P5 · Feeling no control over one's situation
Actual Emotions and mind
Definition
The person feels unable to influence events or decisions about their care.- Hospital routines
- loss of independence
- serious illness
- poor information
- Says no one asks me
- passive
- angry
- refuses care
- leaves all decisions to others
📋 Scenario
A patient says staff decide everything and stops asking questions.
Subjective (S): "Nobody asks me anything. They just decide."
Objective (O): Passive; refuses some care; asks few questions; says he feels trapped.
Assessment tools for this scenario: CP-MIND Mood & Mind Screen CP-SKIN Skin & Wound Score
Validated scales to consider: PHQ-9, GAD-7, C-SSRS, Braden Scale, TIME wound chart
**CarePath diagnosis:** Feeling no control over one's situation related to hospital routines, as evidenced by says no one asks me and passive.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Give information. | Clear information about his condition and care lets him understand what is happening, which reduces feeling trapped and helps him take part in decisions. |
| Offer choices. | Offering real choices, even small ones such as timing of care, gives back a sense of control that hospital routines have taken away. |
| Involve him in the care plan. | Including him in the care plan treats him as a partner, and people who help set goals are more likely to follow them. |
| Respect preferences. | Respecting his preferences, where safe, shows that his views count, which builds trust and reduces anger and refusal of care. |
| Set small achievable tasks. | Small tasks he can finish successfully build confidence and show he can influence his situation, which counters passivity. |
**Expected outcomes**
- Takes part in two care decisions daily.
- Says he has some control.
- Asks questions.
**Linking the data to the diagnosis**
The patient says, "Nobody asks me anything. They just decide." The nurse observes that he is passive, refuses some care, asks few questions and says he feels trapped. His sense of no control is present now, so this is an actual problem, linked to hospital routines. The plan aims to return some control through information, choices and involvement. The expected outcomes are that he takes part in two care decisions daily, says he has some control and asks questions.
CarePath diagnosis
Feeling no control over one's situation related to hospital routines, as evidenced by says no one asks me and passive.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Give information. | Clear information about his condition and care lets him understand what is happening, which reduces feeling trapped and helps him take part in decisions. |
| 2. Offer choices. | Offering real choices, even small ones such as timing of care, gives back a sense of control that hospital routines have taken away. |
| 3. Involve him in the care plan. | Including him in the care plan treats him as a partner, and people who help set goals are more likely to follow them. |
| 4. Respect preferences. | Respecting his preferences, where safe, shows that his views count, which builds trust and reduces anger and refusal of care. |
| 5. Set small achievable tasks. | Small tasks he can finish successfully build confidence and show he can influence his situation, which counters passivity. |
Expected outcomes
- Takes part in two care decisions daily.
- Says he has some control.
- Asks questions.
Linking the data to the diagnosis
The patient says, "Nobody asks me anything. They just decide." The nurse observes that he is passive, refuses some care, asks few questions and says he feels trapped. His sense of no control is present now, so this is an actual problem, linked to hospital routines. The plan aims to return some control through information, choices and involvement. The expected outcomes are that he takes part in two care decisions daily, says he has some control and asks questions.