Legal and Professional Issues in Nursing - Doc
Added on 2021-04-21
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Legal and professional issues in nursingNameInstitution
1IntroductionThe contemporary nursing profession is increasingly focusing on the patient rights and issues on shared decision making. Nurses are not only required to be accountable to their patients, but also to the public, their employers and other stakeholders. However, the application of these principles requires deep understanding of the culture and social issues facing the patient (Cherry and Jacob, 2016). The perspectives and cultures of the Aboriginal people play a critical role in the palliative care decision-making process. The multiplicity of players that influence thiscritical decision create a fertile ground for conflicts and legal conundrums (Crawley and Koffman, 2015). This is the situation that arose in the management of Tom, a patient who was placed in palliative care. The nurse in charge of Tom faces numerous professional and legal issues to deal with in the management of the patient. Issues in the management of the patientClinical issuesThe primary duties of a nurse include the care of all patients, confidentiality, and autonomy. These duties are supplemented by the principles of beneficence and non-maleficence. However, autonomy is complicated in cultures such as the Aboriginal society where the whole family (and sometimes including extended family) is needed to make the management decisions (Johnston, Vukic, and Parker, 2013). It obscures the process of informed consent when each of these members has differing opinions or understanding of the patient management. In the situation of Tom, the nurse needed to respect the palliative wishes of the patient in his management. These included the use of morphine/midazolam for the treatment of his pain or dyspnea and the regard of his medical registrar’s notes. However, the health of the patient is also deteriorating to the dislike of the family, and better supportive care need to be initiated.
2Legal issuesThe biggest challenge is the person responsible for the final decisions of the patient. While the family is aware of the wishes of Tom for palliative care, they are also concerned abouthis deteriorating health. The person Tom had assigned to make decisions on his treatment and be his guardian, Cec, was present when Tom decided to use the morphine and be subjected to terminal care. Tom had also done an advanced care paper. However, the daughter wants to override these decision and uses her power as an attorney to implement the changes. She wants better treatment strategies for her father, which causes distress to the other family members. Her wishes are justified within the legal confines, but create a clinical conundrum in the managementof the patient.The legal issues in the situation extends beyond the basic understanding of the law to the frameworks of the Aboriginal culture. Their indigenous life requires that family strength is maintained, and an effort to divide the family may be disrespectful (Duggleby, 2015 p. 1722). Consequently, the decision on the management of Tom will need to be collective and protracted. However, there is need to also maintain the professional nursing ethos and standards in applying the decisions from the family members on the health of the patient. At the end of the day, the nursing care provided to the patient are based on his best interests.Goals in the management of the patient The complication of Tom’s situation arose from the need of Carina to apply modern laws in a setting that is influenced by cultural forces. The fact that Tom has already gone back to the community and consulted with the other members means that the family is at peace with the palliative care process. It took consultation with the senior members of the society before agreeing to use the morphine treatment. However, Carina believes that the treatment is not
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