Phenomenological Perspective Integrated in the Nursing Practice - Case Study Example

Running head: PHENOMENOLOGICAL PERSPECTIVE Phenomenological Perspective Integrated in the Nursing Practice - Patient w/ Cerebrovascular Accident, Post-Strike Dementia, and DNR - Student’s Name Student Number Course Name and Number Name of Professor Date of Submission Number of Words: 1,306 Introduction The legal, clinical, and ethical dimensions in nursing health care practices are all interrelated with one another in the sense that the ethical dimension of nursing health care practices serve as the universally accepted medical and health care professional practices in terms of moral issues. Since understanding the past events could help us understand the challenges that most health care professionals are facing today (Smith & Liehr, 2005), it is necessary to conduct a research study that is applicable in the case of Mr. Smith. Evidence-based practices and nursing theories serve as the basis in nursing practice (College of Nurses of Ontario, 2006). Therefore, health care professionals are mandated to follow the CNO’s ethics practice standard which includes the need to identify ethical issues and communicate it with the health care team, consider options to solve ethical issues, evaluate the effectiveness of the plan, and ensure that personal values is in accordance with the professional practice (College of Nurses of Ontario, 2002, p. 6). The purpose of this study is to encourage nursing students to learn more about the significance of health care ethics in the nursing profession. As part of solving the ethical concerns behind the case of Mr. Smith, the following questions which are presented in Appendix I on page will be used as a guide in analyzing the case. About the Case Mr. Smith was diagnosed with cerebrovascular accident (CVA) and post-stroke dementia a couple of years ago. As a private nurse in a nursing home, it is my duty to provide the patients with holistic care not only by caring and assisting them with their prescribed treatment by also to listen to the patient’s concerns regarding his pain and preferred treatments. Despite wanting to not to receive lab tests, CPR, and other health care intervention like medication and the use of tube feeding devices, Mr. Smith’s family members including his son and daughter were intervening in the decision-making process as his substitute decision makers. Ethical and Legal Considerations with Regards to the Proper Care and Treatment of Mr. Smith Ethical theories such as autonomy, informed consent, non-maleficence, beneficence, and justice guides the nursing students on how one should care and treat for patients (Bailey, 2007). As a universally accepted health care ethics, health care professionals including the nurses are mandated to respect the patients’ decision-making for their own treatment all the times (College of Nurses of Ontario, 2002, p. 6; Department of Health, 2001). Given that Mr. Smith is firm in his decision not to receive any forms of treatment and laboratory tests, it is important for nurses to respect and grant his requests provided that the health care professionals are confident that the patient is in the right frame of mind at the time Mr. Smith made his final decisions (Department of Health, 2008, p. 3). By doing so, health care professionals will be able to satisfy the ethical principles of autonomy and justice. In case Mr. Smith is not emotionally stable to make his own decisions, health care professionals should give Mr. Smith ample time to calm down until he is no longer emotionally unstable. To avoid legal charges from his family members, health care professionals on behalf of the nursing home should ask Mr. Smith to sign a contract stating that he no longer wanted to receive and participate in any forms of medication and other treatment as prescribed and recommended by his family doctor . The ethical principles of deontology is pertaining to the positive actions of health care professionals based on the set of health care practices that is acceptable in the professional health care law and ethics. In other words, deontology is about the rightness or wrongness of a chosen action which highly depends on moral issues (Audi, 1999, p. 247). Therefore, health care professionals should avoid acting on pure motive alone. Instead, this group of professionals should consider what is logically right aside from the probable outcome of an action when providing care to the patients. Before allowing Mr. Smith to make his own decision with regards to his preferred care and treatment, health care professionals should inform the patient about the general facts concerning the process, advantages, and disadvantages of his treatment, physical assessment, and the provision of personal daily care (College of Nurses of Ontario, 2002, p. 6; Department of Health, 2008, p. 1). In line with this, health care professionals should make it a habit to inform the patient about the treatment procedure and ask the patient’s approval prior to the treatment. Under the common law or case law, the act of ‘touching the patient’ without the patient’s consent is already a ground for professional negligence given that the patient is harmed as a result of the care or treatment given to him by the health care professionals (Department of Health, 2001 a, p. 2). Aside from the ethical principles behind autonomy, health care professionals should also consider other