Taking a Stand Barbara De Groot, RN Walden University
NURS 6053, Inter-professional Organizational
And Systems Leadership
Barbara De Groot, RN
November 14, 2014
Introduction Patient advocacy extends back to Florence Nightingale and remains relevant today. While Nightingale did not explicitly address advocacy in nursing, she did demonstrate advocacy in many ways (Selanders and Crane, 2012). Today advocacy extends beyond the individual patient to local and global populations, and nationally and globally to the nursing profession itself. The purpose of this paper is to describe this author’s role as a moral agent or advocate for a specific issue in this author’s work, and explain one or more negative outcomes that may
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She was scheduled for total hip arthroplasty three days following admission. The daughter wanted to proceed with the surgery, and the son did not. The ethical concern in this case hung on two issues. First, the patient demonstrated a sufficient degree of dementia to ask “will the patient be able to adhere to instructions and hip precautions following surgery.” Additionally, given her degree of debility due to her non-ambulatory status before the injury “would it be in her best interests to proceed with the surgery?” As a team, the nurse, social worker, and I discussed these concerns with the orthopedic PA who agreed that perhaps the fracture should just be allowed to heal on its own instead of going forward with a costly, painful surgery and extended rehabilitation that may or may not produce the desired outcome. The PA, nurse, social worker, and I met with the orthopedic trauma surgeon and the head of orthopedics and presented the problem. Using a duty-based, deontological framework for ethical problem solving, and the principle of beneficence (Marquis and Huston, 2012), it was agreed that in this particular instance it would be best to let the fracture heal. As a team, we spoke with the family and explained why this choice was the best for their mother. Although the daughter had an unreal expectation that her mother would be able to walk again following
Hello all, my name is David Jamison, MHA. I am representing Marion General Hospital as the committee chairman of the ethics committee. I am currently reviewing the case involving female patient Margie Whitson. The patient is a 95 year old patient whom wishes to have her pace maker “turned off”, due to her unwillingness to live. The death of her only remaining son was the last event that, that had forced her to contemplate the reason why she still lives. Mrs. Margie Whitson is no stranger to loss. When she was younger, she lost her youngest son to a severe motor vehicle accident that took his life at the early age of 30. She injured herself over 10 years ago, and received a hip fracture. Her most recently bout was
Today many nurses, doctors, and other health care professionals encounter ethical dilemmas on a daily basis. An ethical dilemma can be defined as when there is more than one reasonable solution to a specific scenario. No one solution is more right than the other. In fact, they may both feel wrong, but a decision must be made (Butts & Rich, 2016). In the healthcare setting, nurses should be prepared to think critically and make ethical decisions. There are many factors that contribute to the process of ethical decision making such as ethical perspectives, principles, theories, and guidelines. Ethical decision making is to be rational and systematic. The selected case to be discussed is the case of Jahi McMath,
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
In this case, although the error started from the transmission of the discharge note to the home health care agency, Physical Therapist and Physical Therapist Assistant made number of mistakes in terms of clinical practice and delegation. First of all, completion and accuracy of patient’s physical therapy record is a professional responsibility of a supervising Physical therapist.1(p4) However, the PT failed to read the hospital discharge referral and documented incomplete and inaccurate plan of care. As a result, important information such as un-cemented prosthesis in situ and weight bearing limitations were not documented. In addition to that PTA elected to follow a protocol for cemented hip arthroplasty without referring back to PT for the missing information in the assessment. According to Texas Board of Physical Therapy examiners rule, “PTA may not specify and/or perform definitive (decisive, conclusive, final) evaluative and assessment procedures.”1(p5) Hence, it was also a mistake of the PTA to conclude the assessment and elect the inappropriate plan of care.
Bernice Buresh and Suzanne Gordon have written a sentinel work for nursing that addresses the misrepresentation or absence of nursing in the media and the public consciousness. This book is more than a call to arms for nurse activism. From Silence to Voice is an instructional aid for shaping dialogue to disseminate an effective message. With the current state of healthcare, nursing needs this manual more than ever to shape the direction of nursing policy and perception.
Standardization is key in hospitals and clinics alike. If a high risk patient such as Bonnie is admitted into an emergency room for a fractured elbow, all of her options should be explained to her. Corrective surgery would be a great option but she needs to be aware of all the risks associated with this procedure and any outcome that could occur. I’m sure if she was told that it is not recommended for someone at her old age or poor health status to undergo surgery, she would have taken more time to think about it. Something this serious should be discussed with family before going through with the procedure.
I am submitting this letter out in regards to your advertisement in The Journal of Specialized Health Care Operations on February 9, 2016. I am pleased to learn of your need for a patient advocacy specialist II, as my career goal and expertise are directly in line with this opportunity. I graduated from Bishop State Community College on May 7, 2013. I have obtained an associate in science and therefore, I am well qualified for this position. My education and experience have provided me with excellent skill in finding solutions and information that patient needs in regards to their rights, strong skills of negotiation and mediation in regards to problem solving and knowledge of family relations, patient care, and other relevant skills required
An article written by Robert Hanks (2012b) from The University of Texas at Health Science School of Nursing titled “Practical Approaches to Patient Advocacy Barriers” highlights the key components of the nurse’s responsibilities regarding patient advocacy. Dr. Hanks (2012b) determined that “only the patient can decide what is in the patient’s best interest and the role of the nurse is to then support the decision-making process.” A therapeutic relationship and effective communication between the nurse and the patient is essential to ensure quality of care. The nurse must support the patient in making their own decisions pertaining to their care, speak on behalf of the patient to communicate the patient’s choices for care, as well as act
In a profession where others' health and well-being are priority, there leaves room for neglect of those who are delegated to care for these people. As a professional nurse, there are many obstacles that arise and affect the care provided to a patient, as well as the livelihood of the nurse. The current deteriorating and unsafe staffing conditions in hospitals and other institutions prompts workplace advocacy as the universally appropriate concept for maintaining professional nursing practice. The Arkansas Nurses Association and the Louisiana State Nurses Association define workplace advocacy as a planned, organized system of services and resources designed to support the professional nurse in the workplace (White Paper on
The purpose of this concept analysis is to clarify, define, and refine how patient advocacy is perceived in the nursing community. Much of the literature has attempted to define patient advocacy and emphasis its role within the nursing profession. This paper will discuss multiple definitions of patient advocacy from existing literature and refine them into two critical characteristics.
