Running head: CASE ANALYSIS

Movie Case Analysis Assignment

Faduma Bare
825-297-237
Humber College
Professor: Anne Senczuk
NURS 222: Nursing Theory
November 15th 2014

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Summery

``The Doctor`` begins as a movie in which a heart surgeons life is turned upside down
and is now in the position of a patient rather than the caregiver. He later became ill and was
diagnosed with laryngeal cancer. The name of the main character is Jack. The highlight of the
movie revolved around the role reversal of jack who now sees things in a patients perspective.
This change of event allowed Jack to fully see what struggles patients go through especially
when quality of life has been compromised which emphasizes how the actions and behaviour of
healthcare provider impacts a patients psychological, social and physical being. As a patient
going thru trials and tribulations in his life, Jack tries to search for comfort and insurance in other
healthcare workers. Since vocal communication is a key aspect in human socialization, losing
this skill can create potential loneliness and anger in the near future. As stated by (Cherith and
Kate, 2004) They must also embrace the reality of profound changes in relation to their speech,
ability to swallow, taste, as well as noticeable alterations in appearance. Such factors led Koester
and Bergsma to describe head and neck cancer as more emotionally traumatic than any other
type of cancer. The importance of family support system and empathy was fully realized by
Jack which in turn gave him a new appreciation for quality care.) Family influences can be
forces that sustain and support the patient in effort to cope with life threatening disease.
Physical Effects
Fatigue
Fatigue is one of the physical impairment in cancer patients according to (Cherish and
Kate, 2004) in addition fatigue is a gateway symptom to other diseases as well. This means as
cancer patients undergo physical changes they have to physically cope with this thus exhibiting

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lethargic symptoms (Lewis et al, 2007). Further more patients with cancer often go through
treatments that are harsh with strong medication and repeated hospitalization. Thus they are
vulnerable to an overall decrease in activity. As a result there is strain on the family and
immediate support system (Veronika, 2003). Other symptoms that can follow up are muscle
weakness and overall deterioration. Interventions that can be applied in this case are exercising
daily activity in order to promote independency, as well as aerobic exercises (Veronika, 2003).
As seen in the movie Jack wasnt able to work long hours due to his altering condition and
fatigue being one of the earliest symptoms.
Impaired Swallowing
Impaired swallowing is the other type of physical challenges cancer patients go through.
Patients will experience on object in the base of theirm9p1t1 throat due to tumour growth. Later
on hoarseness of voice will follow soon even with or without treatment (Veronika, 2003). If not
treated laryngeal cancer will further block the airways and become life threatening. Precipitating
factors after this is dysphasia which can lead to aspiration pneumonia, malnutrition, and
dehydration which can make the situation even more severe (Lewis et al, 2007). In Jacks case he
showed some of the symptoms stated above. One of the more obvious cases being him having
difficulty swallowing his dinner. The effect of this caused concern at the dinner table which may
place mental stress/worry on the family and support system.
Coughing up Blood
Coughing up blood is part of physical impairment for laryngeal cancer. This could cause
the laryngeal lining to erupt and cause coughs with bloody sputum. Patients usually have an
animating dry cough with smelly odour (Veronika, 2003). Persistence of coughing with blood

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can cause anaemia and tiredness (Lewis et al, 2007). Jacks symptom of coughing up blood
caused multiple effects such as sleep disturbance and social embarrassment; especially when he
coughed blood on his tuxedo in the car with his wife before he attended the event. A situation
like such can cause extreme fear and concern putting the family in an uncomfortable situation.
Psycho-social Effects
Fear
Jack is a doctor and he knows that the consequences of losing his voice will have a major
impact on his job where communicating with his colleagues and patients daily is key in order to
perform his job well and maintain his standard of living. Also Jack enjoys singing along with his
friends, so when he realized that he may lose his voice he felt his quality of life may be
jeopardized. According to Veronika (2003), quality of life is characterized by the individuals
position, perspective, purpose and expectation in life and be pursued by good communication
technique. Losing his voice can potentially create frustration and hopelessness. Seeing a speech
pathologist to train the person in other methods of communication such as writing on the small
board should be included in the care plan as Jack did after surgery to address how much he needs
his wifes support.
Impaired Social Interaction
Social interaction is the ability to interact with ones surroundings normally in regards to
social activities. For instance, when cancer patients receive heavy medications and treatment
they tend to become more isolated from the rest of their family and friends. As (Veronika, 2003)
stated; radiotherapy used in management for head and neck tumours can cause hearing loss,
facial damage, voice loss and hair loss. This can contribute to low self esteem. Since jack is sick,

