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Test 3- ethics, legal issue in nursing, evidenced based practice

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  • - Ethics, Legal Issue In Nursing, Evidenced

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  • 11 augustus 2024
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  • - ethics, legal issue in nursing, evidenced
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Test 3- ethics, legal issue in nursing,
evidenced based practice
-directs all aspects of an organization - ANSWER--the mission

-values

-financial practices

-how it responds to the needs of the community

1: Preference of the patient

What does the patient want?

Expected to get better upon admission

Did not specifically say "do everything."

5/20:per MD notes: "earlier conversation with pt indicated he would probably not want to d/c support."

What are the patient's goals? We don't know

Does the patient comprehend? No, per MD notes

Is patient mentally competent? No

Is patient consenting voluntarily? No-vent dependent, unable to respond - ANSWER-

2 parts of moral distress - ANSWER--First causes frustration, anger, guilt, anxiety, withdrawal, self blame



Reactive distress- lingering feelings that can accumulate over time with each new incidence

2: Quality of Life

Does injury or illness threaten to actually or potentially reduce quality of life? Yes

What does quality of life mean to patient? We don't know

How do others perceive the patient's quality of life?

Son→futile

Who should make the decisions of quality of life? At this point... - ANSWER-

3 patterns emerge from reactive distress - ANSWER-1. increased response leads professional to engage
in actions of conscientious objection ( failure to follow orders)

2. desensitization which leads to withdrawal

3. strong physical and psychological stressors which can lead to burnout and leaving the profession.

3.Contextual

Financial: ??

,Test 3- ethics, legal issue in nursing,
evidenced based practice
Social arrangements

1 son

Born in Greece

Lived independently prior to hospitalization

Attitudes of others

Son-futile care, no potential for improvement, prolonged suffering - ANSWER-

4: Indications for Medical Intervention

Diagnosis: CHF, CRF, Ascites (wt ↑25 lbs), End-stage cardiac and respiratory failure

Prognosis:

5/15: pulmonary consult- "overall poor"

5/22: "End stage CHF awaiting terminal event; on maximal support."

Treatment of the medical problem:

Max treatment: meds, vent settings - ANSWER-

advance directives: Children - ANSWER-Innocent 3rd parties



Courts will grant an order allowing doctors to treat children of Christian Scientists or Jehovah's
Witnesses who have denied consent for treatment of their minor children

advance directives: living wills - ANSWER-Written document



Directs treatment according to client's wishes



May be difficult to interpret

Americans with Disabilities Act (ADA) (1995) - ANSWER--Federal statute enacted by U.S. Congress



-Protects the rights of handicapped in the workplace, in educational institutions, and throughout society

autonomy - ANSWER-the commitment to include clients in decisions about all aspects of care.

beneficence - ANSWER-taking positive actions to help others.

bioethics - ANSWER--Ethical questions surrounding biological sciences and technology

, Test 3- ethics, legal issue in nursing,
evidenced based practice

the application of ethical principles to healthcare

case study- end of life

-67 year old male; one son, ex-wife, no other significant others; no advance directives or living will

-Admitted with Congestive heart failure, Chronic renal failure, Ascites, End-stage respiratory and cardiac
failure

-Ventilator dependent; 02 sat=42% on max settings; max treatment;

-MD & patient's son requesting ethics consult to assist with decision/recommendation. - ANSWER-next
slide

Civil and Common Law Issues in Nursing Practice - ANSWER--Student Nurses: expected to perform as
professional nurses would, in providing safe client care.



-Malpractice Insurance



-Abandonment & Assignment Issues

*Short staffing

*Floating

*Physician's Orders

civil law - ANSWER--Protects the rights of individual persons within society.



-Harm to an individual or to property



-Punishment: $$

clinical ethics - ANSWER-Decisions made at the bedside and other client care issues

consent for DNR - ANSWER--Client

-Surrogate with 2 MD's

-2 MD's

-Terminal condition

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