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Dorothy as the Prototype in Looking at Client Expectations; Quality of Life and Functioning

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Getting Started 

  • Listen to Dorothy’s monologue or read it here.
  • What were Dorothy’s expectations of the hospitalization?
  • What were the nurse’s expectations of the hospitalization?
  • What is the connection between Dorothy’s expectations and her functioning?
  • How does Dorothy define her quality of life? Do you agree?
  • How could Dorothy’s transition be influenced by her expectations?
  • What is the best way for the nurse to advocate for Dorothy?
  • How is dignity considered when assessing Dorothy’s needs?
  • What is the impact of immobility on Dorothy’s outcome? 
  1. Student reflection outlining expectations of health care, education, and relationships or a guided class or online discussion on expectations. Consider the following questions in initiating this exercise: 
  • What is most important to you?
  • How have you felt when your expectations were not congruent with that of others?
  • How have you felt when decisions were made for you?
  • When was the last time you felt helpless?
  • What is significant to you when you think of your quality of life?
  • Given experiences that you have had in life, how have your expectations changed? 

2.    Utilize audience response questions to initiate a discussion on quality of life (see PowerPoint file in materials section 2). This format will allow students to answer questions anonymously. The ethical perspective of the questions will likely allow for rich discussions. They can be easily converted into any audience technology available. The questions in this audience response activity are as follows: 

  • The most important part of life is?

    a.   Health

    b.   Family

    c.   Money

    d.   Mobility 

  • If the quality of my life was diminished I would want to die – Yes or No 
  • Dorothy’s mobility should be the priority – Agree or Disagree 
  • I think the most important question to ask Dorothy is:

          “What is important to you?”
          “Have you fallen in the past three months?”
          “Do you want to live?”
          “So you feel your heart skipping a beat?” 

3.  A concept map is a diagram that illustrates relationships between concepts. Assign a concept map to students after they listen to the monologue or have the students do a concept map as a group project in class/seminar, or as a post-conference activity. See the example of the concept map in the materials section 3. This should be considered a draft. Have students start with this draft which uses decreased mobility as a concept and  ask them to identify missing pieces and  identify priorities of care while considering the essential nursing actions and essential knowledge domains. 

4.  Advanced Directives are written instructions regarding what actions an individual wants if they are unable to make decisions for themselves. In the monologue Dorothy talks about her expectations. Ask students to write their own advanced directives as an exercise to help raise their consciousness about quality of life issues and what measures they might want to sustain life in the face of illness or incapacity. This exercise lends itself to a discussion of their thoughts and decisions either in a verbal forum in person or an online forum in a discussion group.