Advocacy is risky, in that other peers may disagree with the decision when addressing the good of individuals or the nurse may potentially lose their position. But being able to find a balance between the foreseeable risks and benefits involved when advocating for better conditions is what leads to a more effective patient care plan (Edelman, Mandle, & Kudzma, 2014, p. 111). In the novel “A Nurse’s Story” by Tilda Shalof (2015), a positive example of advocacy is demonstrated between a patient named Sylvie and a nurse named Tracy. Sylvie is on the top of the organ transplant list for a new lung, but needs oxygen at the moment because she is struggling to breathe. The nurses are put in a situation where she either gets a sedation and intubation but gets taken off the transplant list, or gets the sedation and intubation to help her breathe at the moment. Despite the repercussions of possibly jeopardizing Sylvie’s chance for a lung transplant and going against the doctor in charge’s disapproval, she still gave her a dose of morphine to ease her breathing. Tracy in this situation is a perfect example of an advocate nurse. There were so many risks involved, but she was able to put a whole picture together and add in her instinct to come up with a plan of action. The interpersonal interaction between Tracy and her patient previously enabled her to spend more time to connect with the patient to understand what she needs and how to solve this situation. Not only did the nurse-patient relationship help the patient and her family feel as though they are being cared for, but also helped them feel more motivated to open up to the nurse to achieve better satisfaction. As said in the novel, “it was a small thing, but it was a big thing to Sylvie and her mother” (Shalof, 2015, p.
Engulfed by a cloud of grey, there are many situations that are not unblemished in the profession of nursing. Ethical dilemmas are often the most challenging to handle as they are interlinked with our own personal values and morals, requiring knowledge and attention to many factors (Burkhardt, Nathaniel, & Walton, 2014). Ethical predicaments will cross our paths daily and we need to utilize ethical frameworks, codes and our personal decision making to come to a well-informed conclusion. When we are in the vicinity of an uncertain quandary our human nature is tested, and we thoroughly scrutinise who we are ethically and morally. I am going to work through an ethical decision making model
During the home health observation day, there were several opportunities to observe a variety of patients with varying levels of functioning ability, different illnesses, and different needs and levels of interaction with the nurse. The first patient seen was a seventy-three year old Caucasian female with an ulcer on her right heel. Several weeks prior, she had scratched her left leg and she also had several small wounds on her left leg. The orders were to clean and redress the ulcer. She has a history of end stage renal disease, pneumonia, weakness, diabetes, dialysis, and right hip fracture. Upon entering the home, the patient was found to be sitting in a wheel chair in the living room watching television with her husband close by her side. She greeted the nurse with a smile and began to update her on her current condition. Her heel was “hurting” and she rated her pain an 8 on a scale of 1 to 10. She also had some “swelling” that she could not “get to go away; because, she could not get up and walk. They need to fix my foot so that I can get up and get around.” She told the nurse that she had been to see the doctor “yesterday” and the doctor had given her a written order that she wanted her to see. The order was written for an evaluation for a soft pressure shoe fitting. The nurse read the order to
25). Unfortunately, the article regarding Mr. Benson’s case did not give detail on whether or not proper documentation had occurred. However, one can assume documentation was not done properly as the wrong leg had been amputated. If proper documentation had been completed in Mr. Benson’s case, it is possible someone besides the surgeon may have caught the wrong leg was about to be amputated. An example of proper documentation would be the consenting of the patient for surgery. Mr. Benson had to have been consented for surgery, which means a doctor or a nurse practioner would discussed with the patient which leg was to be amputated, signs and symptoms of complications and what to expect after surgery. If there was any question once the patient was in the operating room, which leg to amputate, anyone could have looked in the patient’s chart to see what Mr. Benson had been consented for. Documentation of the time out could have also prevented Mr. Benson from having the wrong leg amputated. The reason being is, everyone involved in the case would have stopped and made sure the right patient was in the operating room and the right surgery was to be performed so it could be documented this act was completed. Not only proper documentation could have prevented this horrible act but also the help of the nurses could have prevented a mistake like this from happening.
Everyday, healthcare professionals are faced with ethical dilemmas in their workplace. These ethical dilemmas need to be addressed in order to provide the best care for the patient. Healthcare professionals have to weigh their own personal beliefs, professional beliefs, ethical understandings, and several other factors to decide what the best care for their patient might be. This is illustrated in Mrs. Smith’s case. Mrs. Smith is an 85 year old who has suffered from a large stroke that extends to both of her brains hemispheres which has left her unconscious. She only has some brain stem reflexes and requires a ventilator for support. She is unable to communicate how she wishes to proceed with her healthcare. Mrs. Smith’s children, Sara and Frank have different views regarding their mother’s plan of care. The decision that needs to be made is whether to prolong Mrs. Smith’s life, as Sara would like to do, or stop all treatments and care, as Frank feels his mother would want. In the healthcare field, there are situations similar to this case that happen daily where moral and ethical judgment is necessary to guide the decision that would be best for the patient. The purpose of this paper is to explore and discuss, compare and contrast the personal and professional values, ethical principles, and legal issues regarding Mrs. Smith’s quality of life and further plan of care.