Psychological needs

Through a facilitative approach the nurse helps Bianca to explore her feelings. Through the use of open-ended questioning Bianca expresses feelings of guilt and regret. The nurse is then able to offer support to Bianca and advise her to consider the possibility of confiding in her parents or responsible adult.

Physical needs

The nurse addresses this by taking a detailed medical history and performing the relevant tests. She is then able to treat Bianca for her urinary tract infection and prescribe her the emergency contraception.

Ethical decisions

A non-judgemental approach to decision making is essential. Consent, mental capacity and informed choice will be ensured.

Social needs

Lifestyle and support network will be considered in the decision-making process. The nurse has offered Bianca and her friend the opportunity to attend a youth clinic where health promotion will be considered within a safe and comfortable environment. The nurse has also elicited the age of Bianca’s sexual partner thus ensuring safeguarding issues are explored.

Economic needs

The nurse is aware of the high rates of teenage pregnancies and considers future planning to develop a preventative approach e.g. Use of long-acting reversible contraception and sexual health screening.

Spiritual and cultural needs 

Through active listening the nurse facilitates Bianca in expressing her feelings and beliefs. This will help Bianca and the nurse to identify specific needs centred on spiritualty that will help to promote preventative care in the future.

There are a number of decision types the nurse has implemented in the case with Tony.

Prevention

The nurse wants Tony to take control of his condition so that future complications of diabetes can be avoided.

Timing

This was crucial as the nurse knew that Tony’s condition needed to be stabilized before he could consider counselling and taking ownership of his health.

Referral

The nurse was able to identify the appropriate healthcare professional (counsellor) that Tony needed to see in order to have the correct expertise in helping him to come to terms with his condition.

Communication

Active listening and a facilitative communicative approach was applied in the decision-making process.

The nurse was able to empathetically respond to the verbal and non-verbal cues that Tony demonstrated and recognized that Tony was grieving and worried about having diabetes. Responding to Tony’s emotions and awareness of the anxiety and worry patients face with having a new diagnosis of a long-term condition influenced the nurse’s decision in referring Tony to a counsellor.