Introduction
Heath care is a dynamic environment and one in which consumerism is expanding. Patients and families are more educated and involved in their care than ever before. The movement toward health consumerism has spawned additional ethical conundrums. The American Heart Association, American Association of Critical-Care Nurses, Emergency Nurses Association, and other health care entities have all addressed the topic of family presence during resuscitation and/or invasive procedures. Clinicians and researchers have cited a multitude of ethical principles when supporting arguments for or against family presence during resuscitation. On one hand family presence may be unhealthy for the family and cause untoward provider stress during an already tense situation. However, on the other hand do families have the right to attend these events and might it be beneficial for closure and education. Members of the health care team must evaluate both sides of the question.
Impact Statement
Nurses serve as vital members of hospital resuscitation teams and as such family presence during the process directly impacts nursing. Nurses account for the largest group of health care professionals in the nation (IOM, ***). Therefore, it should not be unexpected that they are thought of as the face of health care. Nurses provide not only direct patient care and education, but also frequently interact with the families of their patients. In a resuscitation situation nurses are called to serve in vital roles. Families are likely to look to a familiar and comforting figure for direction and information during this stressful and critical time. The nursing staff will need to facilitate caring for the patient as well as the family which cou...
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...compressions and endotracheal intubation. It is argued that inflicting this psychological trauma upon family members is in contradiction to the ethical principle of nonmaleficence. In the event a family member does not tolerate the resuscitation well, it could detract from patient care and thus be detrimental to the patient. For example, members of the resuscitation may need to step away from patient care to aid family members. An additional concern cited is family presence could increase the stress experienced by the resuscitation team and thus detract from patient care. Beneficence and nonmaleficence are ethical principles that are hand-in-hand with overlapping evidence citations. A distracted resuscitation team has the potential to harm the patient. Additional stress imparted on the resuscitation team is not in the best interest of the individual members.
Braddock, Clarence, and Mark Tonelli. "Physician Aid-in-Dying: Ethical Topic in Medicine." Ethics in Medicine. University of Washington, 2009. Web. 3 March 2015.
Although nurses do not wield the power of doctors in hospital settings, they are still able to effectively compensate for a doctor’s deficits in a variety of ways to assure patient recovery. Nurses meet a patient’s physical needs, which assures comfort and dignity Nurses explain and translate unfamiliar procedures and treatments to patients which makes the patient a partner in his own care and aids in patient compliance. Nurses communicate patient symptoms and concerns to physicians so treatment can be altered if necessary and most importantly, nurses provide emotional support to patients in distress.
This paper will talk about the book No Good Deed and how there are many ethical dilemmas that healthcare providers deal with every day. Each day there are ethical issues that arise, especially when caring for terminally ill patients. The book No Good Deed talks about how two nurses struggle with a situation that is far too common in healthcare today. Despite the literature about end of life care, it still remains an issue for many providers and patients. Nurses are lead to deal with multiple ethical issues seen in the book No Good Deed. After reading the book No Good Deed one is able to see how literature about end of life care is viewed and how beneficence plays are large role in nursing care.
Nurses are both blessed and cursed to be with patients from the very first moments of life until their final breath. With those last breaths, each patient leaves someone behind. How do nurses handle the loss and grief that comes along with patients dying? How do they help the families and loved ones of deceased patients? Each person, no matter their background, must grieve the death of a loved one, but there is no right way to grieve and no two people will have the same reaction to death. It is the duty of nurses to respect the wishes and grieving process of each and every culture; of each and every individual (Verosky, 2006). This paper will address J. William Worden’s four tasks of mourning as well as the nursing implications involved – both when taking care of patients’ families and when coping with the loss of patients themselves.
The nursing discipline embodies a whole range of skills and abilities that are aimed at maximizing one’s wellness by minimizing harm. As one of the most trusted professions, we literally are some’s last hope and last chance to thrive in life; however, in some cases we may be the last person they see on earth. Many individuals dream of slipping away in a peaceful death, but many others leave this world abruptly at unexpected times. I feel that is a crucial part to pay attention to individuals during their most critical and even for some their last moments and that is why I have peaked an interest in the critical care field. It is hard to care for someone who many others have given up on and how critical care nurses go above and beyond the call
My initial response to the issues was only based on the hospital policies regarding the care of the patients within the hospital. However, when I was guided down the different paths and made to look through the different ethical lens, I found it tough to do so and seem to resort to my core values of autonomy and rationality. By putting the patients’ first, hospital policies, and then their loved ones in the first scenario, I determined that a compromise was necessary. Whereas in the second scenario, I feel as no agreement was needed just staff education (EthicsGame Simulation, 2016). In this particular case, Carlotta, the RN shift supervisor, needed further training to understand the hospital policy on who is or is not considered to be family (EthicsGame Simulation,
Including family members in the care of the patient helps them cope better with the patient’s illness and helps them plan ongoing care when the patient goes home. Gaining both the trust of the patient and family can help the health care team get any details that may have been missed on admission, such as medications the patient takes, or special diet, or spiritual needs. Also, the family may provide pertinent information that the patient may not have divulged to the nurse. Encouraging the patient and family to voice their concerns will help implement a safe plan of action.
