Read the following case study and submit an essay on the ethical and legal decisions you would make.
Read the following case study and submit a 1- to 2-page essay in a Microsoft Word document using APA 6th edition in response to the questions.

Case Study:

Ann is a seventy-seven-year-old grandmother. She has one daughter and three grandchildren. Two years ago, she was diagnosed with moderately advanced Alzheimer’s disease, which causes her to have periods of confusion, frustration, anger, and obsessive thinking. When speaking, she is uncertain and her speech patterns are choppy. Before her mental deterioration, Ann was a woman of love, intelligence, and patience. Realizing they were getting older, she and her husband, Frank, discussed their wishes should anything happen to them. She told Frank that if there was no chance of survival, she would not want to be hooked to a breathing machine. They never got around to filling any papers.

Frank is a sweet and sensitive man. His wife’s state frightens him. Ann’s love for him has been the focus of his life for sixty years. His urgent desire for the best care for Ann shows his devotion and love. Their daughter, Sarah, is a businesswoman. She is a hard worker and a good mother. She is forty-five, successful, and intelligent. Although she loves her parents dearly, she lives ten hours away. She regrets not seeing much of them, especially recently. Frank feels his role is to take care of Ann. He has spent the past year with her, watching after her, cooking for her, cleaning the home, and witnessing her deterioration. Finally, Ann is unable to walk alone safely and he finds he must have her admitted to a long-term care facility. He calls Sarah to come and help with the arrangements. After having Ann admitted to a local nursing home, both Frank and Sarah remember the pleading look in Ann’s eyes as they walk away.

After three weeks in the nursing home, Ann starts to cough and run a fever. She is seen by doctors and diagnosed as having pneumonia. She is transferred to a local hospital, where she is given intravenous antibiotics. Although the progress of her pneumonia is halted by the antibiotics, she stops talking and refuses to eat. The physician calls Frank to insert a feeding tube. Frank calls Sarah to ask what to do. They wonder, Is a feeding tube equivalent to a breathing machine? Would it be possible to allow Ann to lie there and die of starvation? Is that murder? What would she want? What is the right thing to do? (Burkhardt & Nathaniel, 2008).

Respond to the following:

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1.Amanda Davis

Amanda_Davis_M4 A7 DB Outcomes of patient empowerment

Nurse and patient empowerment are closely correlated with one another. To recognize empowerment one must take ownership of our lives and understand we can control our actions and feelings (Nathaniel & Burkhardt, 2014). As nurses empowerment helps our profession to advocate for our patients with achieving their own empowerment.

Many different factors should be considered when dealing with decisions with our patients. Some include having cultural awareness. To help our patients we must understand their culture and be sensitive to their culture when providing nursing care. What do they like to eat to help promote healthy and adequate eating? Does these particular cultures believe in alternative medicine and might not agree with modern medicine or our current nursing practices?

A recent example of a patient situation where the patient posed an ethical dilemma for our hospital happened this week. Our nursing department contacted our ethics department and referred this patientâ€s case. A patient was admitted with a urinary tract infection. At baseline the patient was alert and oriented. This patient also had a life threatening illness that she had choose not to treat, a chronic health issue. The hospitalist physician consulted behavioral health to decide if patient had decision making capacity or lack thereof. Decision making capacity is ability to make a specific decision at that time (Cooper, 2010). The infectious disease physician wanted to treat the chronic issue, her attending physician did not want to treat as she made the decision while she was alert and oriented to not undergo treatment. Due to her acute illness the patient could not coherently answer questions.

Even if I had thought this patient was making an unwise decision, as a nurse I canâ€t make the decision. The patient had made her decision to not have treatment for her chronic disease. It is her choice and her trust in me at that moment was to follow thru with her choices. The patient received antibiotics for her urinary tract infection and mental status return to baseline. Our behavioral health deemed her competent to make her decisions, in which she still chose for non-treatment. There should not be any limits on patient empowerment. The nurse should advocate a non bias plan of care for their patients without fail.

Nurses should have effective communication skills to assist themselves with empowerment in nursing and in their own life, and to assist the patients that we take care of everyday (Burkhardt & Nathaniel, 2014). Understanding how everyone can be completely different in every way possible is sometimes hard to grasp when we group patients together so easily.

References:

Burkhardt, M. A., & Nathaniel, A. K. (2014). Ethics & issues in contemporary nursing. Stamford: Cengage Learning.

Cooper, S. (2010). Taking No for an Answer—Refusal of Life-Sustaining Treatment. AMA Journal of Ethics, 12(6), 444–449. doi: 10.1001/virtualmentor.2010.12.6.ccas2-1006

2. Andrey Demskiy

Patient empowerment

M4 A7 DB PATIENT EMPOWERMENT

In todayâ€s diverse society it is not uncommon for a nurse to have a differing viewpoint from a patient. When this happens, it is important for the nurse to consider cultural and spiritual factors that may be influencing the patientâ€s decision-making (Burkhardt & Nathaniel, 2014). The decisions the patient wants to make may seem silly to the nurse, but it is necessary to understand the patientâ€s point of view before passing judgment on the patient. One situation that could be an ethical dilemma for me is if I had differing viewpoints from my patient about how they should treat the rehabilitation process after an operation. For example in some cultures it is believed that the sick should lay and rest to get better. However the way rehab is approached nowadays, patients are often expected to get up and start walking or doing some other work with physical therapy the day after surgery so that they can recover more quickly. This would be a conflicting situation for me because as someone who wants what is best for the patient, I would want to encourage them to be as active as possible after surgery so they can make a quicker recovery. I would make sure that I properly educate the patient on the importance of physical therapy but in the end the choice would still have to remain with the patient and I would have to respect the decision that they make even if it is one that I do not feel is wise.

A nurseâ€s duty goes beyond just giving medications and providing treatments for the patient. It is the duty of the nurse to make a patient feel empowered about their health and providing education regarding their illness plays a big part in that (Chiauzzi et al., 2016). Of course there should be limits in patient empowerment especially if the patient is attempting to physically harm themselves. In that case as an advocate, the nurse must take action in order to prevent the patient from physically harming or worse yet killing themselves. In the end, the patients make their own healthcare decisions, but it is the duty of the nurse to properly educate and empower them so that they have the option of making the choices that are best for their health.

Sources

Burkhardt, M. A., & Nathaniel, A. K. (2014). Ethics & issues in contemporary nursing. Stamford: Cengage Learning.

Chiauzzi, E., DasMahapatra, P., Cochin, E., Bunce, M., Khoury, R., & Dave,

P. (2016, May 7). Factors in Patient Empowerment: A Survey of an Online

Patient Research Network. Retrieved November 21, 2019, from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5107186/.

Post a thoughtful response to at least two (2) other colleagues’ initial postings. Responses to colleagues should be supportive and helpful (examples of an acceptable comment are: “This is interesting – in my practice, we treated or resolved (diagnosis or issue) with (x, y, z meds, theory, management principle) and according to the literature…” and add supportive reference. Avoid comments such as “I agree” or “good comment.”

minimum of 2 references to each post. one from course material and another peer reviewed.

 

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