Question

The nurse is often a moral spectator observing decisions made by others and dealing with the patient’s response to those decisions. Analyze an article about a situation where a decision by a physician, the insurance company, government agency or health institution adversely affected a patient or countermanded a patient’s wishes

The paper should be no more than three pages not including the title page or reference page.

Provide a bibliography of at least three references, the first of which is the citation for the article you selected and the second is the Code of Ethics for Nurses with Interpretive Statements.

Using APA formatting and APA style writing address the following:

The nurse's role in affirming the patient's wishes and risks involved

The social and economic consequences of reversing this decision

Guidance from the Code that sheds light on this situation

The lessons to be learned for similar future situations

The moral residue that haunts the nurse

Answer 1

The nurse's role in affirming the patient's wishes and risks involved

Nursing encompasses many aspects of care: pain and symptom management, culturally sensitive practices, assisting patients and their families through the death and dying process, and ethical decisionmaking. Advocacy has been identified as a key core competency for the professional nurse, yet the literature reveals relevant barriers to acquiring this skill. Challenges exist, such as limitations in nursing school curricula on the death and dying process, particularly in multicultural settings; differing policies and practices in healthcare systems; and various interpretations of end-of-life legal language. Patricia Benner's conceptual model of advocacy behaviors in end-of-life nursing provides the framework in which nurses can become effective patient advocates. Developing active listening and effective communication skills can enhance the nurse-patient trust relationship and create a healing environment.

The social and economic consequences of reversing this decision.

Social consequence may be disgrace socially. There may be loss of patient care. Or may be Mishapening, for which nurse may be blame.

Economic consequences may be job loss. Loss may be to institution if any mishappening cause because patient or relatives of patient can take it legally if any abnormality occurs during treatment.

Guidance from the Code that sheds light on this situation

Nurses respect the dignity and rights of all human beings regardless of the factors contributing to the health status. The worth of a person is not affected by disease, disability, functional status, or proximity to death. Nurses assess, diagnose, plan, intervene, and evaluate patient care in accord with individual patient needs and values. Respect is extended to all who require and receive nursing care whether in the
promotion of health, prevention of illness, restoration of health, alleviation of suffering,
and provision of supportive care to those who are dying.
Optimal nursing care enables the patient to live with as much physical, emotional, social, and religious or spiritual well-being as possible and reflects the patient’s own values. Supportive care is extended to the family and significant others and is directed toward meeting needs comprehensively across the continuum of care. This is particularly important at the end of life in order to prevent and alleviate the cascade of
symptoms and suffering that are commonly associated with dying. Nurses are leaders who actively participate in assuring the responsible and appropriate use of interventions in order to optimize the health and well-being of those
in their care. This includes acting to minimize unwarranted or unwanted medical treatment and patient suffering. Such care must be avoided and advance care planning throughout many clinical encounters helps to make this possible.

The lessons to be learned for similar future situations. The moral residue that haunts the nurse.

dilemma here is that the family, legally authorized to make medical decisions for the patient, desires one action and the staff, who manage the patient daily and who have the clinical knowledge of the ultimate outcome, desire an opposing action. Thus there are two mutually exclusive courses of action both of which are ethically justifiable, and neither of which is optimal. If the family’s desires are followed, Mr. Anderson will endure having a feeding tube placed and his life will be prolonged. Yet one may ask how beneficial is a longer life for Mr. Anderson, and what are the social, familial, and financial costs of this action? On the other hand, if the staff’s desires are followed, Mr. Anderson will surely die sooner, and the family will likely feel abandoned and angry—an end-of-life situation all would desire to avoid. Again one must consider the social, familial, and financial costs of the action.