Four hours after her initial presentation Elenore PDF

Preview

Summary

eywucvety...

Description

-

Four hours after her initial presentation Elenore’s pain score increased to 5/10. The RN explained the treatment and the plan of care in full to Elanore and her mother Elanore declined pain relief advising that she may pregnant and that she did not want her mother to know, the nurse did however, inform the doctor who ordered and ultrasound. Elanore and her mother are Jevah’s witnesses. Consent was gained and Elanore consented to receiving blood products without her mother consent. Her mother was angry and aggressive towards nurses when she discovered her daughter had a blood transfusion.

Introduction, Body and conclusion

Ethical Dilemmas: -

-

-

The ethical and legal concerns that arise in the treatments of Jehovah’s witness patients pose unique management challenges as the likelihood of acquiring consent for a blood transfusion is rare and, in most cases, can lead to poor health conditions and sometimes even death (Taylor et al., 2020). While Jehovah’s witness patients can present significant ethical and medical challenges to providers, the risk of morbidity and mortality can be reduced with careful and extensive planning that is suitable for patients and discusses blood-based and nonblood-based interventions patients are willing to receive (Scharman et al., 2017). Although Elenore gave consent to receive the blood transfusion it was evidently clear from Elanora’s mother’s reaction that had the Nurse asked her mother for consent to a blood transfusion she would not have consented to her daughter receiving the transfusion.

Utilitarianism and Deontology: -

-

Utilitarianism an ethical theory that determines right from wrong by focusing on the outcomes, the greatest good for the greatest number of people. (Time consuming) (Mandal et al., 2016). Deontology and ethical theory that states actions are good or bad according to a clear set of rules, right is right and wrong is wrong, focuses on an individual’s health (Mandal et al., 2016).

Beneficence and Non-Maleficence, Autonomy, Justice (Distributive Justice): -

-

-

Beneficence: Healthcare workers demonstrate this by providing a balance of benefits against risks to the patient. Assisting patients with tasks that they are unable to perform on their own, keeping side rails up for fall precautions, or providing medications in a quick and timely manner are all examples of beneficence (Haddad & Geiger, 2021). Non-Malefience: Non-maleficence requires that nurses avoid causing harm to patients. [6] This principle is likely the most difficult to uphold. Where life support is stopped or patients have chosen to stop taking medication that can save their lives, the nurse is put in a morally challenging position (Haddad & Geiger, 2021). Autonomy: Each patient has the right to make their own decisions based on their own beliefs and values.[4]. This is known as autonomy. A patient's need for autonomy may

-

conflict with care guidelines or suggestions that nurses or other healthcare workers believe is best. A person has a right to refuse medications, treatment, surgery, or other medical interventions regardless of what benefit may come from it. If a patient chooses not to receive a treatment that could potentially provide a benefit, the nurse must respect that choice (Haddad & Geiger, 2021). Justice: Justice involves how people are treated when their interest competes with others. [5]. A current hot topic that addresses this is the lack of healthcare insurance for some. Another example is with patients in rural settings who may not have access to the same healthcare services that are offered in metropolitan areas (Haddad & Geiger, 2021).

Consent: -

Informed consent is the process in which a health care provider educates a patient about the risks, benefits, and alternatives of a given procedure or intervention (Shah et al., 2021). Children (typically under 17) cannot provide informed consent. As such, parents must permit treatments or interventions. In this case, it not termed "informed consent" but "informed permission." (Shah et al., 2021).

Veracity (Truth telling): -

(Zolkefli, 2018) The provision of truthful information to patients is one way to enable them to make correct decisions which benefit their overall health. To consent to any health intervention, a person requires sufficient and truthful information to make an informed and conscious choice; arguably, patients cannot make effective decisions without truthful information (Zolkefli, 2018).

Fidelity: (Hanson et al., 2016) Negligence: Gr i ffit h,R.( 2019) .Negl i gencei saci vi l wr ongorTor tandi sbes tdefi nesas‘ act i onabl e har m’ . -

Negl i genceoc c ur swher eapat i entwasowedadut yofc ar ebyt hedi s t r i c tnur s e, t her ewasabr eac hoft hatdut yofc ar eandt hebr eac hofdut yc aus edl os sorhar m r ec ogni s edbyt hecour t s .

Scope of Practice: (Nursing and Midwifery Board of Australia - Nurse Practitioner Standards for Practice - Effective from 1 March 2021, n.d.) Capacity and competence: Gr i ffit h,R.( 2018) . Documentation: Sel v i ,S.T.( 2017) . -

Documentation is a vital aspect of nursing practice. It involves entering data that requires the use of clear, concise and complete words in the client’s record. This is also referred as charting. This chart can be accessed by the client, physical therapist and the pharmacist or

-

other members of the health care team. The client’s consent is needed before the chart can be seen by other persons like a relative. Record keeping is an integral part of nursing practice. It is a tool of professional practice and one that should help the care process.

Taylor, B. E. S., Narayan, V., Jumah, F., Al-Mufti, F., Nosko, M., Roychowdhury, S., … Gupta,G. (2020). Ethical and medicolegal aspects in the management of neurosurgical emergencies among jehovah’s witnesses: clinical implications and review. Clinical Neurology and Neurosurgery, 194. https://doi.org/10.1016/j.clineuro.2020.105798

Scharman, C. D., Burger, D., Shatzel, J. J., Kim, E., & DeLoughery, T. G. (2017). Treatment of individuals who cannot receive blood products for religious or other reasons. American Journal of Hematology, 92(12), 1370–1381. https://doi.org/10.1002/ajh.24889 Mandal, J., Ponnambath, D. K., & Parija, S. C. (2016). Utilitarian and deontological ethics in medicine. Tropical Parasitology, 6(1), 5–7. https://doi.org/10.4103/2229-5070.175024 Haddad, L. M., & Geiger, R. A. (2021). Nursing Ethical Considerations. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK526054/ Shah, P., Thornton, I., Turrin, D., & Hipskind, J. E. (2021). Informed Consent. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK430827/ Zolkefli, Y. (2018). The Ethics of Truth-Telling in Health-Care Settings. The Malaysian Journal of Medical Sciences : MJMS, 25(3), 135–139. https://doi.org/10.21315/mjms2018.25.3.14 Hanson, L. C., Song, M.-K., Zimmerman, S., Gilliam, R., Rosemond, C., Chisholm, L., & Lin, F.-C. (2016). Fidelity to a behavioral intervention to improve goals of care decisions for nursing home residents with advanced dementia. Clinical Trials (London, England), 13(6), 599–604. https://doi.org/10.1177/1740774516650863 Griffith, R. (2019). Negligence and the standard of care in district nursing. British Journal of Community Nursing, 24(1), 35–37. https://doi.org/10.12968/bjcn.2019.24.1.35 Griffith, R. (2018). Capacity to make decisions: providing the relevant information. British Journal of Nursing (Mark Allen Publishing), 27(7), 408–409. https://doi.org/10.12968/bjon.2018.27.7.408

Selvi, S. T. (2017). Documentation in nursing practice. International Journal of Nursing Education, 9(4), 121–121. https://doi.org/10.5958/0974-9357.2017.00108.8 Nursing and Midwifery Board of Australia—Nurse practitioner standards for practice—Effective from 1 March 2021. (n.d.). Retrieved April 21, 2021, from

https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professionalstandards/nurse-practitioner-standards-of-practice.aspx...