NR 341
NR 341 Week 1 Clinical Medication Assignment
NR 341 Week 1
NR 341 Week 1 Clinical Medication Assignment
1. Login to Medscape.com and register
... [Show More] for the site (no charge)
2. Search for “Ethical Dilemmas in the ICU” (July 1, 2014)
3. Read the article.
4. Answer the following questions.
a. What would you have done differently about LJ’s care than what was provided? Include your objective thoughts on the overall situation and your feelings about the situation.
b. Besides the changes described in the scenario regarding a different approach to caring for the seriously ill, what other changes could be made?
c. Why do you think nurses do not feel a part of the team regarding end of life decisions?
d. How can nurses change that dialogue?
e. How will you change that dialogue?
Answers
a. What would you have done differently about LJ’s care than what was provided? Include your objective thoughts on the overall situation and your feelings about the situation.
In this situation, I would have continued to advocate for my patient, and take my concerns and observations higher, as needed, until something was done. Everyone has a boss. I feel as if the residents, being new, were afraid that they may be the one to deliver the final dose of opioids that finally caused the patient to die. I believe ongoing discussion is needed that death is a normal part of the life cycle, and nothing to fear. The nurses, more likely than the residents and fellows, have seen death. They also spend more time with the patient, both observing and providing care. It had already been agreed upon by all parties that LJ was not going to survive, and her husband did say that he wanted pain management to continue. Pain medications should have continued to be delivered at the same rate. Death should not have to be painful if we have the means to provide comfort.
b. Besides the changes described in the scenario regarding a different approach to caring for the seriously ill, what other changes could be made?
New doctors should be counseled more thoroughly on the process of death and dying. They should be encouraged to explore and discuss their own views, feelings, beliefs, and fears on the topic. Possibly include more seasoned doctors and nurses in the discussion. I feel like once the stigma of death is explored or removed, these issues could possibly resolve themselves.
c. Why do you think nurses do not feel a part of the team regarding end of life decisions?
The nurses did not feel part of the team because they weren’t being treated as part of the team. The ICU nurses are the ones that handle the day to day care of the patient and families. They are usually intimately familiar with what the families want for their loved ones, and they deal with the emotional fall out. Since the nurses spend so much time interacting with the patient, their input should carry more weight than it did in this scenario.
d. How can nurses change that dialogue?
Nurses need to stand up for what they believe in, but in a respectful and tactful manner. There are many resources that can be used, from the floor manager to the ethics committee. Nurses must always advocate for their patients and be their voices if they don’t have one.
e. How will you change that dialogue?
Hopefully, I will be able to effectively communicate my observations and concerns to those around me to best serve my patient and their families. I will ensure that I know my chain of command and who to go to with issues. If I see an area for improvement, I will speak up. I will also keep up with the most recent studies to stay informed. [Show Less]