The given case study presents the case of an individual who is constantly under pressure to perform. After analyzing the case study, it becomes evident that Mr. Jones demonstrates denial regarding his illness. The fact that his hypertensive state is chronic means that he knows the prevalent dangers of failing to take medication for his condition. The fact that he refused to take medication for his condition is a clear indication that Mr. Jones is at a stage where he does not think that the sickness poses any danger to his wellbeing. Ideally, there can never be any other reason that would explain his refusal to take the medication as he had always done. Given the great weight that clinicians place on diseases such as high blood pressure, there is a very low possibility that Mr. Jones was not aware of the dangers that he posed to himself for skipping his medication for days before the accident (Gallo, & Matthews, 2012). Given the high cost of medication in the United States, there is also the possibility that Mr. Jones was trying to cut down on cost for him to be able to take care of his family in a better way.

Ideally, the manner in which Mr. Jones had behaved in the past can be used as a pointer of how he would react to the medication in the hospital. According to research, Native Americans place a huge emphasis on the family unit. In essence, it explains why Mr. Jones has been pushing himself beyond the limit in an effort to provide for his family. One thing that Mr. Jones knows very well is that his family will suffer while he is in the hospital. In essence, there is a possibility that Jones refuses to disclose the extent of his pain in fear of being held at the hospital and all he wants is an opportunity to get back to his family (Gallo, & Matthews, 2012).

Since the nurses are trained to realize when a patient is trying to create the wrong impression, there is a very high possibility that they would refuse to advocate for his discharge despite the wrong impression that he tries to give to them. This will without a doubt make him feel that he is being held against his will, and will, therefore, do every human thing possible to compel them to discharge him. The reaction would include refusing to take medication as prescribed as a protest measure. Apart from thinking about the welfare of his family, the intense anxiety that he is going through at the moment can be used to explain his actions. Stress is known to cause people to behave irrationally and for Mr. Jones his high stress levels can be used to predict his future actions. In reality, the high stress levels that he has been subjected to can be a good way of explaining why he failed to take his medications a few days before the accident. According to research, stress leads to constant worry and impairs one’s ability to make decisions. Stress can also lead to forgetfulness of important things, and this can as well explain why Mr. Jones failed to take his medication despite knowing very well the detrimental effects that his actions had on his health (White, Wilkes, & Barbato, 2013).

Anxiety is usually a response to stress that can be triggered by both physical and psychological factors. For Mr. Jones, the accident will most likely exacerbate his anxiety levels to unmanageable levels. In the event that the stress is not contained, his condition might degenerate to levels that would make it unmanageable. In addition to this, there is a high possibility that his anxiety will worsen his hypertension. Apart from the generalized anxiety disorder that has been brought about by his inability to provide for his family, Mr. Jones also seems to be suffering from post-traumatic stress disorder as a result of the accident that he just suffered. It is critical for the nurses to help him deal with the disorder to ensure that it does not degenerate into something worse. One intervention that they can take is to administer a cognitive-behavioral therapy to help him in the location and avoidance of thought that bring about the anxiety. The nurses can also administer a psychodynamic physiotherapy to help him confront the emotional conflict that has brought about the concern in his life. Lastly, they can also administer anti-anxiety drugs or antidepressants to help him in dealing with the disease (Murphy, 2009).

If the condition for Mr. Jones is carefully explored, then it will be established that the stressors in his life are multiple. The first stressor that can be identified involves the pain Jones is going through because he is the sole breadwinner, and his entire family relies on him. His existent chronic hypertension is also another stressor that can be used to explain his action. The hypertension brings him physical, as well as emotional pain, and this causes frustration in his life. His work is also a stressor given that he has two employees who depend on his business for survival. The fact that he is constantly on call even on Sundays when he should be in church with his family means that his nature of work is demanding, and he cannot afford to be away from it for a prolonged time. Given that Mrs. Jones is a shy person who does not have enough credibility in the family, and it causes some frustration for Jones. In fact, if the condition of his health does not improve, he feels helpless because he cannot depend on her to conduct the business to success. In this way, the family is bound to suffer from lack of money and support of a male role which is a valuable entity among the Native Americans (Gallo, & Matthews, 2012).

The stressors for Mr. Jones family include taking care of the three kids who are obviously on the school going age. Given that Mr. Jones is the only one who knows the inner working of the business, it means that the business is likely to suffer if he stays away from it for a prolonged period. The family is also stressed by the health costs that will be accrued from Mr. Jones stay in the hospital. Given that the family was already struggling financially even before Mr. Jones was hospitalized, it means that his stay in the hospital will compound the family’s financial problems (Gallo, & Matthews, 2012).

There is no doubt that Mr. Jones’ illness will have a great impact on the family system. Given that his children are young, there is no doubt that they will have to drop out of school due to lack of school fees. In addition to this, given that the plumbing business is the only source of income that the family has, the absence of Mr. Jones from the business means that it will also suffer. Although Mr. Jones has two employees, it seems that they only work under his supervision, and this means that his absence will drive them to look for an alternative source of income. For long, the wife has never been an active participant in running the family business but the husband’s illness means that she will be thrust into a sphere of operation to which she is not familiar with (White, Wilkes, & Barbato, 2013).

Nurses can hinder or enhance a patient’s path to recovery. For the Jones family, the nurses play a crucial role in to ensuring that the family remains united during their time of disruption. One way that they can do this is by ensuring that they create a communication channel that keeps the family connected at all times. For Mr. Jones, his main worry is how his family and business is fairing on in the time of his absence. The nurses can address this by coming up with a communication strategy that keeps him informed of what is happening on the outside world (Frampton, & Guastello, 2013).

The nurses can also organize for the social welfare department to look after the children in times when Mrs. Jones is away on visits to the hospital. They can also educate Mrs. Jones on how to approach Mr. Jones illness especially on the aspect of being worried when she is around him as this will only worsen his condition. He nurses provide immediate information to the family on how to care for Mr. Jones so that he can have a comfortable stay. Given that Mr. Jones is a Native American, it means that he is eligible for Medicare. In case he is not yet enrolled in the program, the nurses can look for ways that Medicare can pay for his hospitalization cost. In the event that he is not eligible for this medical insurance, they can instead organize with the hospital management for some of his cost to be waived on account of his inability to pay (Balik, et al, 2011).

References

Balik, B. et al (2011). Achieving an Exceptional Patient and Family Experience of Inpatient Hospital Care. Cambridge: Institute of Healthcare Improvement.

Frampton, S., & Guastello, S. (2013). Putting patients first: Patient-centered care: More that the sum of its parts. Am J Nurs, 9: 49-53.

Gallo, L., & Matthews, K. (2012). Understanding the Association Between Socioeconomic Status and Physical Health: Do Negative Emotions Play a Role? Psychological Bulletin 129: 10-51.

Murphy, P. (2009). Must nurses be forever in the middle? Bioethics Forum, 9(4):3-4.

White, K., Wilkes, C., & Barbato, M. (2013). The Impact of Unrelieved Patient Suffering on Palliative Care Nurses. International Journal of Palliative Nursing 10: 438-444

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