Ethical Dilemmas In Emergency Nursing
Have you had to assist a patient and their families with self-determination? If so, did you have support from your peers and organization at that time?
In the emergency department (ED) the most frequently encountered circumstance with respect to self-determination, is the patient who arrives via emergency medical services (EMS) in extremis who is a no code and objects to extraordinary measures, however, the family desires intervention. Emergency nurses retain a legal and ethical obligation to affirm the patient’s autonomy regarding the decision for no resuscitation and allowance of a natural death (Emergency Nurses Association, 2014).
There is excellent support in our ED when encountering the difficult situation of patient and family conflict …show more content…
Very few patients seeking care in the ED possess an advanced directive (AD), however, when a patient does provide and AD, it is placed into their medical record and observed.
What are potential risks and consequences associated with exhibiting moral courage in the case of Mr. T?
It is a necessity that nurses recognize their own feelings regarding death and dying and have a strong ethical framework in order to support the end-of-life wishes of their patients (Butts & Rich, 2013). Even if one is resolute in their own moral standing, cases such as Mr. T.’s may be emotionally exhausting.
Furthermore, if Mr. T.’s son had not been able to dismiss his defensive posture and remained unwilling to participate in the conversation regarding his father’s request, the nurse may have risked alienating the son and losing his trust.
What did the nurse do right in this case?
The nurse was a strong advocate for Mr. T.’s desire for no heroics, despite the initial pushback from the physician and Mr. T.’s son. The nurse offered Mr. T.’s son support when she offered to contact his sister and pastor. Mr. T. was not removed from the ventilator until 24-hours later, which indicates the nurse’s persistence was essential in convincing the son to support Mr. T.’s last wishes (Lachman,
In the emergency department (ED) the most frequently encountered circumstance with respect to self-determination, is the patient who arrives via emergency medical services (EMS) in extremis who is a no code and objects to extraordinary measures, however, the family desires intervention. Emergency nurses retain a legal and ethical obligation to affirm the patient’s autonomy regarding the decision for no resuscitation and allowance of a natural death (Emergency Nurses Association, 2014).
There is excellent support in our ED when encountering the difficult situation of patient and family conflict …show more content…
Very few patients seeking care in the ED possess an advanced directive (AD), however, when a patient does provide and AD, it is placed into their medical record and observed.
What are potential risks and consequences associated with exhibiting moral courage in the case of Mr. T?
It is a necessity that nurses recognize their own feelings regarding death and dying and have a strong ethical framework in order to support the end-of-life wishes of their patients (Butts & Rich, 2013). Even if one is resolute in their own moral standing, cases such as Mr. T.’s may be emotionally exhausting.
Furthermore, if Mr. T.’s son had not been able to dismiss his defensive posture and remained unwilling to participate in the conversation regarding his father’s request, the nurse may have risked alienating the son and losing his trust.
What did the nurse do right in this case?
The nurse was a strong advocate for Mr. T.’s desire for no heroics, despite the initial pushback from the physician and Mr. T.’s son. The nurse offered Mr. T.’s son support when she offered to contact his sister and pastor. Mr. T. was not removed from the ventilator until 24-hours later, which indicates the nurse’s persistence was essential in convincing the son to support Mr. T.’s last wishes (Lachman,