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Nurse teamwork and communication
Team work and communication in nursing
Team work and communication in nursing
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Dilemmas are an everyday thing. We all have been in a situation where we have to choose between two things. What if you are in a situation where both options are right, or both options are wrong, but you still have to make a decision. Death at any age is traumatic, however I believe it is specially hard when it involves children. children are especially challenging because they cannot make their own decisions and a multidimensional approach is needed. That approach needs to be made done by multiple parties. There needs to be a strong working alliance established between the health care team and the pediatric patient's family. If that strong bond is made, it can help to resolve potential ethical conflicts or avoid them. Culture and religion are also other factors that can impact decision making. There are two important questions that should be asked when an ethical decision needs to be made regarding children. Who is best able to determine what should be done, who decides? Who is the person responsible for making decisions for children? It is the parents right to …show more content…
Parents different beliefs and and cultural backgrounds may influence their perceptions regarding the benefits of palliative care. The team needs to put all these differences together and make them into a united treatment plan that had the child’s best interest. In this situation the whole team consulted with the parents and were able to resolve difficult problems that arose by the child’s life and death, including the mothers fear that if she did not pursue every last medical medical treatment and held on to every last hope, she would not be fulling her role as a parent and gave up on her child. The team was able to reassure and comfort her that palliative care was in the childs best interest. The child was able to go home two days later and was discharged with hospice care. He died peacefully surrounded by his
This paper will focus on the two different sides of adolescents and their choice concerning end of life care. The first section will be adolescent centered and will help to provide a backbone to reinforce the choices they legally should be able to make using their right to autonomy. The American Academy of Pediatrics and the Institute of Medicine did a very helpful study, that is pro adolescent choice that will be discussed in the first section of the paper. The second section will focus on Paternalism and the ethics behind the health care team making the ultimate decision that will benefit the patient. As well as information and studies in regard to an adolescent’s decision making process, and their tendency to be impulsive.
An advanced practice nurse (APN), will be faced with different types of ethical-legal dilemmas that in most cases will require the APN to make urgent decisions that will include both moral and ethical attention. Ethical dilemmas are conditions that have to scenarios course of actions to take that will contradict each other (Westrick, 2014, pp 258-265). The APN will have to choose between the two urgent decisions because each of these choices is deemed to be equally right and urgent. This is the reason that makes dealing with ethical-dilemmas very stressful for the APN and other experienced caregivers involved. It is very noteworthy that an APN has many medical responsibilities to provide care, and are also in the position to make urgent medical decisions that is independent because of being the person in authority at that time. Many of the existing ethical dilemmas will fall in with a variety of treatment withdrawal vs maintenance, the quality of life vs the quantity of life, euthanasia vs non-euthanasia, and pro-choice vs pro-life (Westrick, 2014b, pp.77-83).
Baby Boy Doe’s story was interesting to read and analyze when thinking about ethics. The doctors in this story did what they should have as far as hospital policies are concerned, but they may not have acted as ethically as some would expect. The hospital and the parents are responsible for the death of the child, they each acted as ethically as they could but the end result was devastating. Ethical decision making can be difficult but understanding how to identify an ethical dilemma and moral principles can make the decision easier to work
Physician-assisted suicide refers to the physician acting indirectly in the death of the patient -- providing the means for death. The ethics of PAS is a continually debated topic. The range of arguments in support and opposition of PAS are vast. Justice, compassion, the moral irrelevance of the difference between killing and letting die, individual liberty are many arguments for PAS. The distinction between killing and letting die, sanctity of life, "do no harm" principle of medicine, and the potential for abuse are some of the arguments in favor of making PAS illegal. However, self-determination, and ultimately respect for autonomy are relied on heavily as principle arguments in the PAS issue.
