Peter Year With Explained for Students (Easy Guide)

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Original Question

Peter was a 15-year-old boy with acute myelocytic leukemia. As his condition deteriorated, Peter began to realize that he was dying. He was in pain, angry, afraid, and largely dependent on others to meet his physical needs. However, the nurses on his unit promised that he would not be allowed to suffer and that he would not be alone as he became sicker. During a 6-month period, Peter was in and out of the hospital many times. Although Peter was often difficult to get along with, the nursing staff had begun to care about Peter, and he had learned to trust them. The fact that Peter had lived in foster homes most of his life explained some of his difficult behavior. Of greater concern was the fact that his natural parents had slowly withdrawn from him during his illness. Over time, the staff of the nursing care unit realized that they were, in many ways, Peter’s “family” and that the  nursing staff would be the ones to care for him and be with him when he died. As Peter’s condition worsened, his needs for physical and emotional care increased. The staff decided that he should be assigned a primary care nurse, Sheri Martin, RN, who would coordinate and plan the increasing amount of care that he would need. Within a few days, Peter could no longer walk because of the pain from the effects of his illness. He was often feverish, and he suffered from nausea, vomiting, and diarrhea. He experienced constant fear—of pain, of the effects of morphine, and of the possibility that he might not wake up once he fell asleep. Nighttime was especially difficult for Peter and his nurses. He was in near constant pain but often refused his morphine. Instead, he asked that his nurse stay in the room, talk to him, read to him, do anything to distract him from his pain. One evening, he asked Miss Martin to stay with him even though she had already worked all day. She switched her hours with another nurse and stayed on the unit to take care of Peter. There was a real possibility that Peter was near death. Unfortunately, another staff nurse called in sick. There then was not enough staff to take care of all the patients, especially if Miss Martin spent the majority of her time with Peter. Miss Martin could not decide what to do. She had promised Peter that she or one of the other nurses would stay with him, especially when he died. Yet it did not seem fair to the other patients, some of whom needed careful preparation for diagnostic tests the following day, to forgo their needs in favor of Peter’s needs. Yet if no one stayed with Peter, he would feel abandoned at the time when he needed someone the most. If this happened, the nurses would surely suffer the consequences of feeling guilt, frustration, and anger at being unable to respond to Peter’s important needs. Should promises to Peter be kept when nursing resources were strained to the limit and other patients’ needs were also important?

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