ethical issues including the practice of non-maleficence1, beneficence2, and justice3 (Bailey, 2007; Tuckett, 2005). In order to satisfy the ethical principles of beneficence, health care professionals should continuously uplift the health and well-being of the patient by assisting him with his daily activities of living which focuses on his personal hygiene. Likewise, nurses should provide the patient with holistic care. Even though Mr. Smith was firm about his decision not to receive any forms of medical treatment and tests, health care professionals are still responsible in ensuring that the patient’s remaining life is comfortable (Smith & Liehr, 2005). Applicable to any kinds of health care situation, the health care professionals should strictly abide with the guidelines and standards used in the practice of health care ethics (College of Nurses of Ontario, 2002, p. 3). In relation to the ethical principles of justice, health care professionals should respect both sides of the party by being transparent and explaining the advantages and disadvantages of each health care decisions without aggravating the conflict between the patient and his family members. To promote transparency, health care professionals should meet with the patient, the patient’s family members, and the rest of the health care team when discussing the advantages and disadvantages of not receiving lab tests, CPR, and other forms of life-prolonging devices. Recommendations Given that the health care professional is in the middle of balancing the main concerns of the patient and his family members, it is best to call upon the assistance of a social worker in evaluating the case and free the health care professionals from any forms of health care negligence and malpractice (Carr, 2009; Robbins & Birminghams, 2005). In case the health care professionals are not clear with regards to the legality of the given situation, it is best for health care professionals to seek the professional assistance of lawyers who are specializing in the management of health care related cases (Fasler, 2009). Conclusion As a health care profession, nursing is a very unique in the sense that nurses are made responsible not only in the process of providing care to Mr. Smith but also to search for ways the will enable the nurses properly deal with the patient’s case despite his cultural backgrounds, beliefs, and personality. In case nurses has to deal with sensitive issues such as in the case of Mr. Smith, subjects related to health care ethics, the code of nursing profession including the legal issues that are highly related with nursing profession should be given importance in order to avoid facing legal charges coming from the patient’s family members. Since health care ethics, the code of nursing profession, and legal issues are all interrelated subjects, health care professionals should make it a practice to use these subjects as a guide when making a morally acceptable judgment and decisions about the care and treatment of the patient. *** End *** Appendix I – Relevant Questions 1. What is the ethical dilemma behind the case of Mr. Smith? 2. How can nurses handle patient’s refusal of care and termination without the need to face legal charges coming from the patient’s family members? 3. How does the ethical principle of autonomy differ from beneficence and justice? 4. How can health care professionals avoid facing legal charges with regards to work negligence? 5. How can health care professionals handle sensitive situations in case they are not sure of the legal consequences of their chosen action? References Audi, R. (1999). The Cambridge Dictionary of Philosophy. 2nd ed. UK: Cambridge University Press. Bailey, G. (2007). NASW Standards for Social Work Practice in Palliative and End of Life Care. Retrieved November 5, 2010, from National Association of Social Workers: http://www.naswdc.org/practice/bereavement/standards/default.asp Carr, D. D. (2009). Building Collaborative Partnerships in Critical Care: The RN Case Manager/Social Work Dyad in Critical Care. Professional Case Management , 14(3): 121-132. College of Nurses of Ontario. (2006). Retrieved November 5, 2010, from Professional Standards: Knowledge Application: http://cno.org/Global/prac/learn/modules/profstands/slides/KnowledgeApplication.pdf College of Nurses of Ontario. (2002). Retrieved November 5, 2010, from Professional Standards, Revised 2002. Practice Standard: http://www.cno.org/Global/docs/prac/41006_ProfStds.pdf Department of Health. (2001, March). Retrieved November 5, 2010, from References Guide to Consent for Examination or Treatment: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4019079.pdf Department of Health. (2008). Retrieved November 5, 2010, from Seeking Consent: Working with Older People: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4009325 Fasler, K. S. (2009). Article: In a Nutshell: Use of the Collaborative Law Process to Resolve Medical Issues. Journal of Nursing Law , 13(1): 4-12. Robbins, C. L., & Birminghams, J. (2005). The Social Worker and Nurse Roles in Case Management: Applying the Three Rs. Professional Case Management , 10(3):120-127. Smith, M., & Liehr, P. (2005). Story theory: Advancing nursing practice scholarship. Holistic Nursing Practice , 19(6): 272-276. Tuckett, A. (2005). The Care Encounter: Pondering Caring, Honest Communication and Control. International Journal of Nursing Practice , 11(2):77 - 84. Read More