Mai Nguyen, Nam's mother, has hypertension.

Mai Nguyen, Nam's mother, has hypertension.  She is forgetful about taking her medicines since her husband dies, she has experienced periods of depression.  When asked about her medicines she often replies, ""It doesn't really matter since my husband diet.  If I die, what difference will it make?"" Mai Nguyen was scheduled to have lunch with friends but did not arrive.  When her friends called the house, they got no answer.  At the end of lunch, one of Mai's friends decided to call Nam to inform him of her concerns about his mother.  Nam found his mother unresponsive on the kitchen floor.  He called 911, and she was brought to the hospital by ambulance.  At the hospital, the emergency department doctor tells Nam that his mother has had a massive stroke brought on by uncontrolled hypertension.  He asks Nam whether Mai has an advance directive or living will.  Mai has neither.  The physician asks Nam to consider what level of care to offer his mother.  He tells Nam that comprehensive treatment would include intubation, mechanical ventilation, and tube feeding support.  He fells it is unlikely that she will experience significant recovery from this stroke.  Name tells you, ""I want everything done for my mother.  I lost my father this year, and I'm not going to lose her too.""  Yen, Nam's wife, reminds you that Mai has been depressed since her husband died and has expressed a desire to die.  Because Nam and Yen are not in agreement about the course of action, no decision is communicated.  Mai's condition continues to deteriorate, and the ED physician feels he must intubate her, place her on a ventilator, and admit her to the ICU according to hospital protocol.

You are aware of Mai's statements and her poor compliance with treatment.  What, if any, concerns do you have about this course of action?

Mai continues to decline.  Nam is informed that the ""only thing keeping his other alive is the ventilator and IV medicines"".  Do you consider this heroic treatment?

How would you approach Mr. Nguyen to speak with hi about how he is feeling?

Nam and Yen have asked to meet with the team providing care to Mai.  They announce that they would like all the ""heroic measures to end.""  They request that Mai be allowed to die.  Could you participate in this care?  What actions would you be comfortable with? What actions would you be uncomfortable with?"

To address Nam’s concerns and resolve the conflict regarding Anh Chu’s outpatient cataract surgery, follow a structured approach:To be able to effectively handle Nam’s concerns and find a solution to the conflict involving Anh Chu’s outpatient cataract surgery, a structured approach should be taken:

 1. Acknowledge and Validate Concerns

 Listen Actively: First of all, you are to have a conversation with Nam and attempt at identifying the main concern that this character has in his mind. Absorb the anxiety he has for his aunt’s protection and the kind and amount of attention she is going to receive.

 Validate Feelings: Explain to Nam that he or she should not think of the feeling as ridiculous as what he or she is feeling is important. You should recall that he has some justified concerns about health of his aunt for she is of a certain age and has been through some changes lately.

 2. Provide Clear Information

 Explain Outpatient Surgery: Make certain that Nam understand that outpatient surgery for cataracts and the explanation of why most patient receives attention and is discharged within the same day. Tell them many patients go through this and that is normal to add to the fact that the procedure is relatively safe.

 Detail Safety Measures: Outpatient surgeries are safe and the measures taken are as follows: examinations performed before and after surgery If anything goes wrong the following plans are made: Include info on how the surgical team will ensure that doing the process of sharing the care responsibility does not leave Anh Chu vulnerable to neglect during the process.

 3. Address Specific Concerns

 Assess Risk Factors: Decompose on Anh Chu ailments such as osteoporosis and the new complication with “accidents” as well as the effects of the vices on cure. Stress, however, that all these factors are seen and considered by the surgical team in relation to the upcoming operation and the after-treatment.

 Discuss Support Needs: : Nam’s is concerned he has an aunt who is also targeted to be helped. Educate her on other programs that are available in the society that could assist her once she had been discharged from the hospital such as home care services, transportation services, and any other organization which would be of help to her.

 4. Improving the quality of communication with the healthcare providers

 Arrange a Meeting: Roll for a meeting to Nam and Anh Chu with the healthcare team to discuss more about the plan of the surgery. Ideally, this could be an ophthalmologist, a nurse, or a case manager who could make better sense of the findings and perhaps set the mind of the person at rest.

 Encourage Questions: Tell Nam that for him to get certain questions/ matters he wants addressed, let them take them to the meeting. Ensure that all the questions that he majors in is well answered to the best of your capability.

 5. Support and Follow-Up

 Provide Resources: Inform a relay regarding other related patient database and the support group for the people who had the procedures done to them. This can also (2) help Nam to becomes more empowered and confident as a result of the information acquired.

 Offer Follow-Up: Nam: Organize a short discussion of status of complaints that have been made and satisfaction of vents Nam and fulfillment of postoperative care Anh Chu.

 6. Document the Discussion

 Record Details: Capture all the complains ever made, all the presentations made and any action that was made as an outcome. Ensure this record is shared with the rest of the healthcare team, it can be handy in case some emerged problems appear.

 Conclusion

 In the conflict it would be possible to help Nam with listening to her concerns, offering some factual information, helping her with the communication with the providers, supporting her and follow up for her to help her with the conflict and to ensure that Anh Chu gets the proper care that she needs. It also helps to build the trust that Nam has on the health care team and possibilities to cooperate with them.