This Scenario Has Been Modified From 2023 Keithrn LLC All Ri

This Scenario Has Been Modified From 2023 Keithrn Llc All Rights Res

This scenario has been modified from 2023 KeithRN LLC. All rights reserved. No form of this may be copied, reproduced, or used in any other manner outside of this course lecture without prior permission from the author Keith Richer.

Please read the following case scenario and answer the questions as they apply to decision making in critical care settings. Which findings from the present problem are most important are noticed by the nurse as clinically significant? Which data from the social history is most important and noticed by the nurse as clinically significant?

Most Important Findings Clinical Significance The patient’s vital signs and their current condition such as respiratory difficulties and fractured hip. The lab results are abnormal. The patient’s mental status because she has dementia. These findings are clinically significant because they show the urgency of the patient’s condition. These findings will also guide the clinical interventions to be applied in this case.

Most Important Findings Clinical Significance Family dynamics- Tom is the healthcare Power of Attorney (POA) while Julia is the financial POA. The patient’s family is actively involved in her care. However, Tom does not support his mother financially even though he took over the business. The clinical significance of these findings is that they are critical in decision-making. The emotional well-being of a patient is very important during treatment.

Additionally, treatment decisions will have to consider the patient’s financial support (Kydonaki et al., 2020). Practice Dilemma: Palliative care was consulted, and the physician documented the following: The daughter Julia visited this evening. Julia stated she would be present at the care meeting scheduled for tomorrow, along with two of her other sisters. When she arrived, Tom left the room abruptly, stating, “I can’t be in the room with her.” Which finding are most important and noticed by the nurse are clinically significant? To provide compassionate, holistic care for this patient, answer the following questions.

Most Important Findings Clinical Significance There seems to be a conflict between siblings (Tom refuses to be in the same room as Julia). Tom wants to be the one making all the decisions regarding his mother’s treatment. These findings are clinically significant because emotional distress in a family could negatively affect patient care. Family involvement is important in the provision of patient-centered care but these conflicts can make decision-making challenging (Kydonaki et al., 2020). What additional information is needed by the nurse to clarify the current practice dilemma? Describe the essence of the current practice dilemma in your own words.

What aspects of the American Nurses Association (ANA) Code of Ethics can the nurse use to clarify how best respond to this dilemma? What is the patient likely experiencing/feeling right now in this situation? The patient is probably feeling lonely and anxious because of the family conflicts. What can you do to engage yourself with the patient’s experience and show that they care? To engage with the patient, I would offer emotional support by communicating to them and giving them hope. I would also listen to their concerns and ensure that their ideas are considered as much as possible in decision-making.

Additional Information Current Dilemma/Problem Explore at least two models of critical care decision-making that can be applied to this situation. Please provide a description of these models, why they are specific to critical care, and apply them to handling the situation described in this case study. (Describe below) Ethical decision-making model - This model assesses the ethical impacts of a decision and seeks to uphold the rights of the patient (Haahr et al., 2020). In this case, the model can help to ensure that the patient’s autonomy is respected. Shared decision-making model - This model supports collaboration between the healthcare provider, patient, and family in decision-making (Tan & Volk, 2020). This model can help address the family dynamics concerns and ensure that the family collaborates in decision-making. What types of therapeutic communication can be used by the nurse to promote the physical and emotional well-being of the patient?

Nurse Reflection Reflect on your knowledge of decision-making caring for this patient answering the reflection questions below. ANA Code of Ethics Rationale Autonomy and Beneficence are two core ethical principles guiding decision-making by ensuring that patients’ wishes are respected and their well-being is promoted. Expected Findings

Reflection Question Nurse Reflection As you worked through this case scenario, how did it make you feel (using Emotional Intelligence to apply to the critical care setting here)? This case scenario made me feel empathy for the patient. I was also frustrated by the emotional distress in the family. What did you already know and do well? I already knew that family involvement is a source of ethical dilemma in nursing and therefore had an idea of how to address such a dilemma. What areas do you need to develop to improve? One area I need to improve is obtaining more training on conflict resolution and ethical decision-making to make better decisions. As a nurse leader, how would you provide sufficient resources for bedside nurses and charge nurses to make appropriate decisions in critical care situations like the one described here? As a nurse leader, I would provide resources such as training programs focused on emotional intelligence development and conflict resolution. What did you learn? How will you apply what was learned to improve patient care? I learned the importance of resolving family dynamics issues in healthcare and the importance of ethical principles. I will apply this knowledge to resolve ethical dilemmas and improve patient care.

References

• Haahr, A., Norlyk, A., Martinsen, B., & Dreyer, P. (2020). Nurses experiences of ethical dilemmas: A review. Nursing ethics, 27(1), 24-39.
• Kydonaki, K., Kean, S., & Tocher, J. (2020). Family involvement in intensive care: A qualitative exploration of critically ill patients, their families and critical care nurses (INpuT study). Journal of Clinical Nursing, 29(7-8), 1234-1244.
• Tan, N. Q., & Volk, R. J. (2020). Addressing disparities in patients’ opportunities for and competencies in shared decision making. BMJ Quality & Safety, 29(2), 75-78. http://dx.doi.org/10.1136/bmjqs-2019-010542