Decision-making is the process requiring critical thinking and forecasting ability to assist a person in selecting a logical choice from the available number of options. (Tiffen, Corbridge & Slimmer, 2014). Studies show that nurses make a health care decision every 30 seconds so it becomes an involuntary process for nurses to make clinical decisions. From admission itself, the plan regarding the patient’s bed occupancy, care and treatment will be decided. In geriatric nursing along with many other clinical care decisions nurse need to make decisions on long term care plan like selection of end of life care (EOL) and discharge planning.
The key area of decision-making on direct patient care is intervention effectiveness, picking an intervention that best suits the patient. For example, an 87-year-old woman with end stage respiratory disease on 5L of oxygen showing increased respiratory rate and decreased saturation. Here registered nurse uses the clinical assessment tools, critical thinking and analysing skills to decide either to initiate a medical emergency or to consider EOL. Nurse negotiates with other members of the health care team and does a risk/benefit analysis (Bakalis & Watson, 2013) discusses with the patient or medical power of attorney regarding patient’s wishes. While putting all the information together if it is found that the intervention is going to do more damage and increase the suffering than improvement in the quality of life, registered nurse here advocates and facilitates EOL plan (Herbert, Moore & Rooney, 2011)
In senior roles and managerial roles nurses needs to make decisions on delegation of care. While doing so nurses need to consider organizational requirement of competency or education for the ...
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...re can benefit healthcare institution by preventing over and under treatment and can help the patient to are live the last months and days of life as fully as possible and with dignity and choice (Leuven, 2012).
Hospital stay is often painful and emotionally distressing situation for everyone involved in it. Especially when there is terminal, illness and old age involved (Anderson, 2011). In the matter of aged care placement and EOL decisions an experienced geriatric nurse plays a spoke person role for patients and family and making decisions for them or to guide them through the decision making process. The decision-making commences even before admission to a unit and continues even after discharge. Geriatric nurses’ experience knowledge and skills are reflected in the quality of decisions she makes which in turn help improving the service she provides.
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