A nurse is striving to create a healing environment for a client experiencing chronic pain. Which action most aligns with Jean Watson's concept of transpersonal caring?

Rationale:

A. Autonomy is correct because it is the ethical principle that recognizes the patient’s right to make decisions about their own body and medical care, even if those decisions conflict with the family’s wishes. Supporting the patient’s choice respects their personal values, dignity, and self-determination. In cases of terminal illness, honoring autonomy is central to ethical nursing practice.

B. Nonmaleficence is incorrect because, while this principle involves “doing no harm,” it does not specifically address the patient’s right to make independent decisions. Supporting autonomy may sometimes involve interventions that the nurse perceives as causing harm, but ethically, the patient’s informed choice takes precedence.

C. Justice is incorrect because it relates to fairness and equitable distribution of resources and care. While important in healthcare, justice does not directly guide decisions about respecting an individual patient’s treatment preferences.

D. Beneficence is incorrect because it focuses on acting in the patient’s best interest to promote good. While beneficence is important, it can sometimes conflict with autonomy if the nurse or family believes life support continuation is “beneficial.” Ethical practice prioritizes respecting the patient’s autonomous decisions even when beneficence and the nurse’s personal judgment differ.

Rationale:

A. Refer the patient to a specialist for better diabetes management is incorrect because while specialist care may be beneficial, referral alone does not address the patient’s transportation barriers, which could prevent them from accessing these services. Continuity of care requires consideration of logistical and social factors.

B. Advise the patient to join a diabetes support group is incorrect because support groups provide emotional and educational benefits but do not directly ensure consistent medical management or monitoring for chronic diabetes, especially if access to healthcare providers is limited.

C. Coordinate telehealth visits and arrange for local pharmacy delivery services is correct because this intervention addresses both access to care and medication adherence. Telehealth allows ongoing monitoring, education, and follow-up without requiring travel, while pharmacy delivery ensures the patient receives medications consistently. This approach promotes continuity of care, patient safety, and effective chronic disease management despite transportation challenges.

D. Schedule frequent in-person visits regardless of the patient's transportation issues is incorrect because insisting on frequent in-person visits may be impractical and could result in missed appointments, nonadherence, or reduced access to care. Interventions must be realistic and adapted to the patient’s circumstances.