Shared Decision-Making Model: A Case Study

However, poor communication was not only the fault of the physicians but also of the nursing team. Despite knowing what needed to be done for the patient, the nurses did not know how to approach the situation after the physicians were dismissive. Nurses need to exercise rights to serve as patient advocates and “challenge erroneous decisions of seniors in anesthesia. (Beament, Mercer 2016) All physicians involved lost control of the situation and did not effectively share with one another to manage the damage. Safe and effective delivery of healthcare require communication between individuals with different roles however status of staff (whether junior status or different roles such as nurse) makes it difficult to speak

Barry, M., & Edgman-Levitan, S. (2012). Shared Decision Making — The Pinnacle of Patient-Centered Care. N Engl J Med, 780-781. doi:10.1056/NEJMp1109283

The Institute for Healthcare Improvement (IHI) provided an example of a situation where there was a lack of communication and a team of people who had not worked together before. The patient elected to have knee surgery and was given the wrong dose of medication because the surgery was rushed and they had new nurses in the operating room who were not familiar with orthopedics and their protocols (Institute for Healthcare Improvement, 2016c). With the lack of communication, the lack of

Shared decision-making involves an open and honest conversation between the clinician and the patient. It is a collaboration that takes into account treatment options and the patient’s values and preferences. It gives a patient a voice in their own care. Therefore, pure placebo-prescribing is ethical when the patient has a say – which can foster a placebo effect within the patient. Not from the pill “itself, but rather from the relationship between [the] healer and [the] patient, and the latter’s own capacity for self-healing” (Brody, 1982, 117). In other words, the context in which the pure placebo is prescribed can influence its positive results. Contrastingly, when patients are left out of the decision-making process, there is no room for the clinician’s and patient’s relationship to grow. It also raises the possibility of deception – a concept appearing in almost all of the medical literature on placebo-prescribing in clinical practice.

Over 443,000 people die from smoking each year! Smoking, alcohol, drugs, and much more, are all preventable yet they all kill hundreds of thousands of people each year. With, D.A.R.E. there are fewer and fewer people who do these things and overall fewer deaths due to them. Now I will tell you about the D.A.R.E. program.

The essay aim to explore the relevant objective on how effective theoretical concepts underpin is used to evaluate shared decision making and complying with local, national and professional guidelines in practice. A critical overview explanation will be used to establish a systematic comprehensive assessment, which is the initial stage to identify the care needs related to Mr Thompson's type 2 diabetes and hypertension condition. It is essential to provide a baseline information supporting every aspect entailing Mr Thompson’s complex needs. This includes, planning, intervention and outcome responding to the NHS Outcomes Framework (2015/16) domain 2, which stated the enhancement of the quality of his life with coping and taking responsibility of his own health care that may contributes to a speedy recovery.

This nurse-physician partnership in the management of medication has been correlated with improved patient results (Gabe et al.). Sophia’s nurse in this situation did what she was legally and ethically obliged to do, but the physician would not reciprocate his part. It placed Sophia’s nurse in a hard position as she had strong feelings, as well as multiple signs of how the antibiotic was not a good match for Sophia. She knew that if she was to administer the antibiotic to Sophia again that Sophia would be in pain and would be putting her in danger as her body could not handle the medication and would have stronger reactions to the medication each time her body was exposed to it. Sophia’s nurse did everything she was legally and ethically supposed to do, but she wasn’t receiving any support from her patient’s

Have you ever been in a situation where you didn’t know how to respond? I sure know I have. In fact, for the past 7 weeks, the rest of my class and I have learned so many convenient things during D.A.R.E., including what to do in certain situations. Some other examples would include drug awareness, health effects, and tips on communication. Everything that we have learned are life long lessons; they will lead us to a very safe and happy life. Every week brings another lesson to mind, and as a student, I am very proud to be a part of the program.

Consistent, open, honest, and transparent communication is invariably preferred, and would have best suited this situation, however, given the collective bargaining agreement requirements, this proved an impossibility. Furthermore, the rules governing the negotiation process and that planning occurred without the nurse’s knowledge indicated deception in their judgement. An already frustrated nursing staff became angry at what they perceived as a personal affront and severe injustice. Although the nurses’ could grasp the staffing insufficiencies, the severe changes required to remedy the unsafe staffing conditions evoked serious emotions and injured the trust between management and the nursing staff. Nevertheless, the medical center was obligated to follow the procedures dictated by the

Not everyone is amenable to change. A barrier not mentioned in the articles that I read is, everyone is afraid of being sued. Healthcare professional (HCP) walk a fine line when it comes to the delivery of care. If an adverse reaction arises within the scope of nursing practice and the standard of nursing care and the hospital policy and procedure followed, then your facility will back you 100%. If there is any deviation from the hospital policy and procedure, then the burden of proof is the responsibility of the HCP. HCP have autonomy as it relates to the delivery of patient care, but that same freedom should be recognized when HCP delivery evidence-base care that not implemented into the facility policy and procedure without fear of being

Shared decision-making improves patient care in a variety of ways. According to Ernst (2013), the more involved patients are in their health care, the more satisfied

The article Titled “partners in care: patient empowerment through shared decision-making, Written by Debra J. Hain and Dianne Dandy explores the benefits of shared disciomne making and having a patient- provider partnership. Although the authors specifically mention a patient with chrinoch Kidiney diese and talks about how this helps nurses and their patients in the Nephrology specialty I believed that the subjects talked about in this article can be used by any nurse. Our patient MR.G has a diagnosis of powerlessness relating to the dependence on others and because of this we knew he needed to gain some control back. This is why we decided to aprroce him with the topic of going to a support group but we did not want to just

Before, medical professionals used their skills and knowledge to make decisions for their patients but over the past years, patients’ access to information and changing culture and policies, a process of partnership is emerging [16]. Medical decision-making process has become more of a joint partnership between the physician and the patient.

You shared a great example of collaboration, and I enjoyed that it has the well-being of the patient at the center of it. I agree with your statement that the presence of hierarchy in collaboration is something that can be worked on. There can be a sense of competition, where one party attempts to use their status to make their opinion more valid than others. I have seen this even amongst nurses where one will bring up seniority and try to use this to get their statement heard. Unfortunately, this does not foster an environment of openness where all voices are heard, and can be detrimental to the health of the patient. We must keep in mind that the patient is what matters.

An example of communication among healthcare staff and patient was at the Regional Dialysis Center, when a patient had an active standing order for contact precautions due to MRSA in her catheter site. When the nurse and I approached her, the patient asked “why are we gowning up, when the charge nurse did not”. The nurse stated that she will looking into the situation, but until it is resolved she has to follow policy protocol. After my nurse was finished hooking the patient to the machine, she went and talked to the charge nurse. After talking among each other, the charge nurse decided to call the facility the patient was residing in to find out what was going on with the status. After about an hour, it was decided to do a MRSA swap to see