This assignment evaluates the ethical decision making model in nursing using a case study. It discusses legislative acts, ethical conducts, and nursing standards. The conclusion emphasizes the importance of prioritizing patient well-being and following ethical codes.
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Running head: ETHICAL DECISION MAKING MODEL IN NURSING ETHICAL DECISION MAKING MODEL IN NURSING Name of the Student Name of the University Author Note
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1 ETHICAL DECISION MAKING MODEL IN NURSING Abstract The following assignment would be aiming for the evaluation of the ethical decision making model of nursing with the help of the case study of Fred who diagnosed with myocardial infarction and unionization problem due to his prostate cancer. The nurse’s decision on the basis of the patient’s condition would be evaluated with the factors that impact on the decision making process of the nurse. The legislative acts, the ethical point of views of a nurse, the registered nursing standards of a nurse and other factors as well. Finally the evaluation of the decision also given in the assignment and concluded with all the factors discussed in the whole assignment.
2 ETHICAL DECISION MAKING MODEL IN NURSING Table of Contents Introduction......................................................................................................................................3 Discussion........................................................................................................................................3 Overview of the Case...................................................................................................................3 Legislative Acts for Nursing........................................................................................................4 Ethical Conducts..........................................................................................................................6 Nursing Standards........................................................................................................................7 Conclusion.......................................................................................................................................8 References........................................................................................................................................9
3 ETHICAL DECISION MAKING MODEL IN NURSING Introduction Professional nursing practice depends on several ethical and legal factors and in order to provide a proper nursing care the nurse should consider all these factors. In the context of the nursing care providence the nurse should be considerate about the health condition of the patient as well. The patient centeredness of a nurse needs to be considerate enough about the proper decision making with the consent of the doctor as well. The primary focus of the nurse should be the patient, however, the legal and ethical framework play a crucial role in the care module and thus the model is known as the ethical decision making model (Ling & Hauck, 2017). Here the case of Fred Robinson needs to be evaluated and assessed by the coronary care unit nurse on the basis of this model. In the following section the ethical decision model in nursing care would be discussed on the basis of the case of Fred and the different laws, ethical conducts and nursing standards would be highlighted as well along with the consideration of a different model of care in this particular case. Discussion Overview of the Case Fred was admitted with theTransurethral Resection due to urinal problem and his operation was postponed as he developed a change in the cardiac circulation following the spinal anesthetic. After that he was transferred to the recovery unit where he was diagnosed with the myocardial infarction and went under the condition of ventricular tachycardia. He needed to be provided with defibrillation, cardiopulmonary resuscitation (CPR), intubation, lidocaine and vasopressors to maintain his blood pressure (BP) which was very low by 76/40 mmHg. He was provided with 100% oxygen, IV Dopamine and IV Dobutamine to maintain the sever condition of his health
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4 ETHICAL DECISION MAKING MODEL IN NURSING (Benetos et al., 2015). He very few times responded to the treatment and basically kept alive by the ventilation process and medication. Fred’s son could not be contacted thus the medical team planned to transfer him to the Coronary care unit (CCU) and they also tried their best to provide the care to the patient. However, the coronary care unit nurse need to review the condition of Fred and confirm whether he is having an Advanced Health Directive (AHD) or not and also need to confirm that until the AHD located whether the ventilation process go on or the medication process would be withdrawn (Worcester, 2018). The decision is dependent on the nurse however; the nurse should consult with the doctor and the unit manager before taking any decision (Mathews et al., 2015). Legislative Acts for Nursing Fred had a prostate cancer and thus his urination problem begun and his history of myocardial infarction was the cause for him to diagnose with cardiac problems. Thus Dr. Diamond recognized him and believes he has an AHD. After reviewing his notes a “Not for Resuscitation” found which was signed by a doctor who diagnosed him on his last admission. Thus the evidence of a doctor’s consent found on the patient’s document for the not doing any cardiopulmonary resuscitation and the nurse could have the permit to stop the medication of the patient as the patient is not responding the treatment procedure. However, the nurse should at least consult with the supervisor that is the Coronary Care Unit manager. The nurse should be able to follow the Health Practitioner Regulation National Law (WA) Act 2010 and on the basis of this act the nurse should be able to maintain the health care ethics and conduct a proper care with the consent of the doctor(Legislation.wa.gov.au, 2019). However, the decision taking procedure could independent in minimal cases but in severe conditions such as Fred’s condition the nurse should consider the evidence of the patient’s medical history along with the consent of
