Dnr Case Study

As The role of the neonatal intensive care nurse in decision-making: Advocacy, involvement in ethical decisions and communication defines an ethical dilemma, “An ethical dilemma exists when some evidence indicates that an act is morally right and some evidence indicates that the same act is morally wrong, but the evidence on both sides is inconclusive… Thus, an ethical dilemma is not between the good aspects and bad aspects of a situation or between what can be done and what one wishes could be done, but among two or more morally right, but inconsistent, alternatives” (International Journal of Nursing Practice, 109). West Park Hospital states on their tree of ethics that compassion and respect, commitment, advocacy, competency, accountability/ responsibility, professional growth, knowledge, collaboration, and integrity are the roots and branches of a healthy nurse-patient relationship. Not only do nurses have to deal with everyday ethics, but they are also given the responsibility of making life-and-death decisions for patients who don’t have the ability to advocate for themselves. Within the domain of nursing, ethical decisions of all types occur within the job, but the level of education and responsibility that you have acquired determines many of the ethical decisions that one is required to make on a daily basis. Over the years, technological advances have changed the ethical decisions that occur within the job and the way that we handle those decisions. Technology has changed our world in many ways, especially within the medical field- some for the better and some for the worse, and this is very noticeable within a nurse’s daily life. Nurses have a lot of responsibility when it comes to making ethical decisions, but they are not the only ones that are involved in those decisions when it comes to vulnerable

Although it has been many years since I rotated through an intensive care, I am sure these issues still arise. As a nurse I worked in the pediatric and neonatal ICU’s and thankfully was not exposed to this type of ethical dilemma. In those instances we did everything we could for those little lives. Today, I would report this to the manager and follow the chain of command. The staff needs education and training on end of life care and issues, legal and ethical dilemmas in relation to code status, and review of the nurse practice act. Reviewing legal cases and outcomes with the staff may also increase awareness of the dangers of practices such as slow codes. Nurses are to be healing, caring, empathetic and supportive of patients and families during critical illness, death and dying.

“An ethical dilemma exists when a choice has to be made in which the consequences may have a potential positive or negative outcome.”("Topic 4: Contemporary Ethical Dilemmas (How do managers evaluate beginning-of-life dilemmas?). ", n.d.) The given scenario presents a patient named Jamilah Shah, who is of Turkish descent, 90 years old and collapsed at the side of her bed in the extended care facility in which she resides. The patient suffers from Chronic Pulmonary disease and diabetes mellitus. The patient was rushed to the ER were the EKG and lab tests revealed she suffered a heart attack and she was started on anticoagulants. The patient has no advance directives and a communication barrier exists, the ER department contacts the emergency contact, one of the patient 's sons Bashir. The patient 's family arrives at the hospital and her son states that he makes the decisions and the wants a do not resuscitate order for his mother and no medical intervention other than comfort care. The social worker handling Jamilahs case is concerned by her family 's lack of support and that the family 's wishes are at odds with the patient 's request for help and her expressed desire to live. Furthermore if the patient does not receive a cardiac catheterization or is considered for a coronary bypass, she will surely die.

At times, palliative care may test the code of ethics. Once a patient becomes unresponsive and unable to make his or her needs known, it is the combined responsibility of the family and medical team to make decisions in the patient’s best interest. The hospice facility I work for has an ethics committee that is composed of several different team members, including clinical managers, social workers, chaplains, physicians, and nurses. This board is consulted when the moral principles of any given situation are in question. As an example, I recently had the honor to care for a young woman who was, sadly, dying from cancer. Near the end of her life, she began to suffer vivid hallucinations and irrational fears. The presence of her husband in her room was frightening to her, which was very difficult for him to endure as well. Though he was her power of attorney, his decision making in this time became difficult, likely due to emotional burden, feelings of guilt, and grief (Plakovic, 2016). Influenced by evidence that she was uncomfortable, the board reviewed the option of palliative sedation. Consequently, with appropriate amounts of sedatives, this patient was able to pass peacefully with loved ones at her

An ethical dilemma I have experienced is a parents requesting hospices care for their daughter due to developmental delays and decline in eating. The patient does not have any medical conditions however the patients insisted to process with hospices care. The patient was granted hospices care and was on for two years. However, we keep advocating for her and finally she has been taking off hospice

Ethics is an integral part of nursing practice and with an increasingly diverse population today, nurses need to have an understanding of ethical principles to resolve dilemmas in the workplace. Milton (2014) defined ethics as encompassing a methodical approach to decision-making and as a disciplined reflection on the moral choices individuals make. To arrive at an appropriate intervention, nurses and other health care providers must employ an efficient and organized process to identify an ethical dilemma to determine a viable solution (Grand Canyon University [GCU], 2011). This paper will identify an ethical dilemma in a case scenario and will discuss the use of an appropriate decision-making model and with all parties involved contributing to the resolution.

