Problem:
The nurse is caring for Odina River, a 78-year-old Native American woman, who presents to the emergency department for shortness of breath. The computed tomography (CT) scan shows a mass in her right lung, which is suspicious for cancer. When presented with options for further testing and potential treatments, Ms. River refuses. She states, "My tribe has a folk healer who will take care of this." The nurse remains adamant that Ms. River should consider her treatment options, but she is not interested. She tells the nurse that she will pray about the situation and that she has faith that, if she does have cancer, it can be fully healed with traditional folk medicine. UNFOLDING CLINICAL SCENARIO INFORMATION Three months later, Ms. River presents to the emergency department for severe shortness of breath. Another CT scan is performed and shows multiple tumors throughout her lung fields. She states that she worked with her healer and has been praying, but that she accepts her fate and is ready to die