| Course | NURS 6914 Advanced Palliative Concepts and Interdisciplinary Perspectives |
|---|---|
| Week | Week 4 |
| Paper type | Family meeting writeup |
| Length | About 1,040 words, 6 pages |
| Format | APA 7 student paper |
| School | Walden University |
| Program | Master of Science in Nursing (MSN) |
| Updated | September 2026 |
Free sample paper for NURS 6914 Week 4
"I Want to Go Home" and "I Can't Do It Alone": A Family Meeting Writeup for a 64-Year-Old Man With Metastatic Melanoma
Student Name
College of Nursing, Walden University
NURS 6914: Advanced Palliative Concepts and Interdisciplinary Perspectives
Instructor Name
Month Day, Year
"I Want to Go Home" and "I Can't Do It Alone": A Family Meeting Writeup for a 64-Year-Old Man With Metastatic Melanoma
Background
Admitted to the oncology unit a week ago with weakness and confusion, this composite 64-year-old retired electrician has melanoma that has spread to his lungs, liver and brain despite immunotherapy. The confusion has cleared with treatment of brain swelling, and he has capacity. His oncologist has told him further cancer treatment is unlikely to help. He has said clearly that he wants to go home and die there. His wife, 62, is afraid she cannot care for him at the end. Their 35-year-old son, who lives nearby, has told a nurse he thinks the doctors are giving up too soon. A family meeting was arranged with the patient, his wife, his son, the palliative care nurse practitioner, the unit nurse, the social worker and the chaplain.
The meeting was planned using clinical practice guidelines for family meetings in palliative care, which recommend preparation, clarifying the family's understanding, eliciting concerns, discussing goals and planning next steps (Hudson et al., 2008).
The Pre-Meeting Huddle
The team met for fifteen minutes beforehand. They agreed on the medical facts: his disease is progressing, further treatment is not recommended, and his prognosis is likely weeks. They agreed the palliative nurse practitioner would lead. They did not agree on whether home was safe. The unit nurse was concerned that he needs help to stand, may have seizures and would need two people for care in his final days. The social worker thought home could work with hospice, a hospital bed and additional family help. The team decided to present both concerns honestly rather than paper over them, and to let the family's own resources shape the answer.
The Meeting
The exchange below is condensed. Commentary on the right explains each move.
Table 1
Family Meeting Dialogue With Commentary
| Speaker | What was said | Commentary |
|---|---|---|
| NP | Thank you all for coming. We want to talk about how things are going and what is most important from here. Can each of you tell me what you understand about where things are? | Understanding first, from everyone, before the team speaks. |
| Patient | The cancer's in my brain now. The treatment didn't work. I know how this ends. | Accurate understanding, stated plainly. |
| Wife | They said there's nothing more they can do. | |
| Son | I don't think that's right. There's always something. You're giving up on him. | The son's view is voiced early and not corrected immediately. |
| NP | It sounds like you're not ready to hear that the treatments have stopped working. That's a lot to take in. | Emotion named before information. |
| NP | What his doctors are saying is that more cancer treatment would likely make him feel worse without helping him live longer. We are not stopping care. We are focusing it on what matters most to him. | Reframes stopping treatment as a change in focus, not abandonment. |
| Patient | What matters to me is going home. I want to be in my own bed, with my dog, looking at my yard. | His wish in his own words. |
| Wife | [Crying] I want that for you. But I'm scared. What if something happens at night and I can't handle it? What if you fall? | Her fear stated honestly for the first time. |
| Unit nurse | Those are real worries. Right now he needs help to stand, and that may increase. | The team's safety concern is shared openly. |
| Social worker | Hospice can bring a hospital bed, a nurse on call day and night and an aide several times a week. We can look at what help your family and friends could give. | Resources offered against the named fear. |
| Son | [After a pause] I could stay nights on weekends. Dad, is this really what you want? | The turn: the son moves from challenging the team to asking his father. |
| Patient | It is, son. I don't want to die here. | |
| Chaplain | It sounds like each of you is trying to take care of him in your own way. | Names the shared intention beneath the disagreement. |
| NP | Let me summarize. He wants to go home. His wife is willing, with help. His son will help on weekends. We'll arrange hospice and equipment and plan for what happens if things get harder. Is that right? | Summary and confirmation. |
Outcome
The meeting reached partial agreement. The patient, his wife and his son agreed to discharge home with hospice. The son agreed to stay on weekend nights, and the social worker will help identify friends or church members for other nights. The unit nurse's concern was not dismissed: the plan includes a clear agreement that if his care needs exceed what the family can provide, even with hospice, the family can choose a hospice inpatient unit or respite stay without it being seen as failure. His wife said that knowing there was a way out made it possible for her to say yes.
Preferences for dying at home are common but not universal, and they can change as illness progresses, which is why the plan builds in a way to revisit the decision (Gomes et al., 2013). The team agreed that the hospice nurse will ask the family weekly how they are managing.
Reflection on the Process
Three features made the meeting work. First, every person's understanding was heard before the team spoke, so the son's disagreement surfaced early rather than derailing the end. Second, the wife's fear was named and answered with specific resources, not reassurance. In a trial of a structured approach to end-of-life family conferences in intensive care, giving relatives more time to speak and listening to their concerns reduced symptoms of posttraumatic stress, anxiety and depression among family members months later (Lautrette et al., 2007). The setting differed, but the principle carried over: the family talked for more of this meeting than the team did. Third, the team's own disagreement was presented honestly, which gave the family reason to trust that the safety concern was real and that the plan addressed it. The meeting did not resolve everything. The son still struggles, and the social worker will follow up with him. But the family left with a shared plan and a way to change it.
