Assessment_of_Multiorgan_Failure_Patient

NVT2 TASK 1 ETHICAL DILEMMAMABEL MICHAELWGU November 16, 2011 NVT2 TASK 1 ETHICAL DILEMMAA code of ethic is a guide for an individual, group to follow in making decisions regarding ethical issues.Ethics are the principles that guide an individual, group, or profession in conduct. Although nurses are put in a place to make decisions daily, it still does not make it easy for them, hence the word conflict and dilemma.The study of ethics has led to the identification of basic concepts including rights to self determination, autonomy, beneficence, non-malfeasance, justice, and fidelity.Understanding these concepts assists the nurse with making decisions during difficult situations. For this process to be fair to the health care workers, patients and family should be educated and advised of the care and treatment options in case the become incapacitated. Of course, this topic is not always easy for the health care workers, the patients and their loved ones.State regulation and Nursing Standards.In this case, scenario, the standard of nurse practice that applied was that of 1.Honesty and integrity in nursing practice.2, Nurse respect of patient’s right. concerns, decision and dignity 3, Advocating in the best interest of the patient. 4, Maintaining patient’s confidentiality in nursing practice. (ANA, 2004, pg, 39). (2011) nurse practice act. Utah board of nursing. In addition, the patients’ right to autonomy and self determination. It was stated that Mr. E had mild mental retardation but it was not documented that he was incapacitated at the time the advance directive was executed. Therefore, his right to refuse ventilator intubations should have been respected. The physician violated the patient’s right to autonomy and self determination. The nurse also violated patient’s right to self determination by not respecting and promoting informed decision making as outlined in the Code of Ethics for Registered Nurses (Part1) The nurse’s role in this case was that of patient’s advocate and autonomy. According to (ANA, 2001), the role of the nurse was to support the patient’s right to self determination. right to refuse treatment. Moreover, his right to privacy and confidentiality. The nurse was concerned that the physician Dr G gave medical record information about the patient’s condition to Mr. H. Dr G also notified him of Mr. E refusal to accept aggressive treatment with ventilator intubation and feeding tube. Mr. H was not mentioned in the durable power of attorney record for Mr. E as having privy to patient’s information. . The physician violated patient’s right to privacy and confidentiality... The physician and Mr. H violated his right to refuse treatment .The physician received consent from Mr. H and he proceeded to perform ventilator intubation for Mr. E.Mr. H did not have power of attorney to consent in the patient’s medical record as a family member and should not have been provided with confidential information about the patient’s status and condition. According to HIPAA privacy law and nursing code of ethics, Mr. H was not in a place to authorize treatment for the patient Mr. E. However, Mr. B who was the next of kin and had the power of attorney to carry out the patient’s wish did not participate in the decision for treatment. Had he gave consent to intubate Mr. E, it would be unethical because the patient's wish to not have feeding tubes and ventilator was not respected.Dr G concerned that the patient’s condition was critical. He made an unethical decision. Firstly, he gave medical information to Mr. H whom was not named in the patient’s advance directives. Mr. H also authorized treatment for Mr. E. Secondly, the doctor performed intubation procedure against the patient’s wish, which is the right to autonomy and right to choose.According to American Nurses Association code of ethics, there is a specific charge to protect patients by specifying that nurses should report unsafe, illegal, or unethical practices by any person... The doctor’s unprofessional conduct was unethical and should be reported. It is the obligation of the nurse to safe guard a patient’s privacy. (ANA, 2001). The nurse in the case is accountable and responsible to protect the patient. The nurse must follow HIPAA reporting procedure;1. Document facts objectively.2 confront the person or notify authorities.3, Notify supervisor and follow internal chain of command 4, Report to outside agencies if no responseThe role of nurse autonomy in professional practice according ANA code of ethics is that the nurse helps the patient to understand the nature, extent and the possible outcome so the patient can make health care decisions based on information provided in easily understood manner. The nurse also has the responsibility to continue to provide information to satisfy the moral obligation of maintaining the patient’s autonomy . (Weston, 2008)Autonomy refers to the ability to act according to one’s knowledge and judgment, proving nursing care with the full scope of practice as defined by existing professional regulatory and organizational Rules (Weston. 2008)The nurse’s personal autonomy to practice is affected by Board of Nursing regulation when there is a question of ethics and a patient’s right to choose. According to American Nurses Association , the principle of autonomy encourages patient to function independently and be allowed to freely make informed decisions in an autonomous manner, as a result the nurse can not interfere with the patient’s desires or actions during this process.The nurse’s accountability for this patient’s outcome and advocacy for the quality and safety of his care in this scenario is that the nurse advocated for and strived to promote the patient’s autonomy and ensured his right to privacy and confidentiality ANA (2001). The physician’s unprofessional conducts were questioned. Patient received safe care, his privacy right was protected. He was also protected from injury and harm. The nurse still came out on top as the patient's advocate. Reference:(2011). nurse practice act. utah board of nursing. Retrieved from http://www.rules.utah.gov/publica/code/r156/r156-31b.htm (2001), Nursing’s Social Policy Statement, Second Edition (2003) and the Nursing Scope and Standards of Practice (2003) [magazine]. (2010). National Council of State Boards of Nurse and American Nurses Association. Retrieved from www.ncsbn.org/pdfs/Joint statement.pdfMathews, J. M. (2010, may 31 2010). When Does Delegating Make You a Supervisor' []. ANA Periodicals/OJIN, . Retrieved from Http:/nursingworld.org/MainMenuCategory/ANAMarkeplace/ANAPeriodicals/OJIN/TNurse-related principles of delegation, [magazine]. (2010). ANA Periodicals. Retrieved from www.safestafingsaveslives.org/WhatisSafeStaffing/SafeStaffingPrinciples/PrinciplesforDelegationhtml.aspx#NurseWEYDT, A. (Ed.). (2010). VOLUME 15, NO. 2, MANUSCRIPT 1 [Special issue]. ONLINE JOURNALS OF ISSUES IN NURSING, 15(2). doi: 10.3912 |www.rules.utah.gov/publicat/code/r156/r156-31b.htm||