The brother seemed very frustrated care study essay the daughter kept calling the hospital and was very apologetic to the nursing staff, care study essay. ACP Consult with the medical staff caring for the individual. Free Essays Essay Topics Search Search for: Search. This patient had a chronic history of COPD and Hypertension, but no other health issues. It is clear that Caroline is unwell and the care worker, having consulted the family, assesses that Caroline lacks the capability to make the decision about whether or not to call the physician.
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Doctor Essays. Philosophy of Education Essays. Internship Essays. Marijuana Essays. Drug Abuse Essays. Ethics is very important in nursing and the health care field in general, care study essay. Ethics are moral values that many people use as guidelines in their daily lives. Nurses and other health care providers should always care for their patients in the most ethically way possible, however, each patient and case is different. Caregivers may face many difficult ethical situations throughout their career.
It is important that caregivers resolve the dilemmas they may face without violating an ethical code. Write my paper. An year-old Caucasian female was admitted to the Intensive Care Unit ICU with a diagnosis of pneumonia, after aspirating on macaroni and cheese at home, care study essay. This patient had a chronic history of COPD and Hypertension, but no other health issues. The patient lived with her brother and his wife for a few years before care study essay medical issue. The patient had lived on her own, until her COPD starting to have debilitating effects. The brother and his wife noticed this and took her in to live with them. They had converted their home to make things easier for her.
They installed power stair chairs and hired caregivers to stay with her while they were at work or needed to step out of the home. When the patient moved in with her brother, care study essay, she made him the medical and financial Power of Attorney. They were able to sit up and became very talkative. They ate almost all of their dinner and seemed to be doing well, care study essay. Collectively, a decision was made to retract the hospice care and resume treatment with aggressive antibiotics. Over the course of the next few days, the patient seemed to be declining, care study essay.
The patient had COPD, care study essay, and seemed to be struggling to move air through their lungs. The patient care study essay very uncomfortable and miserable, but the doctors and family decided to keep trying with the antibiotics. Four days had passed and both the doctors and family realized the patient was not responding to treatment. The decision was made to put the patient back on hospice care and a morphine drip was started. The patient expired a day and a half later. It really seemed as though there was a lot of love being shared in that room during that difficult time. My first day assigned to her, care study essay, her brother called and asked for updates. His name was listed in the chart, and I was able to disclose information to him. I was not familiar with her, and I felt as though the patient was alert enough to answer whether I could explain her condition to her daughter.
The patient consented to me talking to her daughter, but I knew the brother was POA, so I briefly told her that her mother was stable at the time. My second day care study essay the patient was more of the same. The patient did not seem care study essay be improving, but doctors and her brother wanted to continue with antibiotics for a few more days. The brother called again for more updates, which were provided to him. The brother seemed very frustrated that the daughter kept calling the hospital and was very apologetic to the nursing staff.
That day, the daughter had come in to sit with care study essay mother for a care study essay hours. The daughter was telling me stories and acted as though there was no barrier between her and her mother. I did not push the daughter to talk about this situation and really did not want to know the underlying issues. It seemed as though the daughter and uncle had two very different sides of what had happened in the family. My care study essay day was the final day I had with care study essay patient. She had a persistent temperature all care study essay and was not responding to the antibiotics. The doctors met with the family, care study essay, and the decision was once again made to proceed with hospice care.
A morphine drip was then started. I sat down with the brother and his wife consoling them and educating them on the decision that was made and what to expect in the next few hours to days. He told me absolutely and that she should be involved in the rest of her care. As I told the daughter that her mother was going back to hospice care and was started on a morphine drip, I suggested she come she her mother as soon as she could. She said she would be in to visit in the afternoon, as she had things to do that morning. The daughter arrived late that afternoon and asked to speak with me privately. All she did was bash her uncle, saying terrible things about them after he cared for the patient for several years, care study essay.
The daughter began pulling out pieces of paper, stating she had been working all day on these arrangements. When I saw what she had, I noticed it was end of life plans for her mother. She knew that her uncle was the power of attorney, and when I suggested that she should speak with him, regarding his plans, she immediately shot me down. It was clear that the daughter and her uncle had two very different sides of the issues in their family. This was my first ethical situation I had been put in, because I have only been a nurse for a little over a year. I reached out to my supervisor, who sat with her and told her there was nothing that we could do because the POA was her brother. She immediately requested copies of all advanced directives in which we could not supply her because her name was not listed on the paperwork.
She seemed as though she wanted nothing to do with her uncle or his wife and was very distressed. At this point, all I was trying to do was to get the daughter to sit with her mother while she was actively dying. The daughter had no interest and became very agitated. She said that she would wait for her uncle to return to handle this situation. I knew how sensitive the situation was, care study essay, and did not want to make this worse. We made sure that if there was not a family member sitting with the patient, one of the staff members was until the family returned. The staff was put in an ethical situation because they wanted to respect the daughter, but at the same time there was nothing that could be done. If the staff was not knowledgeable of the situation, or did not realize that the uncle was stated as POA in the chart, private information could have gotten into the wrong hands.
