Pierre’s Family Palliative Care Free Case Study Sample

Building Trust

During palliative care, the nurse ought to establish a trust to enhance a successful therapeutic relationship with the patient (Kozier & Erb, 2012). The nurse could establish trust in the therapeutic relationship with Josie in four ways. At the outset, the nurse ought to comprehend the current patient’s needs. In this case, Josie carries the responsibility of caring for the extended family’s health needs. As such, Marguerite ought to understand the various challenges that Josie is currently experiencing and the role conflict that is apparent in her career. The nurse should be approachable and able to guide Josie on ways that she can provide care for the outpatients. Second, the nurse should be able to exhibit both attitudes and actions that imply that she cares about the tribulations and challenges that Josie is experiencing. It is imperative to understand that Josie will welcome a palliative care nurse into her household with the belief that they care about the patients (Leininger & McFarland, 2002).

Further, the nurse should be able to provide holistic care to the family members of Josie. In so doing, the nurse will have addressed the cultural and ethnic backgrounds of the patients and achieve cultural congruency (Kozier & Erb, 2012). It will therefore be easy for Marguerite to build trust with Josie when she adopts an approach that considers all aspects of the patients as well as those of their immediate family members. Finally, the nurse should be able to act as an advocate for both the patients and Josie. Trust is built over time and the continued connected relationship with the patients is a way to win trust with Josie.

Culturally Congruent Care

Culturally congruent care is important in palliative care as it provides the nurse with a multidimensional perspective through which they can establish a relationship with the patients. For this case study, the nurse is Haitian and so are the elderly Josie’s parents. Besides, working in an American context could as well be an important factor in the provision of care to Marie and Jack. As such, the knowledge of cultural diversity will provide a positive effect and enhance the holistic well being of the patients. In addition, it will provide important insights for establishing a client-centred relationship.

Knowledge of all the cultural dimensions of her patients assists the nurse to design a particular lifestyle that will result in successful therapy for a specific patient (Kozier & Erb, 2012). This is critical in enhancing the nurse’s ability to incorporate her diverse knowledge with actions that aim at meeting the objectives of palliative care. In this type of care, all the actions that Marguerite will undertake are centred on the best interests of the patients. Besides, culturally congruent care dictates that both the patient and the nurse should participate proactively in designing, planning, implementing and evaluating the specific mode of providing care to the patients (Leininger & McFarland, 2002). Additionally, working closely with the patients enhances the nurse’s knowledge of the pertinent issues that relate to the cultural diversity of the patients. Finally, a culturally congruent approach incorporates various traditions, values and beliefs of the patients (Leininger & McFarland, 2002). This makes trust develop throughout the entire therapeutic period, which boosts the chances of successful therapy.

Impacts of culture on coping

Culture shapes the manner in which people perceive the world and develop cognitive structures. In fact, it dictates the way of life of different social groups since it is responsible for the development of values, beliefs, taboos, and norms among many cultural other dimensions (Kozier & Erb, 2012). Therefore, coping is a human aspect that is heavily reliant on culture. While some cultures reinforce ways that people cope with different situations and occurrences, others impede the development of coping mechanisms. In a fatalistic culture where all things are attributable to fate, people are able to reduce their stressors by assuming that the causative factors are related to fate (Kozier & Erb, 2012).

On the contrary, in societies whose culture regards misfortunes, diseases and natural calamities as punishment from the gods, the patients may be unable to develop successful coping mechanisms. It is agreeable that cultural background plays an important role in the general health of a patient. Kozier & Erb (2012) say that establishing a relationship with the patient to enable them to cope with life’s stressors is dependent on the comprehension of the cultural affiliation of the patient. Leininger, the founder of the concept of ‘transcultural’ nursing explained that the apparent gap in the profession of nursing is in the failure to appreciate that the patients are products of their respective cultures (Leininger & McFarland, 2002). In a context where culture may present a challenge to the coping mechanism of the patients, the nurses are able to intervene by addressing the cultural aspects borne by the patients (Leininger & McFarland, 2002).

How is Josie Coping?

Apparently, Josie faces various sources of stressors. From the onset, she contends with numerous roles that create a conflicting career life. She plays the role of caring for her children, Marie and Jack who experience developmental delays and chronic degenerative disease respectively. She also takes care of her aged parents. Besides, she has to meet the needs of the family by teaching an elementary school. Other members of her family like her husband and the second daughter provide little or no emotional support for her since they are on full-time jobs and college respectively.

Despite the momentous number of stressors she faces, Josie’s cultural beliefs and values have helped her to cope with stress. The belief that all things happen in line with God’s will may have amplified her ability to cope with stress. Besides, the numerous visits by the palliative care team to her home serve as an important avenue through which she reduces her stress. The therapeutic relationship between the nurse and the team has eased the pressure of being the sole care provider for the family members who depend on her.

Josie’s Strengths and Weaknesses

Josie has strengths that may have played a significant role in the provision of care to her family members. First, she is hardworking and able to meet many of her family’s obligations. Caring for at least three people that require palliative care is evidence enough to show her commitment to the well-being of the family. Besides, she has acquired immense experience in providing care to patients considering that her 23-year-old daughter has been experiencing delayed development throughout her life. As such, she understands the importance of family members as caregivers for outpatients.

However, her cultural background could reduce the effectiveness of the therapy owing to the entrenched belief that all happenings are attributable to god’s will. This may result in the feeling of a diminished role in the well-being of her family beings. The nurse therefore should capitalize on Josie’s strengths to assist her to cope with numerous sources of stressors. It would be easy for the nurse to understand their cultural background and the experience of Josie. This would make the process a success.


Kozier, B. & Erb, S. (2012). Fundamentals of Nursing: Concepts Processes and Practices. 8th Edition. Upper Saddle River, New Jersey: Pearson Education. Print.

Leininger, M. & McFarland, M. (2002). Transcultural Nursing: Concepts, Theories, Research, and Practice. 3rd Edition. New York: McGraw-Hill. Print.

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