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Strengths and weaknesses of qualitative research design
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Strengths and weaknesses of qualitative research design
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The purpose of this study was to explain how nurses and physicians in the intensive care units (ICUs) make end-of-life decisions. The research question was how the ICU physicians and nurses portrayed their thoughts and showed their experience in end-of-life decision making. The researchers used a qualitative, descriptive research design to develop a systemic research project and also used grounded theory methods by Strauss and Corbin as the theoretical model. The researchers focused on the population that was ICU nurses and physicians in a Magnet designated, Midwestern hospital. The data were collected from the one-on-one unstructured interviews, the interview transcripts, and the field notes. One research member conducted the interviews with
The controversial act known as the physician aid-in-dying (PAD) challenges us to question our ethical, religious, and cultural values or beliefs. Although it is tragic and perceived as morally inappropriate, suicide is sometimes the only answer. In certain cases this act is a way to end excruciating pain and suffering. The state of Oregon passed a law known as the Death with Dignity Act in 1994. PAD is defined as “a practice in which a physician provides a competent, terminally ill patient with a prescription for a lethal dose of medication, upon the patient's request, which the patient intends to use to end his or their own life” (Braddock, and Tonelli). PAD also raises the question, is it a constitutionally guaranteed right for people to have the power and the medicine to take their own life? PAD, if operating under careful supervision, is an alternative to patients who may have to endure physical, mental, and financial struggles. Doctor Peter Goodwin, a physician from Portland, Oregon campaigned for the Death with Dignity Act, which he called his greatest legacy. Goodwin became a terminally ill patient towards the end of his life. Doctor Goodwin was 83 years old when he took the very medicine that he campaigned so long for. Goodwin was diagnosed with a rare brain disorder, which he had been battling for 6 years prior to PAD.
Atul Gawande’s book, Being Mortal, focuses on end-of-life care for patients in the American healthcare system. Gawande includes evidence along with anecdotes from his own life surrounding his career as a surgeon and his role in helping family members navigate their own end-of-life decisions. Much of Gawande’s argument rests on the premise that while end-of-life care in the American healthcare system is heroic and equipped with the best possible advancements in medicine, it too often fails the patients it is supposed to help. A large part of Being Mortal focuses on the doctor-patient relationship (especially in the context of shared-decision making) and how we often fail to recognize the things that are most important for our elderly in their
The purpose of this paper is to critique a qualitative research article in all phases of the report. For this purpose, the article that will be used is “Lamentation and loss: expression of caring by contemporary surgical nurses” written by Carol Enns and David Gregory. This paper will address the problem statement, literature review, conceptual underpinnings and research questions, research design/method, ethical considerations, sampling, data collection, data analysis, confirmability of the findings, interpretation and discussion of findings, additional considerations, and rating the scientific merit of a research report.
Healthcare providers must make their treatment decisions based on many determining factors, one of which is insurance reimbursement. Providers always consider whether or not the organization will be paid by the patients and/or insurance companies when providing care. Another important factor which affects the healthcare provider’s ability to provide the appropriate care is whether or not the patient has been truthful, if they have had access to health, and are willing to take the necessary steps to maintain their health.
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,
whether or not it makes a difference if a person’s life is ended by an act of active killing,
The type of research study, sample size, variables, intervention, measurement method, findings, and conclusion are all mentioned in the abstract. Statement of the Problem The problem explored in the article was stated as a problem statement. In this article, the authors explain the stressful situations of families having loved ones die in the intensive care unit. They also state that this problem is very important because there is poor communication between staff, physicians, and surrogates in the plan of care for end-of-life measures (Lautrette et al., 2007).
The ethical debate regarding euthanasia dates back to ancient Greece and Rome. It was the Hippocratic School (c. 400B.C.) that eliminated the practice of euthanasia and assisted suicide from medical practice. Euthanasia in itself raises many ethical dilemmas – such as, is it ethical for a doctor to assist a terminally ill patient in ending his life? Under what circumstances, if any, is euthanasia considered ethically appropriate for a doctor? More so, euthanasia raises the argument of the different ideas that people have about the value of the human experience.