CASE ANALYSIS

his friends wanted him to rest so they decided to reduce the amount of group interaction, as a
result this increased Jacks sense of loneliness. Within the movie Jack also avoided social events
due to things such as frequent coughing and bloody sputum.
Family
Family involvement encourages and strengthens the cancer patients emotionally and
socially. It also acts a support system for things such as fears. As (Cherith, 2004) states; family
support has a crucial and significant effect on the patients psychological strength in order to
manage with the disease process. Nurses usually encourage the family to participate in patients
care plan. Jack carried mental burdens such as secrecy. Fears existed such as his wife leaving
him if he told her of his sickness. So he decided to come home early and engage the family in
activities such as cooking. Even though his family was surprised about his new illness they still
stood for him and helped him go through his illness smoothly thus dismissing all pre-conceived
notions.
Area of Priority/Holistic Nursing
The area of priority that should be addressed in this situation would be Jacks mental
condition as a whole. Having mental health issues can greatly affect quality of life. According to
Veronika (2003) good communication techniques affects a persons position as well as
perspective and expectations in life. Due to Jacks past history and absences as a father, Jack feels
isolated and lonely due to his new medical diagnosis. Mental health also has the effect to alter
self perception. This may cause many health issues such as depression, anxiety, loneliness and
much more (Lewis et al, 2007). As a nurse it is our responsibility to help facilitate the clients
need and prevent further detrimental effects.

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Nursing Intervention
One intervention the nurse could use is establishing family centered care. That way the
clients family can be involved in the care as well. We understand that having a strong family
structure will be therapeutic to his mental health since they are the primary support system. In
addition this would bring the client closer to his family and bridge any broken roads from the
past. Secondly helping the client be aware of community support systems will allow the client to
be able to seek help from them in the future and assist them in acknowledging there not alone.
Support groups are related to the area of priority because they behave as an expedite for persons
requiring mental support. Examples of these are the Wellspring cancer support group which has
mental healing as one of it forefront focuses (Wellspring, 2011). Lastly allowing the client to
verbalize his problems is cornerstone to nursing due to its ability to strengthen the therapeutic
nurse client relationship. It also helps the nurse further understand the causative factors of any
precipitating problems. This will also act as a diagnostic tool to target and isolate important
mental health related issues which needs to be addressed promptly.
Collaborative Strategies
The nurse can discuss with the social worker on solutions to facilitate the clients need for
social interaction. They will also act as a guidance tool to help relay the clients problem to other
potential solutions. The clients issue to social isolation can also stem from his decreased
speaking ability. As a result consulting with the speech pathologist will help increase his self
esteem and confidence thus allowing him to be more forthcoming to others in the future. Since
Jack has been feeling much weaker and is experiencing general malaise. An occupational

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therapist along with a nutritionist will help him regain back his strength and energy, to help him
acquire more autonomy in his life which is also one of the nursing principles.
Community Resources
A resource that would be paramount to Jack would be to arrange a family councillor. This
move would be highly beneficial and will help build Jacks relationship with his family from the
ground up again. Jacks feeling of self worth and belonging would receive a boost in addition.
Eventfully this would prove to be extremely beneficial to Jacks mental health since these are one
of the main factors. Another resource that would be greatly beneficial is the Canadian
wellsprings cancer support group (Wellspring, 2011). They are a program open to any individual
having a hard time coping with a certain cancer and acts as a facilitator providing any means that
may benefit the individual. In Jacks case since he started having issues coping with his condition
the area of priority which is his mental health will be put to ease once involved in such a support
system.

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Reference

Cherith, J. S., Kate, S., Lynn George, K. (2004). Psychosocial Interventions for Patients with
Head and Neck Cancer. The Oral cancer foundation. Part 1-2.
Lewis, S., Heitkemper, M., Dirksen, S., OBrien, P., Linda, B. (2007). Medical Surgical Nursing
(7th ed.). Philadelphia, P http://www.wellspring.ca/National/About-Us/Overview.aspxA:
Mosby Elsevier.
Wellspring. (2011). http://www.wellspring.ca/National/About-Us/Overview.aspx
Veronika, F., Richard, C., Marta, K. and Michael, Q. (2003). Cancer Rehabilitation.
Particularly with aspects on physical impairments 35: 153162