Assignment: Decision Making HLT 312
Assignment: Decision Making HLT 312
Details:
In preparation for this assignment, read the assigned article, “Making the Case for Ethical Decision-Making Models,” and the following case study:
Case Study
Carrie, a 26-year-old woman, is taken to the hospital after a serious car accident. She is unresponsive and on life support. The doctors and nurses are concerned about her ability to recover because she is now in a persistent vegetative state with no brain activity. Her parents are optimistic that she will recover given enough time and insist that she continue to receive aggressive treatment. Bob, Carrie’s husband, is by her side. He is requesting that the doctors stop treating her and insists that keeping her on the machines is against her wishes. There is no living will or medical power of attorney in place for the patient. You have been contacted as a member of the ethics committee to determine the best course of action.
Assignment
Apply the four key aspects of decision-making models to the case study based on the discussion in the article.
Write a 1-2 page letter to the attending physician and family that includes the following information:
1. Describe the ethical quandary.
2. Make a recommendation for the best course of action.
3. Explain why you made your recommendation.
4. Determine the ethical issue.
5. Gather relevant facts and information, taking into account the impact, views, and opinions of others.
6. Identify various possible options and select and justify one.
7. Carry out the decision.
Although APA format is not required, strong academic writing is expected.
This assignment must be submitted to Turnitin. Please follow the steps outlined in the Student Success Center.
Ethical Decision-Making
Nurses play a critical role in promotion of patient safety and protection of patient rights through their advocacy role. Advocacy in nursing entails the nurses speaking on behalf of the vulnerable patient populations in their organizations or communities. When nurses play the role of advocates, they abide with the ethical values and principles that guide their practice. The ethical values and principles that must be protected include beneficence, respect for the patient’s autonomy, justice, fidelity, veracity and non-maleficence. Nurses also require the use of effective advocacy skills that include negotiation, decision-making and leadership to work effectively with other teams involved in championing the needs of the patients (Takenouchi, 2018). Therefore, this paper examines a situation where I acted as an advocate of the patient. The analysis also considers the legal ramifications, role of nurse managers and inter-professional members and methods that can be used to improve the quality of decision-making.
Situation
One of the situations where I acted as the advocate of a patient was during my experience in the pediatric ward. A pediatric patient was admitted to the pediatric ward due to severe anemia. The patient required emergency blood transfusion to improve the physiological health wellbeing. However, the parents declined patient being transfused with blood because it was contrary to their cultural values and beliefs. The parents were educated about the importance of blood transfusion in saving the life of the baby but they declined. As a result, I informed the charge nurse who escalated the situation to the top level management of the institution. A decision was reached to transfuse the patient as per the policies of the hospital because the baby was considered part of the vulnerable populations. Therefore, I played my advocacy role in addressing this healthcare issue.
Legal Ramifications
The ethical issue was associated with a number of legal ramifications. Firstly, failing to transfuse the blood to the baby could have contributed to neglect in practice. Nurses have the responsibility of ensuring that the rights of the vulnerable populations are protected. Failing to transfuse the baby could have been considered a violation of the nursing standard of advocating the rights of the vulnerable in their practice. The issue also increased the risk of lawsuits from the family due to failure of the care team and management to consider their values on issues related to health (Watson, 2019). However, the care givers and the hospital acted in the best interests of the patient.
Role of Nurse Manager, Ethics Committee and Other Inter-Professional Members
The nurse manager of the unit and the hospital played critical roles in addressing the situation. Firstly, they informed the family about the benefits of transfusing the baby with blood and risks if the action was not taken. The nurse managers also acted as the patient advocates by ensuring that the rights of the pediatric patient to safe care was promoted. The inter-professional team members also played the role of ensuring that ethical decision was made in ensuring that the safety and rights of the patient were protected. The ethics committee did not play a role in the situation. However, the decisions made were ethical in nature, as they were in the best interests of the patient (Hanks et al., 2019).
Methods to Improve Quality of Decision-Making
One of the methods to improve the quality of decision-making is utilizing best practices in decision making. For example, nurse managers can use ethical decision making model to make accurate decisions in their practice. The other method to improve the quality of decision-making is active stakeholder involvement. For example, parties in a conflict should be actively involved in the process to enable the nurse managers to make accurate decisions on the solutions that should be implemented. The last method to improve the quality of decision-making is learning from experiences. The nurse managers should use their experiences in decision-making to develop effective approaches to solving organizational issues (Price et al., 2017). Reflective practice will enable the nurse managers to identity their strengths and areas of weaknesses that must be addressed for quality decision-making in the future.
Conclusion
Nurses play a critical role in the care process as advocates of their patients. Advocacy in nursing ensures that the rights of the patients are protected in the care process. Nursing advocacy is associated with significant ethical dilemmas that increase the risk of legal issues in the actions taken by the nurses. Therefore, active stakeholder involvement is needed to ensure that accurate decisions are made. In addition, best practices to accurate and quality decision-making should be embraced in the advocacy process.
References
Hanks, R. G., Eloi, H., & Stafford, L. (2019). Understanding how advanced practice registered nurses function as patient advocates. Nursing Forum, 54(2), 213–219. https://doi.org/10.1111/nuf.12319
Price, A., Zulkosky, K., White, K., & Pretz, J. (2017). Accuracy of intuition in clinical decision-making among novice clinicians. Journal of Advanced Nursing, 73(5), 1147–1157. https://doi.org/10.1111/jan.13202
Takenouchi, S. (2018). Empowering Nurses through End-of-Life Nursing Education in Asia: Nurses as Advocates for Patients’ Dignity. Asia-Pacific Journal of Oncology Nursing, 5(1), 9–11. https://doi.org/10.4103/apjon.apjon_68_17
Watson, J. (2019). Nurses as advocates. Nursing Made Incredibly Easy, 17(3), 42–46. https://doi.org/10.1097/01.NME.0000554601.68360.36