The Patient Self-Determination Act of 1990 (PSDA) was created to ensure that patients have the right to be a part of the medical team and have active role in setting up goals related to their plan of care. Patients have a right to autonomy or respect of their health care wishes. Many times the patient’s decision may conflict with what the healthcare provider thinks is the best course of action. Paternalism is when a health care provider interferes with a patient’s ability to make their own healthcare decisions (American Nurses Association, n.d.). For example, this may involve the withholding of information that may make a patient decide against a course of action that the health provider feels is the best course of action.
While this writer does not feel that the home care nurse prevented Mr. H from making an autonomous decision, the nurse did not fully explain the possible negative results of his choices, nor did she offer any other viable option regarding his health care. For example the nurse could have discussed hiring a nurse privately to perform wound care for Mr. H. The nurse could have also checked if the patient was eligible for visits to a wound care clinic once home health care was not an option, and this choice was never presented to the patient.
Teaching – Learning Strategies
The nurse also failed to provide adequate education Mr. H. One of the first steps to teaching a patient is to access for any barriers to learning (T. O’Hara, personal communication, August, 2015). The home care nursing mentions no barriers besides the patient’s overall undesired to learn. The nurse failed to find out why the patient would not make changes necessary to promote health. Perhaps Mr. H simply did no...
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...mily suffers from weight problems. The JNS would help identify healthy lifestyle changes the H family feels they can make. For example the family could switch from eating canned high sodium vegetables to eating fresh or frozen vegetables. While the family may not choose the ideal heart healthy diet even small changes would greatly benefit the H family.
Obviously wound care is a very important part of Mr. H’s health care, and this JNS would make sure if not able to perform the wound care himself, Mr. H at the very least knew what needed to be done and could explain the procedure to healthcare provided. This JNS would also thoroughly assess Mrs. H’s ability to provide wound care. While the JNS would happily provide respite care, it is imperative that someone in Mr. H’s be able to provide wound care in case a dressing got dirty or fell off between home care visits.
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