While this is very true, others can argue that nursing staff members respecting the patient’s DNR is practicing maleficence. In this situation, however, the nurses are limited to certain roles; witnessing patient’s request for a DNR, discussing medical information to those who are authorized, and not initiating lifesaving measures in the event that the patient becomes unconscious and unresponsive in this situation. I asked the interviewee how he justified the action of not initiating lifesaving measures as a nurse. The interviewee explained a valid point that clarified my consistent attempts to justify not initiating lifesaving measure. He explained, “As a nurse, situations such as this do play out frequently, and we have to be able to manage the situation carefully. Even though nurses primarily wish to protect patient’s safety and health, there are times when the patient’s decision comes first and our beliefs do not matter. Then, as nurses, all we can do is to respect the decision and show empathy for the patient and their family.” In essence, the patient’s will is what matters the most in some situations. As nurses, we do want to see people recover and lead healthy lives, but in the end, we also do not want them to suffer. Any patient should be at peace with his or her decision, and as much as we care about our patients, we need to let them make that choice especially regarding living
The end-of-life nurse’s primary objective is to provide comfort and compassion to patients and their families during an extremely difficult time. They must satisfy all “physical, psychological, social, cultural and spiritual needs” of the patient and their family. (Wu & Volker, 2012) The nurse involves their patient in care planning, as well as educating them about the options available. They must follow the wishes of the patient and their family, as provided in the patient’s advance directive if there is one available. It is i...
Ethics govern our relationships with others. Ethics and morals are very similar, in that both deal with questions of right and wrong. Societal or cultural norms determine ethical behavior whereas moral behavior depends on the individuals own sense to decide about what is right and wrong (Ethical Dilemma Scholarly Peer-review Journal, 2017). In nursing, ethical dilemmas are ethically controversial situations experienced through the healthcare professional’s obligation to inform the patients, support participation in patient decision making and patient advocacy. The goals of healthcare professionals are inherently ethical and involve protecting patients from harm while providing care that benefits them (Kim, Han & Kim, 2014).
Hospice focuses on end of life care. When patients are facing terminal illness and have an expected life sentence of days to six months or less of life. Care can take place in different milieu including at home, hospice care center, hospital, and skilled nursing facility. Hospice provides patients and family the tool and resources of how to come to the acceptance of death. The goal of care is to help people who are dying have peace, comfort, and dignity. A team of health care providers and volunteers are responsible for providing care. A primary care doctor and a hospice doctor or medical director will patients care. The patient is allowed to decide who their primary doctor will be while receiving hospice care. It may be a primary care physician or a hospice physician. Nurses provide care at home by vising patient at home or in a hospital setting facility. Nurses are responsible for coordination of the hospice care team. Home health aides provide support for daily and routine care ( dressing, bathing, eating and etc). Spiritual counselors, Chaplains, priests, lay ministers or other spiritual counselors can provide spiritual care and guidance for the entire family. Social workers provide counseling and support. They can also provide referrals to other support systems. Pharmacists provide medication oversight and suggestions regarding the most effective
Ethics and integrity are essential parts of the nursing profession since they provide nurses with the capacity for weighing in on the impacts that their actions may have on the profession (Guido, 2014). However, maintaining high levels of ethics and integrity may create significant challenges for nurses some of which impact on their position as healthcare providers. One of the key challenges that nurses experience as part of their profession is increased cases of ethical dilemmas some of which impact on their abilities to make decisions based on the interests of their patients. The nursing code of ethics indicates the need for nurses to ensure that the decisions or actions they take reflect on the interests
In our current healthcare period, the things we can do aren’t always the things we should do or are best for our patients and their families. It is our responsibility as nurses to support our patients and to care for them. Often, we are the only ones accessible when patients are unable to speak for themselves, particularly at the beginning and ending of life. This is the reason why every nurse should be familiar with the Code of Ethics. We could always fall back on this framework for the decision-making process and to help us strengthen our voices. In this paper, I will describe how I personally apply two of the nine tenets to my nursing practice and how it enhances my own practice as a nurse.
Ruland & Moore (1998) state that there is a need for clinical guidance in caring for patients and their families who are nearing the end of their lives. By providing nurses with clinical guidance, they can give patients and their families quality care. This theory focuses on dying in a peaceful and meaningful way with family members being present; however, there is great complexity in caring for patients who are nearing the end of their lives, and it is important for nurses to have an adequate level of knowledge about end of life care (Ruland & Moore, 1998). It is essential for nurses to help patients and their families during end of life care by providing them with peace, which involves feelings of calmness, harmon...
Taking an example of EOL decision again, death and dying of self or immediate family is the most difficult subject to talk about. She arranges a meeting with next of kin and other health professional depending on the situation and explains the whole situation, the pros and cons of each decision in an unbiased manner (Burgess, Braunack-Mayer, Crawford & Beilby, 2014). With the previous experience and the training received on end of life care, geriatric nurse gets a well-written treatment plan by the treating physician. She communicates the decision among the multi-disciplinary team (Stewart, Goddard & Schiff, 2011) and documents all discussions and decisions for shift handover and as a legal record for later (Chan &
Physician-assisted suicide is legal in some European countries and U.S. states. These regions are Belgium, Luxembourg, the Netherlands, Switzerland, Oregon, Washington, Montana, and Vermount. Amongst various systematic reviews, the US states death range was 0.1%-0.2% and typically the individual was a well-educated male with cancer (Steck, Egger, Maessen, Reisch, & Zwahlen, 2013). Death with dignity is a new issue of compassion and personal choice. Hematological disease wear and tears the body apart, eventually the person. As an active healthcare advocate, a nurse should support for the right of the terminally ill people with unbearable suffering and have the support to control the time and manner of their death. We have to prevail one day against those zealots that inhibits the choices of others. Modern medicine has progressed in innovation and success to life-saving achievements. Medicine can always do more to to enhance the life of a patient, the dilemma is whether sacrificing the dignity or comfort of the terminally ill patient is necessary. Palliative care is a method to face loss of autonomy, but the reality it will not take away a terminal illness.
In the cases of Karen Ann Quinlan, Nancy Beth Cruzan and Terri Shiavo., I would have carried out orders to sustain life without contest and complied once the judicial system ruled otherwise. The approach of deontology fits this situation perfectly. At times, nurses should be objective and allow other to have the final say; even if, your personal feelings conflict. In Terri Shiavo case, it was shameful all the turmoil surrounding this case but she was hospice at this should have been a no-brainer. It appears the practice of open access hospice was implemented in Terri Shiavo’s case against the will of the client and her husband wishes. The philosophy of hospice care is to focuses on comfort and quality of life, rather than cure. Hospice