References
Gomes, B., Calanzani, N., Gysels, M., Hall, S., & Higginson, I. J. (2013). Heterogeneity and changes in preferences for dying at home: A systematic review. BMC Palliative Care, 12, Article 7. https://doi.org/10.1186/1472-684X-12-7
Hudson, P., Quinn, K., O'Hanlon, B., & Aranda, S. (2008). Family meetings in palliative care: Multidisciplinary clinical practice guidelines. BMC Palliative Care, 7, Article 12. https://doi.org/10.1186/1472-684X-7-12
Lautrette, A., Darmon, M., Megarbane, B., Joly, L. M., Chevret, S., Adrie, C., Barnoud, D., Bleichner, G., Bruel, C., Choukroun, G., Curtis, J. R., Fieux, F., Galliot, R., Garrouste-Orgeas, M., Georges, H., Goldgran-Toledano, D., Jourdain, M., Loubert, G., Reignier, J., ... Azoulay, E. (2007). A communication strategy and brochure for relatives of patients dying in the ICU. New England Journal of Medicine, 356(5), 469-478. https://doi.org/10.1056/NEJMoa063446
NURS 6914 Week 4 instructions, in plain terms
Family meeting assignments in this course usually ask you to plan, conduct or document a meeting with a patient's family about goals of care, using recognized guidelines. Writeups of four to five pages are common, often including dialogue. Show the preparation, including any disagreement within the team. Begin the meeting by hearing each person's understanding. Let the patient state his own wishes where he can. Name emotions before offering information, and answer fears with specific resources. Record the turning point honestly. Summarize the plan and confirm it with the family. Close with the outcome, what remains unresolved and how the plan can be revisited if circumstances change. Attach a short list of who was present and in what role.
Inside the NURS 6914 Week 4 example
The background introduces the family and cites Hudson and colleagues' family meeting guidelines. A huddle section records the team's agreement on facts and its disagreement about safety. Table 1 condenses the meeting into fourteen lines of dialogue with commentary, from understanding to the son's question and the summary. An outcome section describes the partial agreement and respite option and cites Gomes and colleagues on changing preferences for dying at home. A reflection section names three features that made the meeting work, citing Lautrette and colleagues on giving families time to speak, and notes that the son still needs follow-up. The team's safety concern stays visible in the outcome rather than disappearing.
Where the marks sit in the NURS 6914 Week 4 rubric
Family meeting writeups are commonly graded on preparation, communication skills, family-centered focus and documentation of outcome. Preparation credit goes to a team huddle that agrees on facts and a leader. Communication skills are judged in the dialogue itself: hearing understanding first, naming emotion and summarizing. A family-centered focus earns credit when each member's concern is addressed, including those who disagree. Documentation should show what was agreed, what was not and what happens next. Honesty about the team's own disagreement often adds credit. Guidelines and evidence should be cited in APA. Realistic dialogue is valued over polished speeches. Graders also look for a clear record of who will do what after the meeting and when the plan will be revisited.
NURS 6914 Week 4 help from the desk
Family meeting writeups lose marks when the meeting runs like a lecture, with the team explaining and the family listening. Another common loss is a neat ending that pretends everyone agreed. Some writeups leave out the team's preparation. Others answer a caregiver's fear with reassurance instead of resources. Prepare as a team, hear everyone first, let the patient speak, name emotions, answer fears concretely, record the turning point and document partial agreement honestly. The desk can draft a writeup for the family in your scenario. Keep the family's words believable and allow some of them to be unfair. Write down the next step for every person who attended.
Get a NURS 6914 Week 4 example written to your instructions
Lay out the scenario in your Week 4 prompt, who attends and what they disagree about, with the rubric attached. The writeup comes back with the huddle, the meeting as dialogue with its difficult moments intact, and follow-up, within 24-48 hours; the first is free. Any meeting framework your course teaches replaces Hudson's.
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NURS 6914 Week 4 questions, answered
Why include the team's pre-meeting disagreement?
Because the family meets a team that is not united, and pretending otherwise misrepresents the case. The huddle records the ward nurse's doubt about safety at home and the social worker's view that it can work, then the agreement on facts and a lead. Your rubric may credit preparation separately, and an honest huddle also explains some of what happens later in the room.
What are Hudson's family meeting guidelines?
Multidisciplinary clinical practice guidelines for family meetings in palliative care, developed by Peter Hudson and colleagues, covering preparation, conduct and follow-up of the meeting. The example uses that three-part shape, which is why the huddle and the follow-up plan receive as much attention as the conversation itself. Citing a structure specific to palliative care keeps the writeup in its own field.
Does the meeting reach agreement?
Partly. The patient, the social worker and eventually his wife accept a plan for home with hospice support and a named fallback if nights become unmanageable; the son does not fully agree, and the writeup says so. An honestly partial outcome, with open questions and a follow-up date, usually reads as more credible to graders than a meeting where everyone agrees.
Where can I find a free NURS 6914 Week 4 sample paper?
The full writeup, huddle, dialogue table, outcome and reflection, is here for anyone and costs nothing. A writeup for the family in your own prompt can be requested.
What made the wife able to agree in the NURS 6914 Week 4 meeting?
Hospice help at home, her son's weekend nights and a clear option to use a hospice inpatient unit or respite stay without it counting as failure.