If the patient has an intellectual disability they may not be able to consent to treatment due to limited or no understanding of the procedure needing to be done. A substituted decision maker who is authorized by law (legislation such Guardianship Act 1987 NSW) will be appointed. Berman et al (2012 pp74-75) 3) Explain the term duty of care when caring for Elijah? The nurse has the responsibility of providing care to their patient at an acceptable standard within their scope of practice regardless if that patient has been assigned to them or not while they are on duty. Berman et al (2012 p 79) 4) Elijah may not be able to give his own consent and his guardian may be involved, as a nurse you may have to act as an advocate for your client.
Bi) How would you explain the term ‘confidentiality’ to Hannah? It is Hannah’s right to make decisions for herself and choose whether to take her medication or not. In this case from the information given it could be detrimental to her health as through Hannah not taking her prescribed medication she may be at risk of harm and therefore I would need to pass the information on to my Manager to ensure Hannah's wellbeing. It is Hannah’s choice who she shares information with and I would give her my assurance that the information would not be shared with her daughter. Confidentiality in general means that information will not be discussed outside of the social care setting.
301 Principles of communication in adult social care settings Task B case study Bi How would you explain the term ‘confidentiality’ to Hannah? Whilst it is Hannah’s right to make decisions for herself and choose not to want to take the medication, in this case from the information given it could be detrimental to her health and therefore I would explain to Hannah that the information given to me is in confidence. Although Hannah not taking her prescribed medication could put her at risk of harm and therefore I would need to pass the information on to my Manager to ensure her wellbeing is being addressed. It is Hannah’s choice who she shares information with and I would give her my assurance that the information would not be shared with her daughter unless she consented to it. Bii Describe the possible tensions that may arise between telling others of Hannah’s decision and keeping this information totally confidential.
(Blais & Hayes p. 91). When playing the part of patient advocate and helping family members to decide what is best for a patient that is unable to make their own competent decisions we refer to provision 1.4 the right to self determination of the American Nurses Association Code of Nursing Ethics. “In situations in which the patient lacks the capacity to make a decision, a designated surrogate decision-maker should be consulted. Support of autonomy in the broadest sense also includes recognition that people of some cultures place less weight on individualism and choose to defer to family or community values in decision-making. Respect not just for the specific decision but also for the patient’s method of decision-making is consistent with the principle of autonomy.
When the CNA ambulated the patient to the bathroom the family noticed a reddened area to the patients back and due to the lack of education of the CNA, this was not taken seriously. If the RN was assisting the patient, a skin assessment should have been done and prevention processes put in place to prevent any further breakdown. The condition of the patient’s skin at the time the patient was ambulated to the bathroom should have been documented and escalated to the provider. This would have been a Hospital Acquired Pressure Ulcer (HAPU) and is reported to the state as well as affects hospital reimbursement. Data collection is important to monitor the ongoing quality of patient care (American Nurses Association, et all, 1999).
NURSING ROLES AND VALUES 724.7.1-01,03,05, 7.2-01-05,07 2 In this case study the registered nurse is faced with two dilemmas regarding her own practice and the physicians in Mr. E’s medical care. The first ethical dilemma is regarding the patient’s wishes on the Advance Directive. The second dilemma involves the physician and HIPAA. In the first situation, Dr. K’s plan is to admit Mr. E to the Intensive Care Unit and place the patient on a ventilator. Mr. E has an Advance Directive in place that specifically indicates no cardiopulmonary resuscitation and no ventilators.
If this action was done right away, the patient might have had a chance to live. According to Bioethics: Principles, Issues, and Cases, “autonomy refers to a person’s rational capacity for self-governance or self-determination - the ability to direct one’s own life and choose for oneself” (Vaughn, 9). The article says, “In the event of a health emergency at this independent living community our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives….that is the protocol we follow” (Fox News). The faculty members at the facility are to respect the patient’s autonomy while they are in their care. The nurses know how to revive a patient in the case of an emergency while waiting for other medical help.
1.1 Explain what it means to have a duty of care in own work role In my role as a nursing assistant on an all-male Dementia ward, it is my duty to ensure that all patients in my care are having their wellbeing and needs met to the best of my ability. Which includes keeping them safe from harm. This could be from other patients, staff, carers or family. Also promoting their rights, independence and giving them choices, where possible about their care. In my work role I also have a responsibility to provide a duty of care to all patients receiving care.
Even though this was in the best medical interests of the patient, the court held that the surgery had been performed without full consent as it was clear that the woman’s religious beliefs forbade sterilisation. Consent that is invalidated by a lack of information could be considered not to meet the required standard of practice and could result in negligence. Depending on the patients’ capacity to consent, different pathways will be followed. If a competent patient does refuse consent, the nurse must explore the reasons why they refused it and ensure that they are making an informed decision by giving the patient all relevant information of the procedure and also the consequences of refusing the procedure. At this point the nurse can also bring in any alternatives to the treatment which the patient may prefer.
power of attorney stating who should speak for you if you become unable to make health care decisions for yourself, or a “living will” or “advance directive” that states your wishes about end-of-life care; give copies to your doctor, your family and your care team. If you or your family need help making difficult decisions, counselors, chaplains and others are available to help. Protection of your privacy.