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Problem-Based Learning

Page history last edited by PBworks 16 years, 6 months ago

Perspectives on Death and Dying




  • Develop a plan to help your patient and patient's family members deal with end of life issues.



  • You and your colleagues are practical nurses at Naples Community Hospital.



  • The patient and the patient's family members.



  • Betty Billie is a 75-year old Seminole Indian woman living on the reservation near Naples. She has a history of non-insulin dependent diabetes and coronary artery disease. She speaks little English and was accompanied by her daughter when she was admitted into the hospital for congestive heart failure. She follows traditional Seminole Indian teachings and seeks guidance from native non-traditional health care providers and concepts in addition to traditional medicine. She takes both traditional medications and healer-prescribed herbs and other medicines. While in the hospital she has continued to worsen and develops more chest pain and dyspnea, possibly needing life support.


  • Betty's daughter, like her mother, is very traditional Seminole and wants to take her mother home to the reservation to see the healer and be with family. Betty's son arrives and indicates that he has an advanced directive. Betty is disoriented and therefore unable to clearly communicate her wishes to her family as well as her health care providers. There is confusion and anger as one family member argues with another over the care of the patient and the wishes of the patient.


  • What will you do?



  • You and your colleagues need to develop a plan and role-play of this scenario with emphasis on the script you might use given the situation.


Standards & Criteria for Success

  • The plan and role-play needs to articulate


    • Understanding of medical life-sustaining measures
    • Knowledge of advanced directives and health care surrogates
    • Understanding of various spiritual and emotional issues surrounding the end of life
    • Impact of family members on various decision-making scenarios

See evaluative rubric for additional grading criteria.

Comments (6)

Anonymous said

at 10:28 pm on Apr 25, 2006

I really like the scenario and I think it is very realistic and will incorporate EOL issues with cultural issues. It should certainly elicit great discussion. I would be interested in using this for August with my new class. Then I can learn more about this new technology. This is my second comment because I did not click add comment but UI'm learning.

Anonymous said

at 10:53 pm on Apr 28, 2006

We may want to include whether Mrs. Billie is oriented and able to discuss her EOL issues. It would be more interesting, I think, if she was not competent in making decisions so the conflict between the siblings would be more of a challenge. On the other hand, if we leave it open the students could repond with their own scenario and we could look at the situation from several angles.

Anonymous said

at 3:23 pm on Apr 29, 2006

Jill, I was thinking that her lack of English comprehension would create the disorientation to what was going on...but agree that the "not competent" would raise other issues. Whatever fits best for your plans, let's do! Even though I started this, I meant it for you to manipulate. You can make edits directly on the page...or if you want me to demonstrate on Monday, I'll be happy to!

Anonymous said

at 8:24 am on May 1, 2006

I made a few changes on the edit page that include her increasing dyspnea and her disorientation:)

Anonymous said

at 4:49 pm on May 1, 2006

Excellent! I just told my professor that you are now 'hooked' and that we are going to present at your conference - he was delighted! He also suggested I submit my paper for journal (practioner-oriented) - is there one that your organization uses?

Anonymous said

at 10:12 pm on May 2, 2006

Thanks for the sidebar on HealthScience1. I asked Fara to put the "sharing" session on the agenda for our dept. meeting on Mon (5/8). Perhaps Jeanette could mention it at the Tues faculty meeting. I know Ina is very interested:)

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