Nurse's Pocket Guide

decisional CONFLICT
NURSING PRIORITY NO.2.To assist client to develop/effectively use
problem-solving skills:
• Promote safe and hopeful environment, as needed, while
client regains inner control.
• Encourage verbalization of conflicts/concerns.
• Accept verbal expressions of anger/guilt, setting limits on
maladaptive behavior to promote client safety.
• Clarify and prioritize individual goals, noting where the
subject of the “conflict” falls on this scale. Choices may
have risky, uncertain outcomes; may reflect a need to
make value judgments or may generate anticipated regret
over having to reject positive choice and acccept negative
consequences.
• Identify strengths and presence of positive coping skills (e.g.,
use of relaxation technique, willingness to express feelings).
• Identify positive aspects of this experience and assist client to
view it as a learning opportunity to develop new and creative
solutions.
• Correct misperceptions client may have and provide factual
information. Provides for better decision making.
• Provide opportunities for client to make simple decisions
regarding self-care and other daily activities. Accept choice
not to do so. Advance complexity of choices, as tolerated.
• Encourage child to make developmentally appropriate
decisions concerning own care. Fosters child’s sense of
self-worth, enhances ability to learn/exercise coping
skills.
• Discuss time considerations, setting time line for small steps
and considering consequences related to not making/
postponing specific decisions to facilitate resolution of
conflict.
• Have client list some alternatives to present situation or decisions,
using a brainstorming process. Include family in this
activity as indicated (e.g., placement of parent in long-term
care facility, use of intervention process with addicted member).
(Refer to NDs interrupted Family Processes; dysfunctional
Family Processes: alcoholism; compromised family
Coping; moral Distress.)
• Practice use of problem-solving process with current situation/decision.
• Discuss/clarify cultural or spiritual concerns, accepting
client’s values in a nonjudgmental manner.
NURSING PRIORITY NO. 3. To promote wellness (Teaching/
Discharge Considerations):
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
178 Cultural Collaborative Community/Home Care