A family's request that their father not hear the word cancer, and the question the nurse then put to him directly, shape the reflection NU435 often sets in Unit 7. Searches like "nu 435 unit 7 assignment example", "nu435 unit 7 sample" and "nu435 unit 7 example" land here.
"Never Say the Word Cancer in Front of My Father": A Cultural Care Reflection on Offering, Not Imposing, Information
[Student Name]
Purdue University Global
NU435: Hospice and Palliative Nursing Care
Unit 7 Seminar Reflection
[Instructor Name]
[Date]
The nurse narrator and family are composites. No background about the family's heritage is given, for the reason explained in the reflection.
The Request
In the hallway of the family's house, before I had met the patient, his eldest son stopped me. "My father is 81. He knows he is sick. Please never say the word cancer in front of him." His father had been admitted to hospice two days earlier with advanced stomach cancer.
My first reaction was irritation, and I want to record it honestly. I thought: he has a right to know, and I am not going to lie to a patient. I had learned in school that withholding a diagnosis is paternalistic, and that full disclosure is how nurses respect autonomy. Standing in that hallway, I felt I was being asked to do something wrong.
Where the Reflex Came From
When I looked at the reflex later, I saw that it rested on an assumption: that every patient wants all the information, and that giving it to them is always respect. Research on attitudes toward disclosure has found that patients differ widely in how much they want to know and who they want to know it, and that preferences for family-centered decision-making are common (Blackhall et al., 1995). My training had taught me one model of respect and treated it as the only one.
The Question I Asked
I did not agree to the son's request, and I did not refuse it. Instead, with the son's knowledge, I sat with the father alone and asked him gently, "People are different about this. Some like to hear every detail from the nurse; others would rather their family hear it and keep them updated. Which suits you?"
He looked at the window for a while before answering: "My son takes care of these things. Tell him. I know I am old and sick. That is enough for me." The right to know includes a right to decline detail, and asking him let him use it.
I had framed the choice as telling him or withholding from him. Asking him turned it into offering information and letting him decide how much to take. He chose his son to hear the details, which was a decision he made, not one his family made for him.
The Paperwork
The hospice election statement required acknowledgment that care would be palliative rather than curative, because a patient who elects the benefit gives up Medicare coverage for curative treatment of the illness that brought him to hospice (Centers for Medicare & Medicaid Services, n.d.). I worried that this form would force the word the family asked me not to use. The team read it with the son and then, with the father, used words he accepted: that the goal was comfort and time at home, and that treatments to cure the illness would stop. He signed. Negotiating wording like this, rather than choosing between full disclosure and silence, is how clinicians can meet both legal requirements and a family's wishes (Kagawa-Singer & Blackhall, 2001).
Why I Say Nothing About Their Heritage
I have not described this family's cultural or ethnic background, and that is deliberate. Adding it would suggest that their request is explained by where they come from, which would turn one family's choice into a stereotype. The only evidence I have is what this father and his son told me. Other families from the same background might want full disclosure; families of any background might ask what this one asked.
What Happened Over the Following Weeks
The arrangement held. At each visit I asked the father how he was feeling and what he wanted help with, and I gave the son the medical details in the kitchen afterward. When his pain increased, the father asked me directly, "Is it getting worse?" I answered that it was, and that we would change his medicine so he could rest. He nodded and asked nothing more, and I did not press further information on him. Offering what he asked for, and no more, felt different from the withholding I had feared in the hallway. He died at home five weeks later with his son beside him.
What I Would Do Differently
I would ask the question sooner, at the first visit, before anyone asks me to withhold anything: "How would you like information about your illness shared, and with whom?" And I would notice my own irritation as a signal to ask, not a signal to argue.
What this family taught me, and only this family: a request not to say a word can be a request to be cared for in a particular way, and the person to ask about it is the patient.
References
Blackhall, L. J., Murphy, S. T., Frank, G., Michel, V., & Azen, S. (1995). Ethnicity and attitudes toward patient autonomy. JAMA, 274(10), 820-825. https://doi.org/10.1001/jama.1995.03530100060035
Centers for Medicare & Medicaid Services. (n.d.). Medicare hospice benefits. Centers for Medicare & Medicaid Services.
Kagawa-Singer, M., & Blackhall, L. J. (2001). Negotiating cross-cultural issues at the end of life: "You got to go where he lives." JAMA, 286(23), 2993-3001. https://doi.org/10.1001/jama.286.23.2993
How this NU435 Unit 7 example is structured
The reflection moves through three moments rather than the stages of a named model, and each is anchored in something said aloud. The first is the son's request, quoted, and the writer's reaction to it, including the assumption that withholding information is always a harm. The second is the question put to the father, which the paper frames as offering information rather than imposing or withholding it: the right to know includes a right to decline detail. The third is the paperwork, where respect for the family's wishes met the election statement's requirement, and the team found wording the father accepted. Throughout, the writer attributes preferences to this family only, and a paragraph explains why no background about the family's heritage appears: it would add a stereotype and no evidence. Two sources on truth-telling support the argument.
Get an NU435 Unit 7 example written to your instructions
Reflections are personal, so the sample can only model the shape, the honesty and the sourcing; the encounter in your paper has to be one you actually had or a composite you build. For a first request there is no charge: describe what the prompt asks and how the rubric scores it, and a model written to those instructions follows in 24-48h. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
NU435 Unit 7 questions, answered
Is it acceptable to write about a family's culture without naming it?
Often it is the stronger choice. The sample leaves heritage out because the argument never depended on it, and naming it would invite generalization. If your prompt asks you to discuss a specific cultural or religious tradition, cite sources for it, describe variation within the group, and tie every point to what the family itself said rather than to the tradition in general.
Can a patient decline to hear his diagnosis?
Most ethics literature supports a capable patient's choice to receive less information and to delegate decisions, provided the choice is his and not imposed by others. That is why the sample's nurse asks the father directly. Hospice paperwork still requires acknowledging the palliative focus of care, so the reflection shows the team meeting that requirement with his agreement. Agency policies vary.
How personal should the reflection be?
Personal enough to show an assumption being tested, which usually means admitting a reaction that does not flatter the writer. Stop short of confession: the patient and family remain the subject, and details of your own losses belong only if the prompt invites them. Your encounter must be your own or a composite, since the sample's family is invented.