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. ... ... middle of paper ... ...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).
Nurses take an active role in advocacy and policy development regarding assisted death and other end of life choices. Through the help of advance care planning, nurses has helped patient think about what gives their life a meaning, learn about medical procedure offered at end-of-life care, help them communicate about their future health care wishes, choosing a person who would speak for them when they cannot speak for themselves and recording goals and wishes. The role of the nurse in end-of-life care is very crucial, they might be getting more queries on physician-assisted death. So, it is significant for nurses to understand the law and professional standard for better continuity of care and also to protect themselves against potential
The American Nurses Association (ANA) thinks that nurses should stay away from doing euthanasia, or assisting in doing euthanasia because it is against the Code of Ethics for Nurses with Interpretive Statements (ANA, 2001; herein referred to as The Code). Overall, nurses are also advised to deliver a quality of care what include respect compassion and dignity to all their patients. For people in end-of-life, nursing care should also focus on the patient’s comfort, when possible the dying patient should be pain free. Nurses have also the obligation to support the patient but also the patient’s family members during these difficult moments. We must work to make sure that patients and family members are well informed about every option that is
The Code of Ethics for Nurses was created to be a guide for nurses to perform their duties in a way that is abiding with the ethical responsibilities of the nursing profession and quality in nursing care. The Code of Ethics has excellent guidelines for how nurses should behave, however; these parameters are not specific. They do not identify what is right and wrong, leaving nurses having to ultimately make that decision. Ethics in nursing involves individual interpretation based on personal morals and values. Nursing professionals have the ethical accountability to be altruistic, meaning a nurse who cares for patients without self-interest. This results in a nurse functioning as a patient advocate, making decisions that are in the best interest of the patient and practicing sound nursing ethics.
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
It is found that nurses report that their most uncomfortable situations come with prolonging the dying process and some struggle with ethical issues by doing so (Seal, 2007). Studies have shown that implementation of the RPC program and educating nurses have increased the nurses’ confidence in discussing end-of-life plans (Austin, 2006). With confidence, the nurse is able to ask the right questions of the patient and make sure that the patient’s wishes are upheld in the manner that they had wanted, such as to not resuscitate or to make sure their spiritual leader is present when passing (Austin,
By establishing a code of ethics the nursing profession provides a framework for judgment calls dealing with these difficult situations. This set of moral principals sets a standard for thinking through ethical problems, which ultimately helps nurses settle these types of issues. These ethical nursing dilemmas usually arise from disagreements in personal values and social issues that regard the decisions or beliefs of patients. The objective is to come to a common understanding which upholds the best interest of the patient while reinforcing the personal values of the healthcare professional.
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
The American Nurses Association Code of Nursing Ethics (ANA) provides documentation in a position statement stating what the nurses’ role and responsibility when counseling at the end of life. The ANA’s position is stated clearly. End-of-life choices are a quality of life issue. Nurses, individually and collectively, have an obligation to provide comprehensive and compassionate end-of-life care, including the promotion of comfort, relief of pain, and support for patients, families, and their surrogates when a decision has been made to forgo life-sustaining treatment (American Nurses Association Code
Nursing code of ethics was developed as a guide in carrying out nursing responsibilities in a matter consistent with quality in nursing care and the ethical obligations of the profession (ANA, 2010). The term ethics refers to the study of philosophical ideals of right and wrong behavior (Olin, 2012). There is a total of nine provisions however, throughout this paper I will discuss provisions one through four. These provisions would include, personal relationships, primary care, nurse commitment, safety, patient rights, responsibility and accountability of the patient.
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...
P. 5). The CNA code of ethics (2008) provides important guidance for nurses caring for individuals at end of life. CNA emphases on providing the person’s informed consent and person’s right to refuse or withdraw consent for care or treatment at any time” (C4, p. 11). It focus on to relieve pain and suffering including appropriate and effective symptom and pain management, to allow persons to live with dignity” (D8, p. 14) and nurses to foster comfort, alleviate suffering, advocate for adequate relief or discomfort and pain and support a dignified and peaceful death. This includes support of the family during and following the death, and care of the person’s body after death” (D9, p.
The care of patients at the end of their live should be as humane and respectful to help them cope with the accompanying prognosis of the end of their lives. The reality of this situation is that all too often, the care a patient receives at the end of their life is quite different and generally not performed well. The healthcare system of the United States does not perform well within the scope of providing the patient with by all means a distress and pain free palliative or hospice care plan. To often patients do not have a specific plan implemented on how they wish to have their end of life care carried out for them. End of life decisions are frequently left to the decision of family member's or physicians who may not know what the patient needs are beforehand or is not acting in the patient's best wishes. This places the unenviable task of choosing care for the patient instead of the patient having a carefully written out plan on how to carry out their final days. A strategy that can improve the rate of care that patients receive and improve the healthcare system in general would be to have the patient create a end of life care plan with their primary care physician one to two years prior to when the physician feels that the patient is near the end of their life. This would put the decision making power on the patient and it would improve the quality of care the patient receives when they are at the end of their life. By developing a specific care plan, the patient would be in control of their wishes on how they would like their care to be handled when the time of death nears. We can identify strengths and weakness with this strategy and implement changes to the strategy to improve the overall system of care with...
...urary/February). The Continuing Challenge of Assisted Death. Journal Of Hospice And Palliative Nursing, 6, 46-59.
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 &
We as health care professionals need to work side by side with the families to provide the best care and decisions that are right by our patients. We have to be mindful of the cause and effect our course of treatment depicts for our patients. No individual wants to live in pain or misery, we all want to be healthy and happy and are willing to go great lengths to achieve this goal. Death is the final stage of life, but as we live and get older we start to prepare for death as to not fear death but accept it. Health care professionals may benefit from the opportunity to acknowledge, normalize and integrate death and dying into the continuum of life, both for themselves as well as their patients. (Sinclair, 2011) With advancements in technology and medicine we are living longer and fuller lives, and given time quality of life will only continue to improve.