This patient knew she was not improving and chose the palliative care route. She knew what would be happening in the next hours to days and agreed with her POA. This patient had completed advance directives and POA information well before she became ill. She knew what her wishes were and knew who would follow them best after her death. Once these decisions are completed and signed, healthcare providers care study essay to follow those guidelines to care for their patients. Both family members wanted different plans for the patient. The brother wanted to respect her wishes, whereas the daughter wanted to do what benefited her the most. Without advance directives, the patient would not have respectfully died based upon her wishes.
Some patients do not complete advance directives because they think that their family knows their wishes and will respect them, care study essay. In a study that was conducted in patients with a terminal illness, most of the wished to not be resuscitated if or when something was to happen and life saving measures were needed. Because this patient had advance directives and POA on file, her wishes were kept during her final moments and after death. The staff was able to respect the patient while remaining ethical.
This dilemma could have gone against the ANA Code of Ethics, but staff was able to resolve the situation while still remaining faithful to the code of ethics, specifically provisions one and two. At the facility I work in, if one feels something needs care study essay be reported to the ethics committee, one must report the event care study essay their manager, care study essay. From there, the manager will contact the ethics committee; and if a meeting is required the committee with contact the ethics council. In our facility, supportive care services are the head of the committee. The employees in supportive care services are our chaplain, care study essay, and palliative care employees, care study essay.
If there needs to be a presentation to the ethics committee, I feel as though the employee calling the meeting, manager, and patient care supervisor need to attend. I feel as though our committee is strong because the members of the committee are very educated in ethics and tackle difficult situations every day. I wanted to keep my patient comfortable and respect her wishes while she was dying. My patient knew that her brother was trustworthy and would respect her wishes when she did not have a voice of her own; that is why she made him the POA, care study essay. She did not have a good relationship with her daughter and decided that this route would be best.
My hope for resolution was to benefit my patient, care study essay. My end goal was to make them all as comfortable and emotionally prepared while my patient was dying. Care study essay supervisor was able to handle the situation delicately, while still showing authority and advocating for the patient at all times, care study essay. The patient in this scenario was placed on hospice because of her condition, withdrawn, and then placed on hospice again due to her condition not improving. I believe the patient and family had a sense of hope when the doctors withdrew hospice and continued treating the patient aggressively with antibiotics.
The patient had designated her brother as POA, and he made the decision to proceed with hospice when the patient was not responding to the antibiotics. When the daughter realized her mother was dying, care study essay, she tried to take over care from her uncle and wanted to make end-of-life plans for her mother, even though she had not seen her for years. The supervisor was able to resolve this situation by gently care study essay to the daughter that no matter what care study essay said or how many documents she tried to obtain, she had no power over her mother at the time, because the patient had already established Advance Directives.
The ethics committee did care study essay have to get involved, because we were able to resolve the situation to put the patient first. Had there not been Advance Directives, this situation could have been very severe. The patient had been living with her brother for several years and he knew her wishes.
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Within three days, Caroline has regained her capability, for this decision. Informed consent is a process for getting permission before conducting a healthcare intervention on a person. For consent to be valid, it should be voluntary and informed, and the person consenting must have the capability to make the decision. These phrases are explained under: Voluntary — the choice to both consent or not to consent to treatment have to be made by the individual themselves, and should not be influenced by pressure from medical staff, associates or family. Capacity — the particular person should be capable of giving consent, which suggests they understand the information given to them, they usually can use it to make an informed determination. If an adult has the capacity to make a voluntary and knowledgeable choice to consent to or refuse a particular remedy, their choice must be respected.
This nonetheless stands even if refusing remedy would end result of their dying, or the dying of their unborn child. This will not at all times be attainable, e. if a person is admitted as an emergency, is unconscious and requires fast remedy. If they wish to make any modifications they want to let their doctor or nurse know as well as their family and associates. When their Advance Care Plan is completed they are inspired to maintain it with them and share it with everybody concerned in their care. What has been written of their Advance Care Plan will always be taken into consideration when planning their care.
However typically things can change unexpectedly, such as their carers family, friends and neighbours turning into over tired or ill- these are unforeseen circumstances. Where the individual refuses to share data with certain individuals the options ought to be explained to them and the implications made clear Any report must be topic to evaluation and if necessary, revision and it should be clear when this is deliberate. Review could additionally be instigated by the individual or care supplier, can be part of regular review or may be triggered by a change in circumstances A clear report of who has copies of the document will assist facilitate future updating and review Copies in notes must be updated when an individual makes any changes. For example, it may be decided that a replica should be given to the individual and a copy positioned within the notes 2.
The advance care plan is a document that goes into impact only if the shopper is incapacitated and unable to speak for herself. This might be the end result of disease or extreme injury—no matter how old is she. It helps others know what sort of medical care she wants. That might explain her emotions, beliefs and values that govern how she make selections. They could cover medical and non-medical matters. Learning Outcome 3: Understand the person centred approach to advance care planning Assessment Criteria. Describe the elements that an individual would possibly contemplate when planning their Advance Care Plan.