5 ETHICAL DECISION MAKING MODEL IN NURSING the supervisor and the doctor in charge. Other than the legislation the nurse should also adhere to the fundamental principles of the ethical decision making framework which includes 5 steps such as the utilitarian, rights, fairness, common good and virtue. The utilitarian step considers the greater good and minimal amount of harm to the person or the patient the nurse responsible for. The rights step comprises of the protection, respect and moral of anyone who could be impacted by the ethical decision making of the nurse in this case the patient and the patient’s family. On the other hand the fairness is the approach of the equality in care that is the nursing care should be comprised of the fact that the every person needed to be provided care without any discrimination. Common good is a factor that considers the well being of the patient and the surrounding of the patient as well. This factor also considers the action of a registered nurse and the ethical consideration of the nurse. Common good considers the affectionate nature of the nurse for the patient as well for the proper treatment and well being. Whereas, virtue is the factor that depends on the ethical standards and the honesty, courage, tolerance, transparency and other factors as well. All these factors are the basic principles of the ethical decision making process where all the factors are used in the process of decision making. However, in this case Fred is a patient with multiple health issues and the condition of him is not promising in any aspect thus the nurse should take a critical decision in order to prevent the suffering of the patient. After all the medication and ventilation process Fred is not responding to the treatment and his heath condition is deteriorating thus the nurse should consider removing the medication process as there is no improvement of the patient. However, this decision needs evaluation and consideration of the ethical codes of nursing on the consent of the doctor assigned for the patient (Peter, 2016). The myocardial infarction and urinal problem of the patient reached to a critical condition which resulted in the deterioration of the health
6 ETHICAL DECISION MAKING MODEL IN NURSING condition of him. Thus the decision should consider taking advice from a cardiac specialist and also from an oncologist as the medical history of Fred includes the prostate cancer. However, the medication process if removed then the patient might be dead and the nurse should avoid the situation as his or her primary objective is to deliver a care to the patient for his betterment in the health condition.The CCU nurse should consider theHealth Practitioner Regulation National Law (WA) Act 2010 before taking any kind of decision on the basis of the legislative regulation of this Act. However, the family member of the patient that is the son of Fred could not be contacted and without informing him the nurse or the organization cannot stop the medication of the patient. This is because the family members of the patient are also one of the stakeholders in the decision making process. Thus the nurse should consider the code of conducts for the nursing practice and should be considerate about the emotional aspect of patient care. Ethical Conducts Thisconditioncreatesaconflictbetweentheregulatoryactionandtheethical consideration of a nurse. The nurse should follow the regulation where the consent of the doctor given to the patient and the organization when Fred appointed for his cardiac diagnosis and after finding the evidence about that consent of Not for Resuscitation however, the nursing ethics of prioritizing patient care as the ultimate objective of the nurse (Cooper et al., 2015). Thus a conflict in the nature of the nurse would work in these critical conditions however, the nurse should be able to avoid the conflict and opt for the professionalism and conducts of the nursing in these kinds of situations (Falco-Pegueroles et al., 2015). Nurse has no permission of taking decision on behalf of the patient thus the primary concern of the nurse is to opt for the doctor’s decision whether the medication process would be stopped or the medical team would try to stabilize and try to improve Fred’s health condition (Grace, 2017).
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7 ETHICAL DECISION MAKING MODEL IN NURSING Nursing Standards Registered nurses should maintain the standards such as critically thinking and analyze nursingpractice,engagingintherapeuticandprofessionalrelationships,maintainingthe capability for practice, comprehensively assessments conducting, developing a plan for nursing practice, providing safe, appropriate and responsive quality nursing practice and evaluating outcomes to inform nursing practice(Nursingmidwiferyboard.gov.au, 2019). All these factors would be helpful in the critical situation assessment such as Fred’s condition and the nurse would be able to take the proper decision for the patient’s well being. However, the nurse should consider the legislative acts and other ethical codes for the decision making on behalf of the doctor but taking the advice of the doctor as well (Kangasniemi, Pakkanen & Korhonen, 2015). The nurse should consider another model of care in this kind of situation that is the Integrated decision making model which would be helpful in the confident decision making. However, the decision making model needs to be divided into several steps that are the critical analysis step, patient well being, patient support, critical decision based on the situation and others (Schwartz, 2016). These factors needed to be incorporated in the training module of the nurses. The nurse of the CCU needed to be evaluating all the factors before the decision making and also take the measures of informing the relatives of Fred before removing the ventilation and the medication system that help him sustain in the condition (van Hooft et al., 2016). Though he was not responding to the treatment procedure but the nurse should consider the benefits of the patient’s health over any other aspect. The primary concern of the nurse in this situation is to have hope for the betterment of Fred’s health condition over the fact of his health deterioration. In this kind of context the nurses have faced difficulties incorporating the ethical decision making model however, it is a useful care model in this kind of situation.
