Nursing and Palliative


Question Sanandhra (Sandy) is 35 years old. She is married to Jack and has two children (Billy who is 12 and Jade who is 8). Sandy was born in India and speaks English as a second language. She was raised as a Hindu, but does not always follow the teachings of Hinduism, having become somewhat “westernised” after 15 years of living in Australia. Sandy and Jack met while Sandy was studying at university. Jack, Billy and Jade were all born in Australia, only speak English and loosely follow the teachings of Christianity. Sandy was treated for breast cancer two years ago. Treatment included chemotherapy and radiotherapy. Within the last month, however, Sandy has noticed a persistent cough and increasing breathlessness. Further tests have culminated in a consultation with her GP who has confirmed the cancer has returned and has metastasised to her lungs and liver. Although Sandy considers herself to be “westernised”, she is revisiting and revising some of her cultural and religious beliefs now that she has received a terminal diagnosis. She has asked Jack and other people in her life to start calling her Sanandhra and has started wearing traditional Indian clothing. Sanandhra’s parents live in India. They are devout Hindus and had become somewhat estranged from their daughter when it became apparent she was not adhering to Hindu teachings. They were also disappointed because they had expected her to return to India once her university studies were complete. However, following the receipt of a terminal diagnosis, they have revised their disappointment and previous feelings about Sanandhra deviating from the teachings of Hindiusm and would like to visit her in Australia. Sanandhra has also expressed a desire to have her parents close to her at this time. However, they cannot afford the airfare, and Sanandhra and Jack are unable to pay the airfare because Sanandhra is no longer working and the costs of treatment have depleted their savings. Using the PCC4U communication workbook as a starting point, discuss the role of effective communication by health professionals as they provide care for the mother and family within a collaborative multidisciplinary approach. If there are any questions in the workbook that you cannot answer (for example, because you have yet to provide care for patients), suggest instead what you believe you would do in the circumstances. Include your completed PCC4U workbook as an attachment to the case study essay. Areas to focus on include:

  1. Communication with the patient, family and within the multidisciplinary team. What communication strategies should be adopted? What factors should be borne in mind when communicating? (Review module 2 and the “Michelle” video in PCC4U for information about communication).
  2. Communication strategies and techniques that will assist in addressing EOL issues across the lifespan (for example: “too young to die”; “how will my children cope without me”; the impact of their mother’s death on the children; the destruction of life plans for both Sandy and Jack; the impact on the elderly parents who will not be able to visit their dying daughter; how will the MDT assist the family to cope with their losses and grief now and their bereavement following Sandy’s death).
  3. Communication strategies and techniques that will assist in identifying and meeting where possible the cultural beliefs and practices that are influencing and being influenced by the care that is being provided. 
    Remember to watch Michelle’s story in the PCC4U module 2 (communication). You will note some similarity between Michelle’s story and Sandy’s story. The similarities should assist you to critique and apply some of the strategies apparent in Michelle’s story. As this assignment is in essay format (with workbook as an attachment), it should follow typical essay structure, ie: 
  4. You do not need headings or a table of contents for an essay. 
  5. Introduction, commencing with a few sentences of general (typically unreferenced) background information, a thesis statement and an outline of the main ideas to be discussed.
  6. Each body paragraph commences with a topic sentence that links (sequentially) to one of the main ideas outline in the introduction. The remainder of the paragraph relates to that topic, critiquing, contrasting, comparing, synthesising, analysing the evidence (from scholarly literature) to support the thesis statement. 
  7. The conclusion summarises the main ideas originally outlined in the introduction, then expanded on in the body. The conclusion finishes with a concluding statement.