The needs are being expressed throughout advance care planning are private and can be about anything to do with the patient future care. They may wish to embrace their priorities and preferences for the future, for instance: how they could want any spiritual or non secular beliefs to carry to be reflected in their care, the name of a person or individuals they wish to represent their views at a later time, their alternative about the place they would favor, if potential, to be cared for, for instance at home, in a hospital, nursing house or hospice their ideas on completely different remedies or forms of care they could be provided, how they love to do issues, for example, preferring a bathe instead of a bath or sleeping with the sunshine on, issues or solutions about practical points, for instance, who will take care of their dog must you turn into ill.
Explain the importance of respecting the values and beliefs that impact on the choices of the individual. Sometimes folks will want to write down or inform others their wishes and preferences for future treatment and care, or explain their emotions or values that govern how they make selections. This might help health and social care professionals establish how the individual would like to be handled without binding them to that course of action if it conflicts with professional judgment A statement of the general beliefs and features of life which an individual values. Your beliefs and values are what make you a unique individual. They are based mostly upon previous experiences in addition to present circumstances. Many of them were learned from dad and mom as properly as different respected individuals.
While some beliefs and values could change from time to time, they proceed to be your personal. Identify how the wants of others could must be taken into consideration when planning advance care. This patient had a chronic history of COPD and Hypertension, but no other health issues. The patient lived with her brother and his wife for a few years before this medical issue. The patient had lived on her own, until her COPD starting to have debilitating effects. The brother and his wife noticed this and took her in to live with them. They had converted their home to make things easier for her. They installed power stair chairs and hired caregivers to stay with her while they were at work or needed to step out of the home.
When the patient moved in with her brother, she made him the medical and financial Power of Attorney. They were able to sit up and became very talkative. They ate almost all of their dinner and seemed to be doing well. Collectively, a decision was made to retract the hospice care and resume treatment with aggressive antibiotics. Over the course of the next few days, the patient seemed to be declining. The patient had COPD, and seemed to be struggling to move air through their lungs. The patient seemed very uncomfortable and miserable, but the doctors and family decided to keep trying with the antibiotics. Four days had passed and both the doctors and family realized the patient was not responding to treatment.
The decision was made to put the patient back on hospice care and a morphine drip was started. The patient expired a day and a half later. It really seemed as though there was a lot of love being shared in that room during that difficult time. My first day assigned to her, her brother called and asked for updates. His name was listed in the chart, and I was able to disclose information to him. I was not familiar with her, and I felt as though the patient was alert enough to answer whether I could explain her condition to her daughter. The patient consented to me talking to her daughter, but I knew the brother was POA, so I briefly told her that her mother was stable at the time.
My second day with the patient was more of the same. The patient did not seem to be improving, but doctors and her brother wanted to continue with antibiotics for a few more days. The brother called again for more updates, which were provided to him. The brother seemed very frustrated that the daughter kept calling the hospital and was very apologetic to the nursing staff. That day, the daughter had come in to sit with her mother for a few hours. The daughter was telling me stories and acted as though there was no barrier between her and her mother. I did not push the daughter to talk about this situation and really did not want to know the underlying issues.
It seemed as though the daughter and uncle had two very different sides of what had happened in the family. My fourth day was the final day I had with this patient. She had a persistent temperature all morning and was not responding to the antibiotics. The doctors met with the family, and the decision was once again made to proceed with hospice care. A morphine drip was then started. I sat down with the brother and his wife consoling them and educating them on the decision that was made and what to expect in the next few hours to days. He told me absolutely and that she should be involved in the rest of her care.
As I told the daughter that her mother was going back to hospice care and was started on a morphine drip, I suggested she come she her mother as soon as she could. She said she would be in to visit in the afternoon, as she had things to do that morning. The daughter arrived late that afternoon and asked to speak with me privately. All she did was bash her uncle, saying terrible things about them after he cared for the patient for several years. The daughter began pulling out pieces of paper, stating she had been working all day on these arrangements. When I saw what she had, I noticed it was end of life plans for her mother. The care delivered was patient-centred and teamwork was integral to providing this care.
First will be a discussion on the importance of self awareness and how this awareness enabled a more assertive and confidant approach to be made to managing patient care. Self awareness must be considered as the foundation for management and is a vital skill and quality needed in leadership. If you wish to provide care that is of a high standard and improve your own performance as a skilled health care professional you need to manage the cognitive, affective and behavioural self in order to engage effectively in therapeutic relationships. Without being self aware, recognising personal and cultural beliefs, and understanding interpersonal strengths and limitations, it is impossible to establish and maintain good relationship with co-workers and patients.
This relates to the need to maximise potential and achieve a sense of personal fulfilment, competence, and accomplishment Maslow, It is important as a student nurse to be completely aware of strengths and weaknesses, and to be conscious of any limitations, self-awareness helps to exploit strengths and cope with weaknesses Walshe and Smith , To understand nursing management it is crucial to understand what nursing management is and the theory behind it. Another definition of management is a process by which organisational goals are met through the application of skills and the use of resources Huber, com, Borkowski, N. Cameron, K. and Whetten, D. Gopee, N. and Galloway, J. Huber, D. USA: W.
B Saunders Company. McGregor, D. The human side of enterprise. Leadership and motivation.
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