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DECISIONAL CONFLICT Nursing Care Plan

Decisional conflict is when a person is uncertain about which course of action to choose when the choices have involve risk, challenge, or negative or disadvantage to personal life values. Here's a good sample of nursing care plan for decisional conflict.

ASSESSMENT
Subjective:
"I want to start my surgery but it will take 3 months before I will fully recover. My 
family depends on me and the 3-month absences in my work would cause us to much trouble," as verbalized by the patient.

Objectives:
I observed that the patient is vacillating between alternative choices. (Vacillation  is when a person cannot decide from the possible choices). Because of that, there is a delay on decision-making and self-focus. Restlessness also observed as the client can find his/her comfort and cannot stay still.

Vital signs are taken and noted as follows: Body temperature is 36.6 degrees Celcius, blood pressure is 130/80 mmHg, respiratory rate is 18 cycles per minute, and pulse rate is 112 beats per minute. The client's body temprature, blood pressure, and pulse rate are normal but his/her blood pressure is categorize as pre-hypertention.

DIAGNOSIS
Decisional conflict related to moral obligation requires performity or not performing actions as manifested by delayed decision-making. (Working for your  family and to sustain their daily needs is one kind of moral obligations).

PLANNING
After 4 hours of nursing intervention the patient will be able to make decision and express satisfaction with the choice and free of physical signs of distress. (Why 4 hours? The primary goal is to help the client make the best decision for him/her self, to decide on a short period of time but have enough time to think about his/her decision).

INTERVENTION
Before you start any intervention, try to actively listen to the reason of your client for indecisiveness because this will clarify the problem and work toward to a solution. While listening to the patient, determine usual ability to manage own affairs. Note for expressions of indecision and dependence on others. Note: Remember that accurate and clearly understood information about situation will help the client make the best decision for self. Also you must accept verbal expressions of anger or guilt but you need to set limits on maladaptive behavior to promote client safety. If you find something that your patient was misinterpreted or misconcepted, correct it and provide factual information because this will provide better decision.

Choices may have risky, uncertain outcomes and msg reflect a need to make value judgements or may generate anticipated regret over having to reject positive choice and accept negative consequences. Just support the client for decisions made, especially if consequences are unexpected or difficult to cope with. Provide positive feedback for efforts and progress noted.

EVALUATION
After 4 hours of nursing intervention the patient was able to make decision and expressed satisfaction with the choice and free of physical signs of distress. (It's okay if the patient took much more time to completely decide but if the patient is still can't decide on his/her own. Try to reassess the patient and make a nursing care plan again).

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