Case studies
Case study 1: Who knows best?
A young woman is brought into the accident and emergency department with a massive gastrointestinal bleed, presumed to be oesophageal varices. Immediately the medical and nursing teams start to resuscitate the woman and the consultant asks for four units of blood to be transfused. However, the woman interrupts and states that she does not want the blood transfusion because of her personal beliefs. Therefore other volume-expanding agents have to be used. Unfortunately the woman dies from the haemorrhage several hours later. Talk around the department is ‘if only the woman had not refused a blood transfusion’. Others say ‘what a waste of life’. Yet the woman’s husband says ‘God’s will was done and she approached death as she believed was right’.
Case study 1 reflections:
- Whose beliefs are correct in this situation?: The woman’s religious belief that being faithful to her god is more important than saving her life, or the health carers who see saving her life as more important than her belief in god? Why? (Remember, from both perspectives what is being asked for is considered to be the correct and most ethical alternative.) Some aspects you may have considered:
- The sudden death of a loved one is almost always shattering. Not only might the bereaved experience an emotional crisis, they may experience a spiritual crisis where as one bereaved parent recalled “everything is smashed, my hopes, my dreams, my future, my faith…”.
- Strongly held beliefs may be the only thing that is intact for the woman’s husband. Whilst he comforts himself in the knowledge that she died as her beliefs allowed her to, he is never the less facing bereavement through the traumatic and sudden death of his wife.
- Appropriate and compassionate support in the immediacy of bereavement may well be the best spiritual care that can be offered.
Case study 2
John, aged 75, is admitted into hospital with a chest infection. While admitting John the nurse enquires about his occupation. He replies ‘I’m recently retired. I was a school teacher – and do you know something? I didn’t think I’d miss it – all the hassle – when I retired, but I do! Life seems to have lost some of its meaning, now that I don’t work.’
Case study reflections:
- Could work be considered an aspect of spirituality? Why?
- If work is deeply tied in with personal identity, worth, value and confidence, how might you help John re-think his spirituality?
- Some aspects you may have considered:
John has only recently retired at 75 which suggests that teaching was his life. His identity may well be bound up with his work. It may well be that he has had no one to talk to about this. He might need to get something off his chest! Helping John get back in touch with memorable aspects to his teaching may remind John that he hasn’t lost that part of his life. - You could ask John?
“What are your favourite memories from your teaching days?”
“Who are the people that you remember most?”
Case studies reproduced with kind permission from: McSherry W (2006) Making sense of spirituality in nursing and health care practice, London: Jessica Kingsley Publishers.