Whenever two obligations are at conflict it presents what is known as an ethical dilemma (Chaloner, 2012). It is nearly impossible to make once choice without sacrificing another. Examples of such dilemmas in healthcare may include decisions such as prolonging life for a terminal ill patient through artificial means or saving a mother via a risky surgery that may jeopardize the life of an unborn child. Healthcare practitioners must always exercise caution when ethical issues arise and find a way to balance societal norms, personal philosophies and values and religious beliefs (Arnold & Boggs, 2007). Personal ethics may guide reactions and initial choices, but the needs and rights of the patient should always serve as guideposts for ethical communication and behavior in administering healthcare services (Reiter-Theil, 2012).

Nurses face ethical dilemmas each day. Whether its dealing with the patient or family members. A few ethical concerns are the patient right to refuse care, death and dying, and the ability to perform task due to it being a cost-effective issue (Yoder-Wise, 2015). Care may be compromise when the patient refuses which leads to more time spent in the hospital. Death and dying effects everyone because nurses may not be willingly to give proper medications and feel they are the ones killing the patient. Patients who are readmitted within 30 days causes the hospital to lose out on reimbursement through Medicare. This can lead to more cost saving concerns for each unit in the hospital for having enough staff and being careful on how many supplies

Advanced practice nurses often face ethical dilemmas in health care, however the care that patients receive must remain consistent and ethically sound. Situations are often created that require decision making under complex circumstances where clear cut rules are often unavailable, therefore medical practitioners must rely on well-established principles as guides to ethical decision making (Shi & Singh, 2015).

I have spent a good deal of time in the past week reflecting on my emergency medicine clerkship experience, specifically in regards to illustrative ethical situations I have encountered. Despite by best efforts, I could not come up with a true “ethical dilemma” I encountered, in the sense that there was never a situation in which there was significant doubt or disagreement between the healthcare team and/or patients and their families about the proper or ethical course of action. In many ways, this is fortunate. Nevertheless, there were several cases that did serve to illustrate some of the core ethical principles in action that would be useful to discuss. One in particular that comes to mind involves the question of advanced directives and

Having spent my nursing career working in the Emergency Room, I have not had many experiences with ethical committees. I did play a small role initiating an ethical consultation after I relayed my concerns to the Intensive Care Unit nurse. I was the primary nurse for an Alzheimer’s patient, who was no longer able to communicate or provide any care for herself. A living will was not created prior to her becoming incapacitated. Her husband continued to make her a full code and put her through numerous painful procedures. She presented to the Emergency Department for a fourth time in a month, but this time she was having

Healthcare professionals are faced with ethical dilemmas frequently in the healthcare industry and they have the ability to influence patient care outcomes. Healthcare professionals face difficult choices concerning what is best for the patients and can sometimes become entangled with ethical dilemmas. Ethical decision making helps the healthcare professionals make the difficult choices when they are faced with an ethical dilemma. Those involved in the decision making process must consider ethical principles including justice, autonomy, beneficence and nonmaleficence as well as professional and organizational ethical

The current practice for DNR use has mainly been established for the use in elderly, sick populations who are believed to be close to death. This naturally coincides with the population that often is cared for in ICUs. While it is important to have a complete consent when deciding a DNR vs. resuscitate order, presently there still a lot of confusion surrounding the existence and explanation of the DNR order. Good ethics practice requires that patients are adequately informed about the context of a DNR order and the implications that can result if a patient chooses cardiopulmonary resuscitation over the DNR.

All health care professionals have ethical dilemmas from time to time and health care administrators have a moral duty to question and address issues in the organization. A Johns Hopkins magazine journal titled, Nursing is hard. Unaddressed Ethical Issues make it even harder is a detailed case study/ current event of nurses struggling in their profession. Nurses have a tough and rewarding job to treat, medicate, educate, and deal with emotional stress for the patients. This type of ethical issue nurses are facing range from not speaking up from short-handedness that affects quality of care to not having enough supply of blood and organ donations. Additionally, when it comes to end-of-life of adults and infants there are standard procedures of handling and communicating to families about it. Nurses are ultimately faced with a difficult dilemma of knowing the moral decision and not carrying out the decision or simply

In Nursing Practice, there are many codes of conduct involved so that we as nurses can follow. These codes are meant as regulations that each employee is bound to, and have to abide by these rules order for the organization (health care) to work smoothly and to be able to provide the best quality care for our clients. Because, in order of the organization to work well, it needs multiple personal that work together to establish the system, there are various individual beliefs and attitudes that come into play, when making certain decisions. When one's beliefs and attitude is in conflict what right or wrong, it becomes an ethical dilemma. In the end, it becomes a matter of outweighing the right or the wrong in orders of "risk and benefits",