In critical and complicating medical cases, family members often find it tedious to decide as to what mode or procedure of treatment is idyllic for the recovery of their patient. In such cases, well-qualified and medically educated can play a pivotal role in deciding the kind of treatment that should be given to the patient to enhance its recovery. In a contrary situation a nurse may know that administering a particular drug may improve the patient’s condition, but may be refrained from conducting the required action due to doctor’s absence or non-permission. There are numerous cases through which ethical dilemmas in the profession of nursing can be discussed. Nurses in order to remain within the defined boundaries ...
This can be seen in the case study as ethical and legal arise in resuscitation settings, as every situation will have its differences it is essential that the paramedic has knowledge in the areas of health ethics and laws relating to providing health care. The laws can be interpreted differently and direction by state guidelines may be required. Paramedics face ethical decisions that they will be required to interpret themselves and act in a way that they believe is right. Obstacles arise such as families’ wishes for the patients’ outcome, communicating with the key stakeholders is imperative in making informed and good health practice decision. It could be argued that the paramedics in the case study acted in the best interest of the patient as there was no formal directive and they did not have enough information regarding the patients’ wishes in relation to the current situation. More consultation with the key stakeholders may have provided a better approach in reducing the stress and understanding of why the resuscitation was happening. Overall, ethically it could be argued that commencing resuscitation and terminating once appropriate information was available is the right thing to do for the
There are many different thoughts and beliefs surrounding ethics. Ethic codes of conduct are in place. Ethics has always existed but has been more closely looked at over the last 40 years. There is discussion about futile care to patients in intensive care settings and do-not-resuscitate (DNR) orders for surgical patients. Guidelines and regulations need to be followed and set forth.
Neonatal resuscitation is intervention after a baby is born to strengthen it’s breathe or to boost its heartbeat. Approximately 10% of neonates require some assistance to begin breathing at birth, but only 1% require serious resuscitative measures. Informed consent regarding neonatal resuscitation is a constant ethical debate. This discourse ordinarily occurs between doctors and parents; parents often feel that the decision has been made for them, believing that they were not fully informed of any consequences that may occur before making their final action plan, or thinking that their opinion was not taken seriously; however, doctors see the procedure in a different light, that the parents can’t choose the best option for the child regardless of counseling, or performing as the parents wished but believing that the result could have differed if the parents had known all the effects that it will have further down the line, or convinced that they would have made a better
In health care, there are many different approaches throughout the field of nursing. When considering the field of family nursing, there are four different approaches to caring for patients. This paper will discuss the different approaches along with a scenario that covers that approach. The approaches that will be discussed include family as a context, family as a client, family as a system, and family as a component to society. Each of these scenarios are approach differently within the field of nursing.
A nurse’s perception of a good death may be different from that of a patients’ or their family. In order to plan individualized care for the patient and their family after death, the nurse must provide a sense of control, dignity, and privacy to the parties involved (Pattison, 2008). In the coming years, nurses are likely to experience an increasing multicultural society and will be witnesses and caregivers to several arrangements of bereavement, grief, and mourning that provide a sense of closure, comfort, and structure during a distressing time (Pattison, 2008). In addition to caring for their patients, novice nurses must acquire knowledge about dying, death, and coping mechanisms to decrease anxiety and increase confidence when faced with
Lautrette, A., Darmon, M., Megarbane, B., Joly, L. M., Chevret, S., Adrie, C., et al. (2007). A Communication Strategy and Brochure for Relatives of Patients Dying in the ICU. The New England Journal of Medicine, 356(5), 469-478.
With the establishment of the DNR order, withholding CPR from an individual has reformed into standing as “ethically appropriate if the anticipated benefit outweighs the harm. However, since then, the literal meaning of DNR has not been clear, thus causing confusion that remains problematic in clinical practice” (Yen-Yuan 4). With the renovation of the DNR order, people and health care providers have worked to progress defining what the DNR order stands for along with people gaining autonomy in their choice of death. Additionally, associations and activists keep pushing forward in the refinement of the DNR order: “there has been increasing focus on promoting quality of care for the dying [. . .] However, the persistent problems with DNR orders suggest that physician behaviors toward communication with patients about goals of care and resuscitation decisions have not measurably changed in the past 20 years” (Yuen 7). Through the efforts of benefactors such as the American Heart Association and others, the DNR order will continue to increase in quality over time as improvements are made. The DNR order sprouted from the first incentives that people deserve a say in how they shall die and today has transformed into a necessity that functions to entitle people to their own choice of death or