Author: Betty R. Ferrell, PhD, RN
Tired of Treatment
Paulo is a 49-year-old man with a recurrent brain tumor; he is now hospitalized after experiencing seizures. The tumor was diagnosed when Paulo was 44 years of age, and he has had extensive surgery, chemotherapy, and radiation therapy.
Three months ago, the brain tumor team advised Paulo and his family that there were no further treatment options; his family then took him to Mexico, where he has had numerous herbal therapies and traditional folk remedies. He has experienced weight loss, increasing severe headaches, nausea, and now seizures.
After a severe seizure last week, his girlfriend brought him back to the emergency department for care. He says that he is tired of treatment and being taken far away and wishes that his girlfriend and children would “give up and just let me be at home, so I can play with my dog and be with my friends.”
As the nurse practitioner, how should you respond to Paulo’s statement?
Assure Paulo that you understand his distress, but that he needs to continue treatments that will prolong his life.
Suggest that Paulo and his girlfriend come to the clinic, and you will arrange a family conference with his clinicians.
Arrange for Paulo to come to the clinic alone, so you can help him communicate his goals.
Explain that herbal and folk remedies have probably made his condition worse.
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