Nursing Diagnosis:  Powerlessness related to feelings of loss of control and lifestyle restrictions secondary to hospitalization.
Data: Patient is sitting in bed crying. Patient actively seeks information from healthcare team about her condition. Patient’s newborn was moved to a different hospital for possible NEC or Hirschprung disease. Patient inquires about a pass to leave the hospital. Patient states, “all I want to do is see my daughter but they won’t let me leave the hospital.” Patient’s family visits and she asks them to wait until the cardiologist visits so he can order her a pass and they can take her to the pediatric hospital. Patient expresses feelings of frustration of not being able to see her daughter.
Short term goal: Patient will verbalize an understanding of why she needs to wait to leave the hospital.
Long term goal: Patient will obtain a pass to leave the hospital and see her newborn daughter. 
Interventions:
1.	Be an active listener by allowing the patient to verbalize concerns and feeling and assess for areas of concern. In order to help the patient gain control of her feelings I tried to facilitate effective communication with her by actively listening and asking open ended questions to allow her to express her feelings. I asked her what her major concerns were and I listened to her responses.
Rationale: To help the patient gain control of her feelings. “Because powerlessness is subjective, the nurse must validate with the client all inferences concerning the client’s feelings of powerlessness. The nurse assesses each client to determine his or her usual level of control and decision making and the effects that losing elements of control has had.” (Lippincott, Williams & Wilkins 2006, p 572)
Evaluation:  The patient expressed feeling of helplessness related to the separation of her daughter. The patient also expressed a frustration related to the ineffectiveness of the medication. The patient verbalized the dangers associated with uncontrolled hypertension. 
2.	Explain all procedures rules and options to the person. We did this by educating the patient on the dangers associated with uncontrolled hypertension and the need to see a physician and get the proper medicine. We found out the procedure for obtaining a pass to leave the hospital. We explained that obtaining a pass to leave the hospital was policy and that we would contact the proper persons in order to obtain that pass. 
Rationale: “People with a sense of hope, self-control, direction, purpose, and identity are better able to meet the challenges of their disease.” (Lippincott, Williams & Wilkins 2006, p. 574)
Evaluation: The patient expressed an understanding of hospital policy and she expressed a readiness to do whatever it took to obtain the pass. 
3.	“Emphasize positive aspects when the person becomes focused on the fears of the worst” (Lippincott, Williams & Wilkins 2006 p 574) We did this by listening to the patients fears about her child’s suspected condition and her own battle with hypertension. We explained to her that after she saw the physician and took her blood pressure medication she would be allowed to see her daughter. We emphasized the fact that both her and her daughter being in the hospital would allow for the best possible treatment. We re-emphasized that they had ruled out NEC that morning and that if her daughter did have Hirschprung disease it was a treatable condition. 
Rationale: “Self –image changes negatively because of restricted lifestyle, social isolation, unmet expectations, and dependence on others.” (Lippincott, Williams & Wilkins 2006 p. 574)  We tried to help the patient focus on the positive aspects of the situation.
Evaluation: The patient expressed that she understood that she was not at fault for her daughters condition and that she understood that she and her daughter would receive the best possible care. 
4.	“Advocate within the system to eliminate policies and routines that contribute to powerlessness.” (Lippincott, Williams & Wilkins 2006, p. 574) We did this by discussing with the nurse the patient’s desires to obtain a pass to leave the hospital. We contacted the physician and explained the urgency of the situation. We sent the order for the new medication to pharmacy and administered it as quickly as possible. We helped that patient get ready to leave the hospital by providing a wheelchair. 
Rationale: To help the client gain situational control (Lippincott, Williams & Wilkins 2006, p. 574)
Evaluation: The goal was met by contacting the right people in order to help the patient gain control of the situation and see her newborn daughter.