A patient is in stage of dying and says that 'I just want to see my grandchildren's birth, then I am ready'. Identify the stage of dying?

Appeared in: DSSSB - 28 August 2019 (Shift-1)

Explanation

The patient's statement is a clear attempt to negotiate for more time in exchange for a specific life event (seeing their grandchildren's birth).
This act of making a deal to postpone death is the defining characteristic of the Bargaining stage in the Kübler-Ross model.
The phrase '...then I am ready' shows the patient is offering their acceptance of death as their part of the bargain.

Option A: Depression is characterized by sadness, withdrawal, and hopelessness, not by making deals. The patient's statement is hopeful and goal-oriented, which is contrary to the depressive stage.
Option B: Acceptance involves coming to terms with death without trying to change the outcome. A patient in acceptance would be at peace, not trying to set conditions for their passing.
Option D: Anger is expressed as frustration, resentment, or blame (e.g., 'Why me?'). The patient's statement does not show any anger or resentment.

Clinical Relevance

Nursing practice connection: Use the key finding related to The concept tested is the identification of the stages of grief and dying according to the Kübler-Ross model to guide bedside assessment, documentation, and the next nursing action.
Recognizing the stages of grief allows nurses to provide appropriate psychosocial and spiritual support tailored to the patient's emotional state.
For a patient in the bargaining stage, the nurse should listen empathetically to their hopes and fears, acknowledging their goals without giving false reassurance or confirming the 'deal'.
What if the patient said, 'I'm ready to go, I have made peace with everyone'? This would indicate the stage of Acceptance, and the nursing care would shift to supporting the patient and family through the final moments, ensuring comfort and dignity.

How to Approach the Question

First, read the patient's statement carefully: 'I just want to see my grandchildren's birth, then I am ready'.
Analyze the core emotion or action in the statement. The patient is setting a condition or trying to make a deal.
Recall the five stages of grief as described by Kübler-Ross: Denial, Anger, Bargaining, Depression, and Acceptance.
Match the patient's action (making a deal) to the corresponding stage. The act of negotiating for more time in exchange for a future event is the definition of Bargaining.
Evaluate the other options to confirm they are a poor fit. The statement doesn't show anger, sadness (depression), or peaceful resolution (acceptance).

Concept Tested & Keywords

Concept Tested: The concept tested is the identification of the stages of grief and dying according to the Kübler-Ross model.
Stem keywords: stage of dying, grandchildren's birth
Lead-in keywords: Identify the stage
Clinical cues: Patient's statement: 'I just want to see my grandchildren's birth, then I am ready'
Negative lead-in flag: false

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 p. 102-104

E6 Psychology Applied Sreevani 6e Sem1 p. 94-96

E6 Psychology Applied Sreevani 5e p. 94-96

Practise the full DSSSB - 28 August 2019 (Shift-1)

Attempt every question from this paper in a timed mock, then review the full solution for each one.