End of Life
Ethical nursing care
Nurses are faced with ethical decision making on a daily basis. This could be both stressful and challenging. The following case study I chose to walk through is: Mr. Clarke is a patient who has advanced AIDS with related pain syndromes and is also actively abusing drugs. The nurse is concerned about his abusing his pain medications and is not sure if she should give them to him as he leaves the hospital. It will be my assumption that this patient is nearing the end of their life. The value, be, do ethical decision-making model will provide the framework I need to assess this case study (Schaffer and Norlander). I also will be using ethical decision making tools to guide my decision making process. What should I value?
The first step of the value, be, do ethical decision-making model answers the question what should I value? It is time that I look deep into the meaning of my life in regards to my professional nursing practice. What do I value in life? The meaning of life for me involves personal and professional respect for my patient and his physician in charge of his care. This involves respecting my patient and his situation. Also, trusting the prescribing Physicians education and training is something I value. Along with valuing respect; I value quality end of life care for my patient. Every individual deserves a peaceful death with minimal pain and suffering if possible. To obtain this, I also need to value my relationship with my patient. Developing a trusting relationship is important for him and also me when dealing with uncomfortable conversations that may have to take place. Finally, I think that I value my education and critical thinking skills. These skills are important to value because I will have to make a decision if I think my patient can handle taking his own pain medications on his own. My education and critical thinking skills will guide me to problem resolution that has the best outcome for the patient. Who should I be?
Not only is it important to understand what values impact my actions and decisions; it is also important to make sure my actions reflect my values. The values I have make sure that I am an advocate for my patient’s comfort as well as their safety. They also help me be an active and compassionate listener as well as a teacher. If I am a trustworthy person; my patient will hopefully feel comfortable talking to me about his addiction. Finally, to ensure a quality end of life experience for my patient, I will stay educated on medication dosages, side effects, and other treatments for pain. By critically thinking, I should be able to educate my patient and help communicate to the Physician about the patients concerns regarding pain addiction and pain control. What should I do?
By understanding what I value and who I am; I now should be able to fulfill my actions. First, I feel that I should take time to analyze the patients past medical history and medications that helped his pain. Second, I will review the pain medications with the Physicians to ensure I have a proper understanding of his or her plan. Then I will review what is needed to provide quality end of life care with good pain control to a dying AIDS patient. After I feel that I have a great understanding of the situation; it is time I listen and talk with my patient. Assure them that I am there as their advocate for safe and complete end of life care. This may require me to act as a counselor or bring in interdisciplinary team members to assist my patient. My number one goal is to provide safe end of life care; but as painless and comfortable as possible. Analyze response to case study
It is always challenging to give patients medications knowing that they may become, or have become addicted. In my current practice we see many patients who go to pain clinics and have pain contracts to help with...