8 ETHICAL DECISION MAKING MODEL IN NURSING Conclusion Based on the above discussion it can be concluded that the ethical decision making model and the integrated decision making model would help the nurse in the proper decision making for the patient. The main focus of the nurse however, should be in the betterment of the patient and evaluate and consider the advice and decision of the doctor over the decision of his or her own. The nurse needed to consider the ethics of nursing and the codes of the professionalism of the organization. The main focus should be the ethical purity and support the patient and the family of the patient. In the context of decision making the nurse cannot make any decision on behalf of the patient as seen in the case of Fred. Fred having multiple issues and do not have any kind of response towards the treatment might be believed to be dead and this factor would be resulting in the removal of the medication. However, the nurse should follow the Government legislative acts in that field of decision making as well to prevent any kind of ill situation build up for the organization and also should have the ethical view point of health betterment of the patient.
9 ETHICAL DECISION MAKING MODEL IN NURSING References Atkins, K., De Lacey, S., Britton, B., & Ripperger, R. (2017).Ethics and law for Australian nurses. Cambridge University Press. Benetos, A., Labat, C., Rossignol, P., Fay, R., Rolland, Y., Valbusa, F., ... & Gautier, S. (2015). Treatment with multiple blood pressure medications, achieved blood pressure, and mortalityinoldernursinghomeresidents:thePARTAGEstudy.JAMAinternal medicine,175(6), 989-995. Cooper, E., Spilsbury, K., McCaughan, D., Thompson, C., Butterworth, T., & Hanratty, B. (2017). Priorities for the professional development of registered nurses in nursing homes: a Delphi study.Age and ageing,46(1), 39-45. Falco-Pegueroles, A., Lluch-Canut, T., Roldan-Merino, J., Goberna-Tricas, J., & Guardia- Olmos, J. (2015). Ethical conflict in critical care nursing: Correlation between exposure and types.Nursing ethics,22(5), 594-607. Grace, P. J. (Ed.). (2017).Nursing ethics and professional responsibility in advanced practice. Jones & Bartlett Learning. Kangasniemi, M., Pakkanen, P., & Korhonen, A. (2015). Professional ethics in nursing: an integrative review.Journal of advanced nursing,71(8), 1744-1757. Legislation.wa.gov.au. (2019). Western Australian Legislation - Health Practitioner Regulation NationalLaw(WA)Act2010.Retrievedfrom https://www.legislation.wa.gov.au/legislation/statutes.nsf/main_mrtitle_12106_homepage .html Ling, T. J., & Hauck, J. M. (2017). The ETHICS Model: Comprehensive, Ethical Decision Making.VITASonlineretrievedfromhttps://www.counseling.
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10 ETHICAL DECISION MAKING MODEL IN NURSING org/knowledge-center/vistas/by-year2/vistas-2017/docs/default-source/vistas/the-ethics- model. Mathews, R., Wang, T. Y., Honeycutt, E., Henry, T. D., Zettler, M., Chang, M., ... & TRANSLATE-ACS Study Investigators. (2015). Persistence with secondary prevention medications after acute myocardial infarction: insights from the TRANSLATE-ACS study.American heart journal,170(1), 62-69. Nursingmidwiferyboard.gov.au.(2019).NursingandMidwiferyBoardofAustralia- Professionalstandards.Retrievedfrom https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional- standards.aspx Peter, E. (2016). The politicization of ethical knowledge: feminist ethics as a basis for home care nursing research.Canadian Journal of Nursing Research Archive,32(2). Schwartz, M. S. (2016). Ethical decision-making theory: An integrated approach.Journal of Business Ethics,139(4), 755-776. van Hooft, S. M., Dwarswaard, J., Bal, R., Strating, M. M., & van Staa, A. (2016). What factors influencenurses’behaviorinsupportingpatientself-management?Anexplorative questionnaire study.International journal of nursing studies,63, 65-72. Worcester, D. (2018). Implementation of an Advanced Directive Protocol among Hospitalized Patients.