Choose a patient-care situation in which the RN should intervene and advocate for the patient. An example of such a situation might be when a patient has not been given complete informed consent.
Describe the clinical situation concisely and descriptively. It can be an actual situation or a hypothetical one.
Apply the Bioethical Decision Making Model to the specific clinical ethical situation that you choose. Address each section of the model. Conclude with a discussion of nursing advocacy in the clinical setting and the nurse’s role as a patient advocate.
Full Answer Section
Bioethical Decision Making Model
- Identify the ethical issue.
The ethical issue in this situation is the patient's right to informed consent. The patient has the right to make informed decisions about their care, and this includes the right to refuse treatment.
- Gather additional information.
The nurse should gather additional information about the patient's concerns. This may include asking the patient about their values, their goals of care, and their understanding of the risks and benefits of hemodialysis. The nurse should also assess the patient's decision-making capacity.
- Identify the personal and professional moral positions.
The nurse's personal moral position may be that hemodialysis is the best course of treatment for the patient. However, the nurse's professional moral position is to respect the patient's right to make informed decisions about their care.
- Identify the values of key individuals.
The key individuals in this situation are the patient, the patient's family, and the healthcare team. The patient's values are important because they will guide the patient's decision-making. The family's values may also be important, as they may influence the patient's decision. The healthcare team's values should be focused on providing the patient with the best possible care.
- Identify the value conflicts, if any.
The value conflict in this situation is between the patient's right to make informed decisions about their care and the healthcare team's desire to provide the patient with the best possible care.
- Determine who should decide.
The patient should ultimately decide whether or not to undergo hemodialysis. The nurse can provide the patient with information and support, but the final decision is up to the patient.
- Identify the range of actions and anticipated outcomes.
The range of actions in this situation is for the patient to either agree to undergo hemodialysis or refuse treatment. If the patient agrees to undergo hemodialysis, the anticipated outcome is that the patient's life will be prolonged. If the patient refuses treatment, the anticipated outcome is that the patient's condition will deteriorate and they will eventually die.
- Decide on a course of action and carry it out.
The nurse should respect the patient's decision, even if the nurse does not agree with it. If the patient agrees to undergo hemodialysis, the nurse should provide the patient with support and education. If the patient refuses treatment, the nurse should provide the patient with comfort care and support.
- Evaluate the results.
The nurse should evaluate the results of the decision. This may include assessing the patient's physical and emotional well-being. The nurse should also reflect on their own role in the decision-making process.
Nursing Advocacy
Nursing advocacy is the act of speaking up for and protecting the rights of patients. Nurses are in a unique position to advocate for patients because they have a close relationship with patients and they are familiar with the healthcare system.
In the clinical setting, nurses can advocate for patients by:
- Providing patients with information about their condition and treatment options
- Helping patients to understand their rights
- Assisting patients in making informed decisions about their care
- Speaking up for patients when their concerns are not being heard
- Protecting patients from harm
The nurse's role as a patient advocate is to ensure that patients receive the best possible care. Nurses can fulfill this role by being knowledgeable about patients' rights, being assertive in speaking up for patients, and being compassionate in their care for patients.
Conclusion
In the clinical situation described above, the nurse should advocate for the patient's right to make informed decisions about their care. The nurse should provide the patient with information about hemodialysis and the risks and benefits of the procedure. The nurse should also assess the patient's decision-making capacity. If the patient decides to refuse hemodialysis, the nurse should respect the patient's decision and provide the patient with comfort care and support.