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...
The purpose of this essay is to analyse various theories on ageing, death, dying, and end of life issues from different perspectives such as: biophysiological theories, psychosocial theories; and taking in consideration the cultural, historical, and religious implications around the aforementioned life stages. One will also discuss important issues relevant to social work practice such as dignity, autonomy, and their relationship with the concept of a successful ageing and a good death. One considers these areas important since they upheld anti-discriminatory practice and may perhaps promote the development of personalised care pathways, as well as fair and justifiable social policies.
The subject of death and dying is a common occurrence in the health care field. There are many factors involved in the care of a dying patient and various phases the patient, loved ones and even the healthcare professional may go through. There are many controversies in health care related to death, however much of it roots from peoples’ attitudes towards it. Everyone handles death differently; each person has a right to their own opinions and coping mechanisms. Health care professionals are very important during death related situations; as they are a great source of support for a patient and their loved ones. It is essential that health care professionals give ethical, legal and honest care to their patients, regardless of the situation.
In BJ Millers TedTalk, “What Really Matters at the End of Life?” BJ Miller discusses on how we think on death and honor life. He speaks to the audience about how for the most people the scariest thing about death is not death itself, it is actually dying or suffering. The targeted audience is everyone in the world, because eventually everyone is going to die and everyone thinks about death. BJ 3 has big points in the article saying, Distinction between necessary and unnecessary suffering. Also by having a little ritual that helps with this shift in perspective. Another point is to lift and set our sights on well-being. We need to lift our sights, to set our sights on well-being, so that life and health and healthcare can become about making life more wonderful, rather than just less horrible.
Several ethical principles that are incorporated in the nursing care of patients on a daily basis are nonmalificence, autonomy, beneficence, justice, fidelity and paternalism. Nurses should strive to comply to as many of the principles as possible. In this case there are principles which support and conflict with the wishes of the patient. The first principle that supports the wish of the patient is autonomy. Autonomy means that competent patients have the right to make decisions for themselves and the delivery of the healthcare that they receive. Another factor that would support the patient’s wish to not be resuscitated is nonmalificence. Non maleficence means that nurses should not cause harm or injury to their patients. In this case the likelihood of injury after resuscitation was greater than if the patient were allowed to expire. A principle that could have negatively affected the outcome of the provision of ethical care was paternalism. Paternalism is when a healthcare provider feels that they know what is best for a patient, regardless of the patient’s desire for their own care. I demonstrated the principle of paternalism because I thought that I knew what was best for the patient without first consulting with the patient or family. This situation might have had some very negative consequences had the patient not have been competent. Practicing a paternalistic mindset might have caused a practitioner in the same instance to force their ideas about not resuscitating the loved one onto the family. This could have caused a sense of remorse and loss of control of care amongst the
“Western culture, Western civilization (the modern culture of western Europe and North America)” (Princeton University). The definition of western culture is broad and can be applied to many different aspects of life. In the world of health care, western culture prevails when discussing end of life situations. The main focus of western communication in these situations is keeping trust between patients directly and communicating the situation with them in a clear but respectful manner (Hawryluck). According to the National Health Service in the United Kingdom most health and social care staff have received some basic, generic communication skills training for end of life communication. However seeing as end of life situations are one of the most intense and demanding situation of a health care professionals career to deal with, “most believe they would benefit from further training to address the challenging demands of conversations with people approaching the end of life” (NHS). One of the major factors in these discussions is the age of the patient in question. Since it’s not usual for a family member to die before they are old and considered elderly, different situations are in need of different responses. Especially in the case of a child, teenage, or any other death for people under the age of 60. The dialogue between the patient and doctor or any other health care official is greatly influenced if the patient is a minor or an adult. Conversation structure and even the person the professional is likely to have a conversation with might change. In the western world society tends to be split up into 3 major age groups; children and young adults (under 18 years of age), adults (19-60 years of age)...