- Planned, organized, and established priorities based on individual patient’s needs and scheduled activities and adjusted priorities and activities in response to unanticipated events. - Delivered care and provided care coordination for patients in an intensive care setting. - Initiated and coordinated interprofessional team assessments and plans of care including physical, spiritual and psychosocial needs of patients across the continuum of care. - Developed plans of care to achieve identified patient goals in an intensive care setting including planning for transitions within and from the hospital setting. - Communicated regularly with the interprofessional team members throughout the patient care experience.…
The ethical dilemma here is that the patient is still lucid and not in a terminal state, should the medical staff ignore the DNR on a chart and hospitalize the patient with an intubation and ventilator or go with the patient's wishes? Since the patient is still lucid and understands the conditions, should the medical staff asks the patient's opinion if option if he/she will like to be hospitalized and incubated? Another ethical dilemma most common in the long-term care facility are the ethical dilemmas faced by the medical staff (nurses' aide, licensed practical nurses, registered nurses) in the use of restraints on dementia…
The Staff of Life Care had an Ethical responsibility and the duty to speak up for their patients’ rights regardless of the conflict it may have cause them with colleagues or opposing authorities. Also, Provision four of the Code of Ethics for Nurses states that it is in the authority of the nurse to delegate tasks to promote optimum care for their patients (Brown 2015). This did not occur with these patients. Life Care staff passively allowed Memorial to make decision regarding the care of patient they were ultimately responsible for. The instead of being assertive and advocating they relinquished their power and…
Application of Ethical Codes to Ethical Dilemmas I worked as a social worker in a long term care facility with a ventilator unit for 16 years. During my time there, there were a few residents who lived on the ventilator unit who decided to terminally wean off the vent or it was decided with the doctor on the unit, the guardian , and an ethic’s committee meeting a resident would terminally wean off the vent due to a poor prognosis, and lack of a acceptable quality of life. These decisions where rarely debated with most of the staff, family, physician, and administration in agreement for the wean to occur. However, when a younger woman with a young child decided she no longer wanted to live attached to a vent for the rest of her life, and stated…
Case Study Discussion Questions A. How are patients prioritized for bed assignment? I do not believe this case study talks about prioritization of beds. The case study mentions that “bed assignment is made on the basis of level of care required, the doctor preferences in the choice of the nursing unit, and the scope of care supported by the nursing unit”. The hospital I work for has a bed control department and the members of the bed control departments are basically triage nurses.…
Every nurse has the opportunity to make a positive impact on their patients and the nursing profession on a daily basis through the use of advocacy (Tomajan, 2012, Abstract section). Advocacy plays a significant role in nursing and must be demonstrated to give patients a voice when they are unable to express themselves to protect the patient’s safety and well-being. Throughout the novel A Nurse’s Story, Tilda Shalof actively demonstrated advocacy regarding her patients, which enhanced her qualities as a nurse. Advocating for a patient improves the quality of their stay at a health care facility and increases the likelihood for the patient to utilize health care services in the future. It is important for nurses to work together as a team to…
In medicine, multiple goals for patient outcomes exist including “preventing death,… cur[ing] disease, reliev[ing] suffering, and promot[ing] the well-being of the patient” (Veatch 53). Someone might argue that by choosing to remove the ventilator, the family may have attempted to meet another medical goal, that of a duty to relieve suffering. However, this argument does not appear to be substantive because it is ambiguous if the patient felt any sense of suffering. Therefore, it is difficult to accept this as a valid argument.…
Your proposed PICO question is very interesting and I would love to read more about your findings in your future posts. I do not have any experience in ICU, but I understand your stand on nurse-led extubation protocol. Like Cody mentioned that registered nurses spend their time at the bedside and know their patient very well. Thus, nurses should be able to perform this task without harming the patient. Before your post, I did not even know that the extubation was in the scope of practice for registered nurses.…
Because new graduate nurses often choose to specialize in critical care, nurse educators who design and teach undergraduate critical care nursing courses are obligated to address ethical decision making as part of the curriculum. In this article, I present a case study of an ethical issue in critical care and describe a method of clinical ethical analysis that nurse educators can use when teaching students about making ethical decisions in clinical practice. The presence of patients’ family members during cardiopulmonary resuscitation (CPR) is an…
The most frequent challenge of DNR orders is the lack of one. A DNR order, “Is arguably one of the most important decisions in patient care. Previous research suggests that patients and families might lack general knowledge about what the term do not resuscitate implies and this confusion can lead to added stress at already difficult times” (Robinson, Boyko, Berkowitz, Calam, & Collins, 2012). This can present a situation where ethical and moral decision making collide for a nurse. Ethically speaking, the nurse is to follow and advocate for their patient’s wishes, however, in some cases patients have not made their families aware of DNR orders that they have in place.…
My field supervisor was out sick today so I get to experience a new area of the hospital today, the ICU. It was so interesting to see how differently the ICU social worker, Lynne, works in comparison to Jamie. There is a lot less patient interaction since the ICU patients are in much worse conditions and a majority of them were not even conscious. Lynne’s case load seems much more complicated as she works with families and other agencies.…
Patient safety concerns in the acute care setting is an increasing focus of research. Increasing patient safety has become the golden standard. Such events as patient falls, and patient elopements may be reduced by the implementation of purposeful rounding process, while increasing patient satisfaction. Personal Practice Environment In the acute care setting, such as the emergency department and the medical-surgical unit, patient acuity varies, but the need to provide a safe care setting remains.…
ICD is an acronym for International Classification of Diseases. It is a medical code book that is used to classify and monitor disease diagnoses. It also provides information for health analyses like the study of mortality and morbidity trends. It is published and copyrighted by the WHO. No, that is not the legendary English rock band that asks Who Are You, I am meaning the World Health Organization which is a specialized agency of the United Nations that is concerned with international public health.…
Intensive care is an extremely expensive medical resource, and long term survival rates after admission are relatively poor (Parno et al 1982). As a result of both of these factors there are limitations placed on the number of beds available in intensive care units. Once it is acknowledged that these restrictions are necessary, it is important to determine and control exactly how the health service should be affected by these limitations. Admission to ICU could be limited as to provide each individual with the best healthcare available at the time, or to provide maximum fairness to individuals and the greatest utility to society. Throughout this essay, the idea of placing an upper age limit on admission to intensive care is used to illustrate…
The semester is nearing its end and I feel that I have grown personally and professionally during our clinical rotation at Saddleback Memorial Hospital. It has helped me recognize my strengths and areas for improvement, as well as given me a valuable outlook of what I want to do after graduation. Looking back at the previous weeks during this clinical rotation has brought some invaluable insights on nursing practice, safety, and advocacy. Preconceptions of Critical Care…