As the nurse attending to Mrs. Wong and her husband, collecting priority data is crucial to tailor interventions that meet their unique needs. I would inquire about Mrs. Wong’s current physical condition and any symptoms she may be experiencing related to her early labor. I would assess her vital signs, monitor the frequency and intensity of the contractions, and ensure the safety of both mother and baby. I would then engage the couple in sensitive and open conversation to understand their emotional and psychological states (Xiao, 2023). It is vital to explore their concerns, fears, and any stressors that have arisen due to their history of abnormal alpha-fetoprotein levels and the unresolved issue of potential fetal anomalies. Establishing a trusting and non-judgmental rapport is essential. I would ask them about past conversations regarding their pregnancy’s future and any reached decisions concerning potential anomalies. I would also ascertain any specific cultural, religious, or ethical beliefs that may influence their choices and decision-making process. The data would help develop individualized care plan that respects their autonomy, offers emotional support, and addresses their physical and emotional well-being(Swihart & Martin, 2023).
In the event that Mrs. Wong and her husband face a negative outcome in the birthing suite, my primary role as a nurse is to provide them with unwavering support, empathy, and a safe space to express their feelings (Chan et al., 2019). Regardless of my personal views on terminating or continuing a pregnancy with a risk of potential anomalies, my duty is to ensure that the couple’s wishes and values are respected and upheld. Setting aside personal beliefs enhances focus on patient-centered care (Engle et al., 2019). I would actively listen to their concerns and provide information on available options and their potential consequences without imposing my perspective. Factors that could influence my personal views might include my upbringing, cultural background, or past experiences. However, I recognize that these should not affect the care I provide to the couple (Billings et al., 2021). My role is to offer emotional support, advocate for their autonomy, and facilitate any medical or emotional interventions that align with their choices.
The influence of the Human Genome Project and the ability to predict open spinal defects earlier in pregnancy is likely to bring significant changes to maternity care in the future. Advancements in genetic testing and diagnosis can offer expectant parents more information about the health of their unborn child at an earlier stage, potentially empowering them to make more informed decisions regarding the pregnancy (Julia et al., 2022). However, it also poses ethical, psychological, and emotional challenges. The advancement empowers parents with opportunity to prepare for childbirth with special needs and make decisions regarding their pregnancy with full understanding of potential risks. Conversely, it may increase anxiety and complex moral dilemmas. Parents can grapple with decisions of continuing or terminating pregnancy based on predictive information. Maternity care will need to adapt to provide comprehensive counseling, emotional support, and ethical guidance for couples facing these difficult decisions. Healthcare professionals will also need to stay current with evolving genetic technologies and their implications to provide the best care possible in an era of increased prenatal diagnosis and decision-making (Clarke & Wallgren-Pettersson, 2019).
References
Billings, J., Ching, B. C. F., Gkofa, V., Greene, T., & Bloomfield, M. (2021). Experiences of frontline healthcare workers and their views about support during COVID-19 and previous pandemics: a Systematic review and qualitative meta-synthesis. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06917-z
Chan, E. A., Tsang, P. L., Ching, S. S. Y., Wong, F. Y., & Lam, W. (2019). Nurses’ perspectives on their communication with patients in busy oncology wards: A qualitative study. PLOS ONE, 14(10), e0224178. https://doi.org/10.1371/journal.pone.0224178
Clarke, A. J., & Wallgren-Pettersson, C. (2019). Ethics in genetic counselling. Journal of Community Genetics, 10(1), 3–33. https://doi.org/10.1007/s12687-018-0371-7
Engle, R. L., Mohr, D. C., Holmes, S. K., Seibert, M. N., Afable, M., Leyson, J., & Meterko, M. (2019). Evidence-based practice and patient-centered care: doing both well. Health Care Management Review, 46(3), 174–184. https://doi.org/10.1097/HMR.0000000000000254
Julia, Zamora, A. N., Outram, S., Sparks, T. N., Lianoglou, B. R., Norstad, M., Sahin, N., Norton, M. E., & Ackerman, S. (2022). “Let’s just wait until she’s born”: Temporal factors that shape decision-making for prenatal genomic sequencing amongst families underrepresented in genomic research. Frontiers in Genetics, 13. https://doi.org/10.3389/fgene.2022.882703
Swihart, D. L., & Martin, R. L. (2023). Cultural religious competence in clinical practice. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK493216/
Xiao, M. (2023). Positive experiences in emotional labor: Deep acting, symbolic boundaries and labor autonomy. Chinese Journal of Sociology. https://doi.org/10.1177/2057150×231185926