Advance Directives Reflection

As a registered nurse practicing in the state of California I am responsible for practicing within my states legal regulations and nursing scope of practice. My concern for the welfare of the sick and injured allows me to practice ethical provisions of nursing. These are required if I am to carry out competent and effective nursing care. Nursing encompasses the prevention of illness, the alleviation of suffering, and the protection, promotion, and restoration of health in the care of individuals. Therefore, as health care professionals we must be familiar with the different philosophical forces, ethical principles, theories and values that influence nursing. At the same time, we must be respectful to our patient’s

Patients have the right to self-determination and individuals should have control over their own lives. With respect for human autonomy comes respect for patient rights. Apart of the nurses job is to promote, advocate and protect the rights, health, and safety of our patients. Patients have the right to determine their health needs, make informed decisions, and the right to information regarding their treatment and also the refusal of treatment. Nurses are obligated to know the rights of a patient and to make sure the patient understands their treatment plan. Supporting patient autonomy includes making decisions in the best interest of the patient, considering their values and recognizing differences between cultures. In the treatment

Nursing is more than a profession taught by science. It is an art that the nurse refines through the creative use of oneself based on the skills and expertise, to transmit emotions and meaning to the patient. Nursing is a process that is subjective and requires interpretation, sensitivity, imagination and active participation. A core skill utilized by a nurse is advocacy, both for our patients and our profession. Our profession requires participation of advocacy at all levels of nursing, starting at the bedside and continuing all the way to nurses in legislation. To be a proficient patient advocate, the nurse must be able to assess the patient’s constant change in physical, psychological, spiritual, and social needs. I apply my knowledge

I believe that patients have the right to decide what they intend to do for their future health care. Patients are not just people we give a bed to so they can die. They have plans that they intend to have laid out for themselves. As healthcare professionals, we must respect the patient’s

In Nursing, there will always be instances where the patient's nurse needs to advocate for their patient. There are numerous reasons why a nurse would advocate for their patient ranging from getting the doctor to change the patient’s orders, helping the patient’s treatment team understand what it is the patient is requiring for the day, to expressing the patient’s last wishes before death. In every situation, the nurse should do what is in the patient’s best interest. Tomajan (2012), “Advocacy skills are the ability to successfully support a cause or interest on one’s own behalf or that of another. Advocacy requires a set of skills that include problem solving, communication, influence, and collaboration”(p. 2). With those skills, the

Healthcare professionals have an ethical obligation to respect patient’s wishes. Consequently, many legal and ethical dilemmas arise in healthcare in response to clinical decisions related to the needs, beliefs, and preferences of patients and families. Other dilemmas result over concerns about the integrity, competence, or actions of other healthcare professionals. Preserving human dignity, relieving suffering, equality, integrity, and accountability are essential nursing values (Kangasniemi, Pakkanen, & Korhonen, 2015). Nurse leaders have an

The nurse in the case study is faced with an ethical and professional, dilemma. How can she be an advocate for her patient Mr. E? Dr G. is proceeding on a course of action or plan of care that is directly contrary to the patients advance directive and his verbalized objections to the course of treatment proposed by the physician and that is concerning for her. There are multiple issues to consider. For the nurse, she needs to think about her code of ethics, her scope of practice and the legal issues regarding advance directives and Durable Power Of Attorney (DPOA). She also needs to consider the patients right to privacy and confidentiality. As with most areas and issues in modern healthcare the statues can be

As a patient advocate, the nurse should engage in multidisciplinary support to help family understand the legal aspects and obligation of the power of attorney in making life end decisions and the legal obligations of the Advance Directives. Nurse must be firm in stressing these considerations to family so they may realize the full legal and ethical implications of their decisions.

In this paper, I will discuss advance directives, what it is, and the reason for it. I will talk about the issues that are currently facing advance directives care and talk about whether it has failed, or not. Finally, I will prove my stand on the issues with evidence.

Nursing profession is constantly changing with the development of new technologies that lead to a new level of responsibility. The new level of responsibility challenges nurses torespond to different and difficultsituations in the health care industry, especially in protecting the human right, dignity of patients and their safety. Nurses hold adistinctive position as patient advocates, regardless of their respective areas of practice; either in a home health, clinic, or in a hospital setting. Nursesare faced with ethical decisions, both personal and professional decisions.

I, as a Registered Nurse, am bound by duty to protect the patient’s rights. This includes the treatment or withdrawal of medical care. Critical Care Quarterly states “The Advance Directive is a legally binding document written by a competent adult and should be carried out as such in the health care facility.”(Lark & Gatti, 1999, p. 1)

While the nursing profession is fulfilling, it is not without challenges. Nurses are faced with a multitude of ethical dilemmas in clinical practice on a daily basis. According to Fant (2012) no matter where nurses function in their diverse roles, they are faced with ethical decisions that can impact them and their patients. Some examples of moral issues that nurses encounter in contemporary nursing practice and research include but not limited to: refusal of treatment, scarcity of resources, disagreement with caregivers, treating patients with impaired decision-making, futile treatment decisions for cancer patients, end-of-life decisions, advanced treatment directives, and euthanasia (Leuter, Petrucci, Mattei, Tabassi, & Lancia, 2013).

Nursing is an all encompassing profession in which practitioners are not only proficient in technical medical functionality, they also have the obligation to remain compassionate and respectful of patients and as such are expected to adhere to pre established codes of ethics. Of these ethics, autonomy is of extreme importance as it offers patients a sense of personal authority during a time where they may feel as if their lives, or at the very least their health, is no longer under their control. Autonomy in the context of nursing allocates the patient and often their family with the final word on the course of treatment. The concept of patient autonomy is a highly variable subject in all fields of health care. It is a universal concept that varies widely in its meaning and interpretation. Autonomy in its simplest form can be defined as a state of independence or self governing (Atkins, 2006). Patient autonomy can also be defined as the ability to make once own decisions, based on one’s sound judgment. It is defined by the American Nurses Association (ANA, 2011) as the "agreement to respect another 's right to self determine a course of action; support of independent decision making." This seemingly straight forward ethical concept is rife with difficulties when one considers potential disagreements that may arise even when informed consent is provided, particularly among children or vulnerable people. Relevant research and

Therefore, acknowledgment of personal values needs to be understood and kept in check when having these discussions. Furthermore, these discussions are better received when one can intelligently speak to each question and apply the language to the discussions with patients and families. Moreover, reflecting on these questions can help the clinician be prepared for sensitive questions that may arise. All of these measures will help guide the advanced directive formulation process.

Autonomy applies to the profession of nursing because the patient should always be allowed to make decisions regarding their care while being treated with respect and dignity; however, autonomy can serve as a limiting agent when the patient decides to refuse care that would be of benefit to them. Autonomy is a sensitive issue because it allows the patient to choose to die and all health care can do from that point is allow the patient to do so comfortably. With healthcare always being one step ahead, it allows a surrogate to serve as a voice piece for that patient when they are unable to make decisions. However, that surrogate can end up making decisions they think is best for the patient ignoring the patients’ will. The responsibility of the nurse and interdisciplinary team is to inform and educate the patient and patient’s surrogate on all aspects of care to include medical diagnosis, treatment, and care plan so that the patient and