THERAPEUTIC COMMUNICATION

SCENARIO
Patient Yen is a 46 years old female who is diagnosed with lung cancer for years.
Although the hospital has given her medication that helps in managing her
discomfort, she has come to the hospital because she is extremely concerned about the
future of her children. She is aware that her life is reduced and that there is no cure for
her cancer. Her husband is a smoker and alcoholic, and she fears he will not look after
her children well when she dies.

Dhanizelle: Hi ma'am, good morning. I am Dhanizelle Dalo and I will be

your nurse for today. May I know your name and birthday?

Patient: I'm Yen Macondara. I was born on November 30, 1975.

Dhanizelle: So, how are you doing today, ma'am?

Patient: I'm doing quite well. The hospital has given me some drugs so I
can bear and manage the discomfort.

Dhanizelle: I believe you came here today because you'd like to talk about something.
Can you elaborate so that we may determine what more we can do for you together?
Rest assured that everything we discuss will be confidential.

Patient: I have been feeling extremely anxious and worried.

Dhanizelle: When did this started, ma’am?

Patient: Several months ago. This has been causing me a lot of concerns since I've
learned about my prognosis of my lung cancer. The problem is I am worried about the
future of my two children.

Dhanizelle: So you mentioned that you have been experiencing a significant amount
of anxiety and fear. Can you give more details?

Patient: I've already accepted my situation and the fact that I only have a limited
number of days left. My children are still quite young, though. My oldest child is just
14 years old, and I worry that without me, they won't receive the assistance they
needed. Additionally, I am not sure I could rely on my husband in this situation.

Dhanizelle: Do you worry that he wouldn't be able to take care of your children?

Patient: Well, yes. He is an alcoholic and I am worried that if I were to leave this
world, he would become much more irresponsible toward our children.

Dhanizelle: Have you considered discussing your worry with your husband?

Patient: I have previously given it some thought, but since he is rarely sober, I haven't
really had the chance to address it with him in detail.
Dhanizelle: Has he always behaved in this way since then?

Patient: No, he didn't always have such severe drinking and smoking issues. He first
became upset when he discovered that there is no cure for my illness. He was always
so trustworthy and responsible. But I can’t even remember the last time I had a
meaningful conversation with him.

Dhanizelle: If I may make a suggestion, you might consider finding a quiet spot with
him and starting a dialogue regarding about the future of your family, especially your
kids. Be sure to mention how his drinking and smoking issues affect you and the kids
as well as his health.

Patient: What if it will hurt his feelings and ignores me because he is upset with with
me?

Dhanizelle: Using terms like alcoholic or drunkard might make people who are
dealing with such issues angry or defensive when addressed. So in my professional
opinion, be cautious and avoid blaming him and try to understand that he may be
struggling to deal with your current circumstances, which has caused him to be more
anxious than usual. This might be the cause of his increased dependence on booze
these days. He might even say that he shouldn't feel bad about seeking professional
assistance if he needs it.

Patient: You might be correct. When I notice that he is in the correct frame of mind
later today, I'll try to speak with him. Then maybe he'll pay attention to me.

Dhanizelle: If you feel that all of the people you know are unable to take care of your
children, I could set up a meeting with social welfare and ask about additional legal
possibilities for you, such as guardianship, your will, and the like. They'll be able to
respond to more of your inquiries about this subject, but if so, we could still try
alternatives like speaking with your husband and enlisting your parents' support.

Patient: Yes, please, schedule the meeting. I'd really appreciate that. I'm also open to
all other possibilities you've spoken about.

Dhanizelle: Of course, ma'am, we can go on when I make a few calls. Is there

anything else that I can assist you?

Patient: No, I believe that is all. Thank you, nurse. I feel a lot better now that I've let
my troubles out and unburdened myself. Once more, many thanks.