Nursing managemnt - Assignment Example

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The essay aims to address a two-fold objective to wit: (1) to summarize the article; and (2) to explain the impact on organization in terms of financial, personnel, patient care, the reputation of the hospital, and legal ramifications.
Parker, Paine & Parker (2011) authored the…
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Nursing Management The essay aims to address a two-fold objective to wit to summarize the article; and (2) to explain the impact on organization in terms of financial, personnel, patient care, the reputation of the hospital, and legal ramifications.
Nursing Management
Summary of the Article
Parker, Paine & Parker (2011) authored the article entitled “Establishing an Analytical Framework in Law and Bioethics for Nurses Engaged in the Provision of Palliative Sedation” to address the ethical and legal issues that nurses need to understand and to draw a clear distinction between palliative sedation, voluntary euthanasia, and physician-assisted death (p. 58).
As a health professional, nurses often find themselves in an ethical dilemma when administering these palliative interventions; thus, authors of the article define and differentiate palliative sedation, voluntary euthanasia, and physician-assisted death. According to Parker, Paine & Parker (2011), palliative interventions differ only in terms of the actor’s identity as palliative sedation administer sedatives to relieve intractable pain and other distressing symptoms that often accompany later stages of a terminal illness, physician-assisted death prescribes barbiturate at a dose that enables patient to immediately terminate his/her own life when he/she chooses to ingest it, and voluntary euthanasia entails an affirmative act of one person to bring about the death of another (p. 59). Differences between the palliative interventions were clearly addressed but not the boundaries between law and bioethics which has caused ambivalence among health care providers, particularly nurses. The law grounds palliative interventions to the patient’s right to autonomy but the ethical distinction between affirmative interventions and passive decisions opposes the general application. Meanwhile, bioethics justify palliative interventions in terms of double-effect but some state laws limit application because palliative interventions might be considered as homicide subject to criminal prosecution.
In line with this, commentators proposed the development of clinical guidelines that are susceptible to universal population to enhance critical thinking and analysis of nurses in palliative measures and to create a framework for a focused decision process, and should include: education of medical and nursing staff, a provision that limit and incorporate safeguards, implementation of palliative after consultation of the attending physician to the interdisciplinary team, establishment of an internal mechanism, and adopting sedation to unconsciousness as a last resort (Parker, Paine & Parker, 2011, 63).
Impact on the Organization
Adopting a general framework for palliative interventions might affect the financial, personnel, patient care, hospital’s reputation, and legal ramifications. Davies & Higginson (2004) stated that people under palliative care viewed medical advances as an extra expense; however studies suggest that increased in an organization’s medical spending is not associated with higher quality care, better access to care, or better health outcomes or satisfaction (p. 12). Therefore, the financial implication of a general framework for palliative care is still undetermined. With regards to personnel, Parker, Paine & Parker (2011) stated that the adoption of a general framework for palliative care would enhance critical thinking and analysis of nurses and other medical staff in dealing with ethical and legal conflicts in end-of-life care (p. 63). Adopting a general framework for palliative would make an organization’s patient care more holistic, active, and individualized as the proposed framework combines the evidences from ethical and legal practice, thereby enhancing the hospital’s reputation and creating a positive image (Baldwin & Woodhouse, 2011, 10). Lastly, the legal ramifications of the proposed framework include a clear distinction between law and ethics and protection of health personnel from legal sanctions; however, following the due process might prolonged the pain and suffering of dying patients.
Baldwin, M.A. & Woodhouse, J. (2011). Attributes of Palliative Caring. Key Concepts in Palliative Care (p. 7-11). London: SAGE Publications Ltd.
Davies, E. & Higginson, I.J. (2004). Better Palliative Care for Older People (p. 1-36). Denmark: World Health Organization. Retrieved on December 9, 2011 from
Parker, Jr. F.R., Paine, C.J. & Parker, T.K. (2011). Establishing an Analytical Framework in Law and Bioethics for Nurses Engaged in the Provision of Palliative Sedation. Journal of Nursing Law, 14(2): 58-67. Read More
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