The decision of euthanasia should not have to be made. No one has the right to say whether death should be inflicted on him or herself. That decision is left to someone of much higher power as it has been since the beginning of time. The patient may not be aware enough to make a sane decision. In this case, the decision would be left to the family. How would the family know whether the patient would want to live or die? No one has the right to judge that another person’s life is not worth living, and no one’s life should be taken because someone else thinks his or her quality of life is too low. There would be some cases in which family members would want the parent’s money instead of it being spent for hopeless medical treatment and request that the parent be put out of his or her misery. There have also been some cases in which the doctor performed the inhumane task without any form of consent (Katz).
Unfortunately, parents sometimes are at the losing end of a child with advanced stage cancer in hospice. It depends on the age of their child at the time of their passing, and the extent and time frame of their illness, but most
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...
When caring for a dying child, nurses face unique obstacles that must be overcome. First, it is common for there to be a lack of communication between the child’s parents and healthcare providers regarding end-of-life issues. Nurses feel a lack of support from their peers and health care team members. According to Lee and Dupree, caregivers in these situations require emotional support (CITE). A lack of physical and emotional support is a common source of stress for nurses. One of the largest obstacles nurses deal with, is their opinions regarding patients’ plan of care being ignored. A study performed by Davies and Connaughty confirmed that only 20% of the parents were pleased with the communication ability of the health care staff. In order to improve end-of-life communication, nurses should be comfortable talking about death even if they are in a situation where the death of the child is inevitable. Nurses play an important role in the health care team. Excellent communication skills are one of the most important tools a nurse can provide to the family members of a patient. As the patient’s advocate, the nurses need to act as the patient’s voice and prot...
of End-of-Life Care in the Pediatric Intensive Care Unit: Parents’ Priorities and Recommendations. Pediatrics, 117 (3), 649-657. doi: 10.1542/peds.2005-0144
According to Haley and Daley (2013), cancer as the main cause of the terminal illness in the paediatric age. For the recent years, the survival rates of children with cancer have increased significantly with 7 out of 10 recovers (Selwood, Langford, & Wright, 2012). Haley & Daley (2013) also mentioned that parents act as the decision-makers and as the primary carer, moreover, physical and psychosocial developmental factors of the child affects the perception of death as temporary and the capability to communicate and make their own decisions. Moreover, parents make the decision for the child as for legal matters, but the child needs encouragement to actively participate and to develop the sense of authority. Children may have a different idea of pain and illness, for instance, they may think that they did something wrong that is why they are suffering. Children may refuse or not participate properly in any treatment without the supervision of the primary carer. Providing the child and family with health education during palliation as well as helping them to the transition to adulthood is an important task for the nurse. Derby, Tickoo, and Saldivar (2014) mentioned that the major difference of between old and younger adults is the need for extensive support of the family. Decision-making for older people might include the patient’s family, surrogates and Advanced Care Planning (ACP) at the time they are not able to make their own decision. Derby et al., (2014) stated that “ACP prepares for lack of capacity in decision-making and relieves the burden of decision-making on others” and surrogate decision-maker “is a person whom the patient designates to make decisions if/when he or she is unable to do so”. Older patients need a representative, mostly an elderly act as a primary carer to make the decision for them or someone who will make
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
Getting a major in biology will allow you to better your understanding of the world around you.
In nursing, it is not uncommon to encounter situations where nurses are required make ethical decisions based on legal and ethical principles. These situations often are seen in pediatric nursing when there are conflicting views between the parents and their child. For example, Mike is a 15-year-old boy who has been diagnosed again with acute myelocytic leukemia (AML) and is to continue another taxing round of chemotherapy. Mike confides to his nurse that he would like to discontinue treatment. Meanwhile, his parents are adamant that treatment continues. The nurse must decide whether to terminate or continue with Mike’s chemotherapy.
When I am an adult I plan on becoming a pediatrician and I found my pediatrician code of ethics on www.ama-assn.org/sites/default/files/media-browser/principles-of-medical-ethics.pdf and my website is the American Medical Association. This PDF was last updated in 2016 by the American medical association.
“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)...