Promoting Patient Choices

The healthcare industry has intensely advanced throughout the world, in turn changing the principles that incorporate the practice and culture of nursing practice. Altering the model of care to a patient-centered mode signifies an organizational culture shift and requires the participation of executives at the senior level (Cliff, 2012). To practice this care to provide the best care possible, it goes beyond the nurse to all healthcare professionals and senior leadership. The days of patients and nurses following a physician’s order without favor to care has now loaned themselves to more of an interdisciplinary approach to practice. Though, it is encouraged that the patient makes decisions for themselves, after receiving the proper education and information on their condition. Part of the patient-centered care is to be the patients’ advocate, by letting them know you are there for them when they are unable to speak and advocate for themselves and what is in their best interest. That goes in hand with educating them on “self-management of care, health literacy, patient, and family education through nurse-patient communication and interaction (Finkelman & Kenner, 2016, p. 271).”

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

Within the practice of nursing, situations often arise where nurses are forced to make decisions regardless of their level of experience in the profession. Providing care and following the physician’s orders historically were the nurse’s sole responsibilities. However, social change, changes in health care finances, increasing international perspectives, and demographic population changes, have resulted in a significant evolution of the roles and responsibilities emplaced on today’s nurses (The National Association of Clinical Nurse Specialists (NACNS), 2007). Kelly and Crawford (2013) believe budget cuts, higher client acuity and clients with complex needs, mergers of hospital corporations as well as a general shortage of qualified nurses has made it necessary for nurses to play a role in decision making. Decision making is defined as “cognitive process leading to the selection of a course of action among alternatives” (Kelly & Crawford, 2013, p. 352).

This assignment will critically analyse and justify the decisions based around a fictitious patient using a clinical decision making framework highlighting its importance to nursing practice. The chosen model will demonstrate clinical decision making skills in the care planning process. The patient’s condition will be discussed in-depth explaining the pathophysiology, social, cultural and ethical issues where appropriate in the care planning and decision making process. Any vulnerability that the patient may experience will be discussed and dealt with in the care planning and decision making process. The supporting evidence based literature will be analysed and

Nurses face numerous challenges in their daily advocacy duties. Some physicians may not respond to nurses in a timely manner as they prioritize their task differently (Mendes & Ventura,2016). Additionally, institutional limitation frequently makes barrier for nursing to be able to advocate for patients (Mendes & Ventura,2016). Some professional who support nursing advocacy believe nurses should have higher autonomy to protect the patient in better way (Mendes & Ventura,2016). Nursing ethics constantly deals with challenges to freedom of practice, especially in hospital settings.

Nurses are constantly challenged by changes which occur in their practice environment and are under the influence of internal or external factors. Due to the increased complexity of the health system, nowadays nurses are faced with ethical and legal decisions and often come across dilemmas regarding patient care. From this perspective a good question to be raised would be whether or not nurses have the necessary background, knowledge and skills to make appropriate legal and ethical decisions. Even though most nursing programs cover the ethical and moral issues in health care, it is questionable if new nurses have the depth of knowledge and understanding of these issues and apply them in their practice

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

Nurses effectively carry out their duties by constantly providing care for patients without prejudice or discrimination, however sometimes it might be difficult if the patient is not actively participating in their own care plan. This might be frustrating for nurses because the patient refusing to adhere to taking prescription might not yield to better treatment results. But patients active participation in their own care plan provided by a nurse increases motivation for the nurse and gives satisfaction to both the nurse and patients.

The positive outlook of this approach is if nurses give patients enough information about their care patients can become participants in making decisions about their health Brenan and Safron (2003) According to (Stewart 2002) We can empower patients by giving them the power to influence

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

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

The key factor that had been identified to facilitating advocacy is to develop ‘nurse-patient relationship’. Piper (2010) had mentioned that, this relationship is indeed necessary to create the right climate for decision making. From patients’ perspective, appropriate relationship between a nurse and patient is necessary for advocacy. Patients had even mentioned that, the establish relationship between nurse and patient is more important that family relationship as nurses gave them a sense of security and patients value it. The nurse role of an advocator can be influence by the quality of nurse-patient relationship. Having this professional relationship had promoted the patient’s involvement in their self

Providers of nursing care have a huge responsibility to patients. Providers of care are required to provide a patient-centered type of care. Research and evidence-based practice indicate that patients recover faster when they receive respect, value, personalized care, and support. Consequently, the evidence-based practice provides a number of aspects. First, care providers are expected to show unwavering respect and genuine care to all patients irrespective of their background, which leads to improved quality of care (Marquis & Huston, 2015). Secondly, caregivers are expected to listen and openly share information with patients and their relatives, especially when making a critical decision that involves surgical procedures (Marquis & Huston,

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

After therapeutic collaboration with the patient, she should be given ample time to contemplate and weigh all the available options and services. When health is compromised, informed decision-making can take more time than usual. One aspect of the Eight Primary Dimensions of Patient-Centered care asserts: “Respect for patient's values, preferences, and expressed needs: includes attention to quality of life, involvement in decision making, preservation of patient's dignity, and recognition of patient's needs and autonomy” (Yoder-Wise, 2015, p. 415). Regardless of the patient’s decision, healthcare facilities promote a blame-free environment in an effort to learn from reported errors; subsequently, vitalizing the ability to provide efficient, cost-effective, safest, and high-quality care.