Southern Luzon State University

College of Allied Medicine

Conejos, Emmanuela Ann A.
BSN IV – B

Nursing Care of Clients with Life Threatening Conditions

Please answer the following questions:

1. What are the Different Nursing Roles of an ICU Nurse and how?

A. Independent
In aspect of independent care, the ICU nurse’s role was to perform
nursing diagnosis, treatment and care alone whereas once he/she settled on
an autonomous choice, he/she acknowledges the full liability and responsibility
for his/her choice and activities. They are fully aware or knowledgeable and
competent enough to perform procedures in the critical care by prioritizing
them initiatively and accountable in promoting, restoring, and maintain the
health of condition of the patients at the ICU.

B. Dependent 
In aspect of dependent care, the ICU nurse’s role was to work
collaboratively with the different health care team member. Their nursing
interventions are the interventions dependent on another discipline's request or
order and authorized to perform nursing practice on common law and relevant
statutory laws such as performing pharmacological interventions whereas they
can perform techniques in pain management before adhering to medications,
they can also perform integrative health interventions which focuses on treating
the whole person rather than the person’s specific damaged organ system and
lastly, they can also perform immunologic therapies to improve the immune
system of the the patients at the ICU.

C. Interdependent
In aspect of interdependent care, the ICU nurse’s role was to promote
inter-relationship between the patient and with the other members of the health
care team. They are building rapport to the patient as well as having a joint
responsibility with the physician and other health care team to ensure that  the
patient is receiving the prescribed diagnostic and therapeutic care as well as the
relevant nursing care.

2. During the final phase of a terminal illness, as an ICU nurse how will you
prepare the patient and the family for what to expect in terms of:
A. Personal needs
As an ICU nurse, I will prepare the patient and the family in terms of
personal needs by promoting the patient’s hygiene and educating the family
about it such as:

 Oral Care - To make the patient comfortable if they are not already
capable of drinking or eating.
 Nutrition – To monitor the patient’s nutritional needs even though they
are not eating much.
 Bathing – To promote patient’s comfort and dignity
 Pain Relief – To control pain. For some instances, if the patient does
not have the ability to take tablets orally, they can receive medications
via IV infusion or in liquid form as prescribed.
 Bowel and Bladder Care – To prevent contamination or infection.
 Positioning – To prevent pressure ulcers since skin breakdown may
occur for the patients who are bed ridden in long period.

B. Impending death
When it comes to impending death, as an ICU nurse, I will prepare the
patient and the family by helping them to overcome the severe anxiety, fear,
and depression that can occur such as supporting and educating them on what
they might expect to happen during this time, addressing their questions and
concerns honestly, being an active listener, and providing emotional support and
guidance. In addressing the questions and concerns of the patient and family, it
is important to answer them honestly to avoid false hope or protecting the
feelings of the person by not telling the truth and complicate things.

C. Social Needs
For social needs, I will prepare the patient and the family through
performing a detailed assessment to put their affairs by coordinating with a
social worker or a legal representative to address their plans and needs and
promote interaction with close friends and family if  this is an important aspect
of the person’s life and wishes to provide comfort.

D. Ethical and Legal Issue

In dealing with ethical and legal issues, as an ICU nurse, it is important
to prepare and educate the patient and the family by informing them about the
decisions they will make such as using the advance directives to set out the
patient’s wishes when they become unable to make decisions for themselves at
the end of their life which requires completed and signed while the person is well
and still able to make informed choices, if not, the legal guardian, parent, spouse,
the assigned person by the patient or the power of the attorney can make the
decision.