Obtaining a comprehensive health history or full physical examination is unnecessary until the acute distress has resolved. A focused physical assessment should be done rapidly to help determine the cause of the distress and suggest treatment. Although family members may know about the patient’s history of medical problems, the patient is the best informant for these data. 2. When preparing the patient with a right-sided pleural effusion for a thoracentesis, how will the nurse position the patient?
A clear solution to this dilemma would be if the patient had a DNR (do not resuscitate) advance directive. Unfortunately the patient does not have one and the family refuses to assign him one. According to the American Nursing Association’s code of ethics “The nurse’s primary commitment is to the patient, whether an individual, family, group, or community; as well as, The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient”(as cited by Potter & Perry, 2013, Pg. 288). In this scenario the family is now the voice of the patient and it is the nurse’s responsibility to carry out their wishes.
Even though many of these elderly patient’s have Living Wills in place, the dilemma at times is that the family is not quite ready to let go. The patient’s wish’s regarding what they would choose if faced with a terminal illness with no hope of recovery should take precedence over anything else, but this is not always the case. As healthcare workers, we are often faced with this dilemma, dealing with families not willing to let go, even though it is obvious that the patient is suffering and there is no chance of recovery. Is allowing the patient a “good death” what is morally right? Or, is honoring the family’s wishes to keep that patient alive at all cost morally acceptable?
I feel like my job as a nurse would be to make sure that no errors occur, and that the patient is safe at all times. When researching my topic, I learned that a lot of patients in the hospital die due to medical errors. I also learned that a lot of injuries occur among hospitalized older adults due to safety related issues. I think it’s sad that many people are being harmed and losing their life all because of something that could have been prevented. Patient safety is a huge issue that should never be overlooked.
If a doctor or nurse requires a chaperone, in the first instance, another clinical member of staff is asked for. If they are unavailable, then a member of reception is asked to chaperone. A chaperone should always be offered where necessary and in every instance it should be logged on the patients’ record if a chaperone was present, who it was, or that a chaperone was offered and declined. In an ideal world, a chaperone would be available any time a health care professional was required to carry out an examination, but this would not be cost effective as another member of staff would have to be hired to be on stand-by all day every day in case they were needed to chaperone, and very often a chaperone is declined by the patient which would waste these expensive resources. Since working through the PRP course and reading in the PRP Handbook Part One about chaperoning, I have spoken to my Practice Manager about how I can actively help to make staff aware of what being a chaperone requires and how I can make patients realise that a chaperone is available to them.
This also means that it would not allow information to be given out over the phone. When a physician refuses to give out a patient's information, it lowers the chance of the wrong person getting the information. This rule also gives the patient the rights over all his or her health information. However, this also means that the patient has the right to examine and obtain copies of any health records at any given time. The physician cannot refuse for any reason.
The Patient Bill of Rights has a significant impact and is essential for the people who are in the health care organization for the purpose of getting treatment properly and easily. In this scenario, June is suffering from anorexia and the doctors feel she may need to be placed on a feeding tube to save her life. June agreed to the procedure but became combative, disoriented and refused to have the tube place the evening before the procedure was to take place. The patient bill of rights applies, as the patient has a right to know what treatment options are available to one and what the possible outcomes may be. The patient has a right to decide one’s medical care.
Does the patient in this case have a right to an advance directive? Why or why not? Yes, everyone has a right to an advanced directive. Considering the case, the patient was told he had a terminal illness, and did not believe in today’s options for cancer treatment. The patient has the right to dictate specific measures regarding the type of care he wants in retrospect to his ending days.
Circulation refers to the flow of blood around the body from the heart to vital organs. In order to ensure adequate circulation, the patient may require the use of one or more intravenous (IV) tubes (Berniker). Through the IVs the patient receives fluids, drugs, and blood transfusions as needed to support circulation. When vital organs fail, the body cannot regulate these components, and must be quickly restored to a normal state by a doctor. Preserving the body’s internal equilibrium requires careful monitoring of innumerable indicators of the patient’s well-being.
A nurse may personally feel that a patient who is dying of cancer should utilize any and all pain management options available to them, however, if the patient does not wish to use pain medications because he/she feels “out of it” or is afraid of becoming “addicted”, the nurse needs to respect that patient’s choice. One may personally feel that a patient should try all treatment options available when dealing with an illness such as cancer, but needs to be respectful if a patient does not wish to continue treatment or try something new even if the nurse feels that is the “right” thing to do. B. In the scenario presented, different strategies can be used in the Thomas’s situation to improve the quality of life for Mrs. Thomas and her husband during this illness. First of all, discussing with Mr. and Mrs. Thomas what their wants/needs are is imperative.