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End-of-life Decision-making Process

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Nurses provide guidance and address the problems in the end-of-life decision-making process. It is the nurse’s role to explain to families and other healthcare professionals when an advance directive would be put to use. An advance directive serves as a guide for clinicians to respect and honor the autonomous decision of the patient when they are in a position to not be able to express their wishes (Roux & Halstead, 2009). Nurses could assist in ensuring the patient needs are met along with protecting their rights. The registered nurse act as client advocates in health maintenance and clinical care (Standards of Nursing conduct or practice, 2003). Advocating for patients could bring implications such as conflicts with physician and families regarding decision on the plan of care. Nurses struggle with having the feeling of powerlessness towards family decision rather than supporting patient decision. Nurses also experience moral distress and outrage at unsuccessful attempts at becoming patient advocate.

According to provision two of the American Nurses Association nursing code of ethics, the nurses’ primary commitment is to the patient, whether an individual, family, group, or community (American Nurses Association, 2001). This code impacts the nurses’ professional decision because if conflict arises, they are the ones to assist in resolving it. The loyalty of the nurse is still towards the patient especially when conflict persists. They inform patient and their families of options leading towards decision making. Nurses however, have to ensure patient safety, oversee what is important, and support whatever decision the patient made.

Mr. E’s scenario of being placed on the respirator has multiple ethical implications. ...

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...the services should be initiated by the nurse as soon as personal or professional values/interests are questioned. The use of a multi-disciplinary approach should be considered to assist in attaining and representing a shared goal in which Mr. E’s wishes and end-of-life choices are supported.

Works Cited

American Nurses Association. (2001). Code of Ethics for Nurses with Interpretive Statements. Retrieved March 26, 2012 from http://nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics.pdf.

Roux, G., & Halstead, J. A. (2009). Issues and trends in nursing: essential knowledge for today and tomorrow. (p. 349). Sudbury, Massachusetts: Jones and Bartlett. Retrieved from http://wgu.coursesmart.com/9781449608347/1?CSTenantKey=wgu

Standards of nursing conduct or practice. Washington Administrative Codes. WAC 246-840-700 (2003).
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