Decision-Making About AJ’s Care

The case mentions that AJ’s father has been appointed his healthcare surrogate, and therefore he should make decisions about his care. According to Su, Yuki, and Hirayama (2020), surrogate decision-makers are responsible for making care decisions for adults who have lost the capability to make decisions. AJ’s condition prevents him from making his own decisions.

Factors Influencing Healthcare Decision-Making

In this case, one factor that might influence decision-making is the personal values of the family members and those of the healthcare providers. Culture is the second factor that can influence care, as different cultures hold different perceptions about an illness. Healthcare providers thus have to be careful about cultural factors affecting care and consider the patient’s values and backgrounds when administering care (Stubbe, 2020). Providers should understand the patient’s culture well when considering care options.

Provider Decision-Making Behaviors

Healthcare providers play a vital role in patients’ treatment and care decision-making. Informative behavior is helpful as it can ensure providers give the family complete information about diagnosis and prognosis. Facilitative behavior can guide the surrogate as he makes patient care decisions.

Care Plans

The further diagnosis revealed that chances for neurological recovery are nil, meaning there is no need for a treatment care plan. Comprehensive inpatient rehabilitation is a care option that helps patients who cannot function independently (Matney et al., 2022). The second option is putting AJ in long-term care on life support since there are no chances for recovery.

Communication Strategies to Apply

The APN should employ effective communication strategies in this case because it is core to the decision-making process. Communication is the basis for building patient-nurse relationships and offering comfort in care (Afriyie, 2020). The goal of communication guides effective communication. The APN should consider the communication culture of the patient’s family not to hurt them unknowingly in the process. The communication should be brief and clear, ensuring the recovery gets all the critical parts of the message.

Moral Distress

The APN is an individual as well, and nurses show compassion. Critical and end-of-life care nurses are likely to suffer from moral distress (De Brasi et al., 2021). The APN might be overwhelmed by kindness which might lead to moral distress. The family’s decision might harm the family and the patient instead of helping them, making the APN experience distress.


Afriyie, D. (2020). Effective communication between nurses and patients: an evolutionary concept analysis. British Journal of Community Nursing25(9), 438-445.

De Brasi, E. L., Giannetta, N., Ercolani, S., Gandini, E. L. M., Moranda, D., Villa, G., & Manara, D. F. (2021). Nurses’ moral distress in end-of-life care: a qualitative study. Nursing ethics28(5), 614-627.

Matney, C., Bowman, K., Berwick, D., & National Academies of Sciences, Engineering, and Medicine. (2022). Rehabilitation and Long-Term Care Needs After Traumatic Brain Injury. In Traumatic Brain Injury: A Roadmap for Accelerating Progress. National Academies Press (US).

Stubbe, D. E. (2020). Practicing cultural competence and cultural humility in the care of diverse patients. Focus18(1), 49-51.

Su, Y., Yuki, M., & Hirayama, K. (2020). The experiences and perspectives of family surrogate decision-makers: A systematic review of qualitative studies. Patient Education and Counseling103(6), 1070-1081.