MISSION

VISION A premier university in historic Cavite recognized for excellence in the development of morally upright and globally competitive individuals.
Republic of the Philippines CAVITE STATE UNIVERSITY (CvSU) DON SEVERINO DE LAS ALAS CAMPUS Indang, Cavite
It shall produce professional, skilled and morally upright individuals for global competitiveness. Cavite State University shall provide excellent, equitable and relevant educational opportunities in the arts, science and technology through quality instruction and relevant research and development activities.

College of Nursing

A Movie Review

MY SISTERS KEEPER

In Partial Fulfilment of the Requirement in NURS75 Care of Clients with Problems in Cellular Aberrations, Acute Biologic Crisis, Emergency Care and Disaster Nursing for the Degree Bachelor of Science in Nursing

Submitted by: ANGUE, AILEEN T. BSN IV 2

Submitted to: MS. EDERLYN C. PAPA, RN, MAN Level IV Clinical Instructor

JULY 01, 2013

A MOVIE ANALYSIS ON

INTRODUCTION
Anna is not sick, but she might as well be. By age thirteen, she has undergone countless surgeries, transfusions, and shots so that her older sister, Kate, can somehow fight the leukemia that has plagued her since childhood. The product of pre - implantation genetic diagnosis, Anna was conceived as a bone marrow match for Kate - a life and a role that she has never questioned until now.

--Like most teenagers, Anna is beginning to question who she truly is. But unlike most teenagers, she has always been defined in terms of her sister - and so Anna makes a decision that for most would be unthinkable a decision that will tear her family apart and have perhaps fatal consequences for the sister she loves. My Sister's Keeper examines what it means to be a good parent, a good sister, a good person. Is it morally correct to do whatever it takes to save a child's life even if that means infringing upon the rights of another? Is it worth trying to discover who you really are, if that quest makes you like yourself less? The author vividly evokes the physical and psychic toll a desperately sick child imposes on a family, even a close and loving one like the Fitzgeralds there can be no easy outcomes in a tale about individual autonomy clashing with a sibling's right to life, but Picoult thwarts out expectations in unexpected ways a telling portrait of a profoundly stressed family.

CHARACTERS Anna Fitzgerald - The youngest Fitzgerald child

and the protagonist of the novel. Described by her father as their familys constant, thirteen-year-old Anna is smart, funny, and observant. Annas actions drive the plot, as she struggles to reconcile her knowledge that only she can provide Kate, whom she loves dearly, with the organs she needs to survive and her desire to live without this extraordinary burden. While the rest of the family has often been left to sit idly by in Kates fight against cancer, Anna, because her genes match Kates, has been an active participant. Annas role in Kates survival has been a blessing and a curse for her, as it has made her Kates savior but has also made Anna unable to be her own person.

Sara Fitzgerald - The mother of the Fitzgerald family.

Sara is strong, stubborn, and intelligent, and her life centers on her efforts to keep Kate alive. She has extremely strong maternal instincts, but her single-minded focus on saving Kate sometimes exists at the expense of her marriage and her relationships with her two other children. Even so, she has a deep and abiding love for all her family, though she does not always know how to show that love.

Kate Fitzgerald - The middle Fitzgerald child and the focal point of many of the novels events. Kates cancer is at the heart of the story, but she only narrates the prologue and epilogue. She has struggled with cancer nearly her entire life, and she appears to have come to terms with the fact that she might die. The reader sees glimpses of the girl Kate could have been, but for the most part her battle with cancer defines her character.

Dr. Chance - Kates oncologist. A warm but serious man, Dr. Chance represents the science and medicine keeping Kate alive. He speaks to Sara and Brian very honestly and directly about Kates condition, yet no matter how bleak Kates situation gets, Dr. Chance always offers hope that a treatment may work, even when the chances are slim.

Campbell Alexander - Annas lawyer. Initially arrogant and brusque, Campbell gradually emerges as a character with many layers. In many ways, he mirrors Anna. Both have found it difficult to be who their parents want them to be, and both have secrets they are unwilling to share. Campbell struggles between his urge to erect barriers around himself and his genuine desire to reach out to people. He ultimately experiences the most personal growth of any of the characters, and by the end of the story he has formed strong bonds with the people around him.

CORE COMPETENCIES
1. Safe and Quality Nursing Care Nurses must demonstrates knowledge base on the health /illness status of individual / groups, promotes safety and comfort and privacy of clients, ensures continuity of care, administers medications and other health therapeutics and utilizes the nursing process as framework for nursing At Kates early age, she had undergone a lot of examinations to recognize her real condition or illness. This was through the advice of the first doctor where her mother has brought her which referred them to the oncologist. This showed safe and quality nursing care since it is a way to identify the need of the client and it will explain the real health status of Kate Fritzgerald. As the patient undergone hospitalization, their family had a great doctor which monitors Kates condition. He was visited by his doctor on time and Dr. Chance really helps a lot on the patients side since he enhances the wellness of the patient and manages her illness. On the other hand, the nurse on duty showed some disrespect to the patient. Nurses should use therapeutic communication with their patients since they are the one who should understand patients all the time. 2. Management of Resources and Environment Under this, we can observe utilization of financial resources to support client care, establishes mechanism to ensure proper functioning of equipment and maintains a safe environment. The patient was very lucky to be in a good hospital having a good quality of resources and materials that will help her to lessen her sufferings. In one of the procedures done which is called bone marrow aspiration, sterility was observed which supports this core competency since it adheres to policies, procedures and protocols on prevention and

