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Essays on advance care directives
Essays on advance care directives
Essays on advance care directives
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Apart from physicians, nursing professionals act as patient advocate in supporting end-of- life decisions as they spend maximum time with patients than any other member of the healthcare team. In many health care settings, the nurse has the responsibility of asking the patient about advance directives. Since each state identifies different laws regarding advance directives, it is important that nurses be aware of the rules of these documents for the purpose of accuracy and compliance. The nurses are required to document any conversations about advance directives in the patient's medical record and keep it timely and updated. Nurses can play vital role in resolving conflicts arising from moral and ethical issues related to advance care planning
(Lark, & Gatti, 1999).
As we get older and delve into the real world, it is important to start thinking about end-of-life care and advance directives. Although it is something no one wants to imagine, there is an absolute necessity for living wills and a power of attorney. Learning about the Patient Self-Determination Act and the different legal basis in where you live is important because it will help people understand why advance care directives are so important. Although there are several barriers in implementing advance care directives, there are also several actions that healthcare professionals can take to overcome these obstacles. These are also important to know about, especially for someone going into the medical field.
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.
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
Two examples of Advance Care Directives, which are living wills that allow a person to document end of life medical treatment, are the FiveWishes and MyDirectives in the United States. The FiveWishes directive is described as living with a heart and soul and follows five wishes. These wishes include: the person which will make decisions regarding the patient’s health when the patient is not able to, the kind of medical treatment wanted and not wanted, the level of comfortability of the patient, how the patient is treated, and the amount of information that the patient’s loved ones know. The MyDirec...
...endent judgments about their own fate. In keeping with this trend there is now a growing drive to review the current laws on euthanasia and assisted suicide.” (McCormack, 1998) Nurses are faced with various ethical dilemmas every day. If theses ethical decisions are not treated in a professional manner there can be harsh consequences for both the patient and the nurse.
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,
In chapter 7 Neil explains that he never question or thought of how his job should be. He assumed that he would treat the patients and the patients always followed his plan of care for them. This idea changed once he began to work with the Lee’s. Neil believed that the Lee’s not following his plan of care was child abuse. If Neil had not reported the Lee’s there is a possibility his license could be on the line, based off US law. Lia had been in and out of foster homes. Finally she was placed with Dee Kordas. Lia had a hard time adjusting to her new life. Dee saw the way Lia had been treated by the medical staff and felt it was disrespectful. Lia’s seizures were progressively getting worse. Her parents were seen by the courts not
Brunner, L.S. & Suddarth, D. S Textbook of Medical- Surgical Nursing, 1988 6th ed. J. B. Lippincott Company, Philadelphia
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...
While navigating the abundant and sometimes confusing legal language of advance directives can be time consuming, it would benefit every person to consider their end of life wishes and have some form of written statement available for their doctor and family to understand those wishes. Doing this in advance can prevent emotional anguish, suffering and expensive litigation. In the end, clearly and when possible, written, documentation of a medical directive, a living will, or a chosen health care power of attorney will lessen the burden for the medical professionals and family of a dying or incapacitated person.
This paper will evaluate the local, national and international drivers that have influenced the development of advanced nursing practice. The discussion will include the political, economic, social, and technological influences that have contributed to the transformation from the traditional nursing role to the numerous exciting advanced level career opportunities achievable in nursing today. Dynamics that have shaped my own current advanced nursing role will be discussed and to conclude some thoughts on the future of advanced nursing practice.
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...
In conclusion, there are numerous legal and ethical issues apparent in the nursing practice. Nurses should study and be as informed as they can with ethics and legality within their field in order to ensure no mistakes occur. Ethical issues vary based on patient’s views, religion, and environment. Nurses are influenced by these same views, but most of the time they are not the same as the patients. As a nurse we must learn to put the care of our patients and their beliefs, rights, and wishes before our own personal
Various factors are associated with the development of ethical dilemmas, including advances in medical technology, increased life expectancy, the high cost of healthcare in an environment of limited resources, lack of time to provide care and conflicting values and cultures among patients, nurses and other healthcare professionals. All of which, including the growth of the nursing profession, have brought an increase in the nurses’ participation in human rights and life and death decision-making situations (Kim et al.,
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 &