solve
the problem (Social Welfare Department, 2017a). The clinical psychology units
are located at Hong Kong’s various regions such as Kowloon Bay and Quarry Bay
(Social Welfare Department, 2017b). Mrs. Wu and Tim can participate in psychological
assessment which helps them discern the basic problem and some proper
psychological services will be allocated to them. Besides, Hospital Authority
brings psychological counselling to patients and their family which gives
support (Hospital Authority, 2017). There are social workers counsel with
patient’s family and make them feel comfortable. Mrs. Wu and Tim will be relax
and loose after seeking psychological support.




Financial support

Mrs. Wu and Tim can
have application on Charitable or Trust Funds through Social Welfare
Department. A temporary cash allowance will be provided by four charitable
trusts including Li Po Chun Charitable Trust Fund, Tang Shiu Kin and Ho Tim
Charitable Fund, Brewin Trust Fund, and Kwan Fong Trust Fund for the family
with economic difficulties (Social Welfare Department, 2017c). Since Mrs. Wu
becomes a single mother, the academic expense of Tim will become a worry. The
Hong Kong Jockey Club Charities Trust and the Education Bureau initiate the
Jockey Club Life-wide Learning Fund which provides financial assistance to the
students with need to take part in the life-wide learning activities at school
(Education Bureau, 2017). If they apply in financial support, their financial
difficulties will be alleviated.



Virginia Henderson’s
need theory can be utilized to look out Mr. Wu and his family because this
theory considers the need of the clients and their family. Mrs. Wu and Tim
confront the stage of grief because of the loss of Mr. Wu. The grief influences
their psychological aspect. The death of Mr. Wu affects the social aspect of
Mrs. Wu and Tim during Strobe and Schut dual process model. Moreover, nurses
can use empathizing and active listening to communicate with Mrs. Wu and Tim.
Besides, Social Welfare Department, Hospital Authority, the Hong Kong Jockey
Club, and Education Bureau provide various support to them in psychological and
financial support.