control of infection. Moreover, uses of equipments that will support the patient with her condition were also observed from the movie. 3. Health Education Health education is very important with each and every patient for them not only to be aware about their condition but also for the interventions and future plans the family should do and follow. Assessing the needs of the client, implementation of the health education plan and evaluation of the outcome of health education were observed but most of the time the doctors were the one present from the movie. The health care providers were very important from this movie since the patient really had a serious condition which is cancer. The best quality of care must be rendered to the patient for her to relieve the pain she if feeling from the moment she was hospitalized. 4. Ethico moral Responsibility Respecting the rights of individual or groups, accepts responsibility and accountability for own decision and adheres to the nurses code of ethics lies under this competency. As observed, nurses was able to render proper and consistent nursing care following the bills of right such as privacy, confidentiality of information and others. Privacy and confidentiality of information was really seen practiced from the movie for they only talked about the clients situation/condition in a specific room with the family and relatives of the patient. 5. Personal and Professional Development Under this competency, nurses must identify own learning needs, pursues continuing education gets involve in professional organizations and shows professionalism to his/her work.

Professionalism was not observed when the nurse on duty needs to get a urine sample from the patient. That one nurse does not possess a positive attitude towards the patient and she does not project a professional image of a nurse. On the other hand, the entire health care team showed professionalism in all aspect pertaining to how they provide care to the patient who is suffering from cancer. 6. Quality Improvement Quality improvement talks about how the nurse should gather data for clients improvement, participates in nursing audits and rounds, identifies and reports variances and recommends solution to identified problems. To improve the clients condition, you can see that the nurses were the one visiting the patient in her room. One of the nurses provides appropriate suggestion on corrective and preventive measure when the patient told her that she wants to go to the beach. Immediately, she communicates with the patients family which the father consulted the doctor if it could help to his daughters condition. In addition, nurses where the one providing personal care because we all know that cancer patients really need special care. Moreover, a nurse who has specialization of hospice care was also seen from the movie. Hospices really give help to cancer patients who are dying. Hospice means a concept of care that provides comfort and quality of life to clients, and their significant others, who are facing lifes final journey associated with terminal illness. Hospices provide comfort, relieve physical, emotional, and spiritual suffering, and promote the dignity of terminally ill persons. 7. Research On the early part of the movie, a nurse was the one who gives result about the patients laboratory exams. But still, the doctor was the one who explained everything about Kates condition. At this part, recommendation of actions as for implementation was observed. The doctor who they visited first presented that the laboratory results showed

decrease in white blood count or maybe an autoimmune disorder which concluded him to ask Mrs. Fritzgerald that they should consult to the oncology. Another good job was still observed from the doctors part. It was a very nice idea that the doctor advised the family to have another child which can be a donor of Kate to her condition. This shows a good research that can help the patient to her condition. 8. Records Management Maintaining accurate and updated documentation of client care, its outcome and legal imperatives in record keeping are the focus under this competency. It is very important that a health care provider must update the clients records for it will be a proof that you have done such care or interventions to clients health. It is not really seen from the movie that the nurses are documenting specific care rendered for their patients. But in a part of it, one nurse was on the station writing something on a chart. At that part, I can say that it was utilized since it maintains safety of information since the nurse was doing it inside the station. Additionally, confidentiality and privacy was observed from the movie since the doctor, Dr. Chance (doctor of Kate) talks with the family privately. He even discussed the patients situation in detailed. 9. Communication Interaction between the nurse and the patient is a very important element to gather information about the clients needs and how the nurse will provide proper care to his/her patient. Communication between the nurse and patient interaction was not really observed from the movie. Establishing rapport with the client is very important but after watching the movie, I observed that the doctor was the one who established rapport and always there making interaction with the patient. But still, the viewers can see that the nurses respond to the needs of the patient, the family and their team. In one part of the movie, one

of the nurses was really not good in communicating with her patient. She even utters words which she should not use when talking with patients. Therapeutic communication was not observed with that nurse on duty.

10. Collaboration and Teamwork This part was about how the nurse establishes collaborative relationship with colleagues and other members of the health team, contributes to decision making regarding clients needs and concerns, participates actively in client care management including audit, etc., And in my opinion the most important part here is how the nurse maintains good interpersonal relationship with clients, colleagues and other members of the health team. At this point, collaboration and teamwork was observed on the last parts of the movie wherein the nurse has a good interpersonal relationship with her patient that she was able to know what her patient wants. Kate, the client wants to visit the beach before living this world with her family. The nurse on duty that time utter what her patient wants on the family which shows collaboration on plan of care with the members of the family. In addition, Mr. Fritzgerald ask permission for his daughters wish which the doctor approved.