As discussed in class with the classmates and the instructor, nursing encompasses optimization, protection and promotion of health and abilities. Nursing’s major objectives include diagnosis and treatment to alleviate pain and suffering, advocacy for care in various populations and prevention of injuries and illnesses. Optimum care for patients is the core of nursing practice. Nursing’s obligation is to ensure that the patient receives the best possible care. However, nurses sometimes face moral and ethical burden in care provision decision making; especially when doing what is considered right is limited by environment or legal considerations Lutzen (2010). In further discussion with the classmates, we identified various ethical considerations such as information privacy, autonomy, advocacy, beneficence and non-maleficence. In the paper, I would discuss patient autonomy and advocacy.
Miss Olive had been under my care for several months. The patient was suffering from Stevens - Johnson syndrome. In the process of giving care, Miss Olive and I developed a good rapport, and we were more of friends that a nurse and a patient. The patient was very knowledgeable of her condition; that according to prognosis was uncertain. In our routine discussion of the type of care Miss Olive would wish to be given incase her situation deteriorated to vegetable state; she disclosed to me that she would not wish for life sustaining measures and she should be left to die peacefully. The patient further disclosed that she had consulted widely with the family members about her decision, and the decision had been articulated in the durable power of attorney.
In august 2014, Miss Olive developed an arrest and became unconscious. Her condition required constant administration of dopamine to maintain the blood pressure. As the care team met to discuss how to execute the next treatment options, I informed the team about the wishes of the patient. The doctor in the care team and the management declared that the wish was against of values of the organization and nursing practice. The two argued that the failure to offer the patient care was of no different with assisting the patient to die.
The case of miss olive required the care team to choose between patient autonomy and patience advocacy. From my nursing experience and understanding, patient autonomy was supreme. The team should have discontinued the treatment according to patient wishes because her situation was terminal, and treatment of care elongated the suffering rather than alleviated it. Terminating the treatment was within the law as stated in the durable power of attorney and denial of services amounted to the violation of the patient rights. Guaranteeing Miss Olive her wishes meant that her family would have a peace of mind knowing that the wishes of their loved one were respected (Tschudin, 2013).
References
Lutzen, K. (2010). Nursing Ethics Into the Next Millennium: A context-sensitive approach for nursing ethics. Nursing Ethics, 218-226.
Tschudin, V. (2013). How Nursing Ethics as a Subject Changes: An analysis of the first 11 years of publication of the journal Nursing Ethics. Nursing Ethics, 65-85.
