Creating a Policy
Purpose: You will analyze a situation where legal, ethical and moral decisions overlap using standards of nursing care and the ANA Ethics for Nurses.
Directions:
Read “The Solution\" at the end of Chapter 5. Using the reading and additional research materials, analyze the situation and accountability of care thoroughly. Develop a detailed and specific policy as a nurse manager to resolve the ethical practice dilemma in \"The Solution\". Be sure to discuss the implications of safety, ethics, outcomes, and legal issues. Use evidence-based research to support your policy.
Ensure that your viewpoint and purpose are clearly stated.
Demonstrate logical and appropriate transitions from one idea to another.
Your paper should be highly organized, logical, and focused.
The Solution
Acacia Syring
Staff members and nursing leadership began by working together to understand the varied viewpoints of the healthcare team. We attempted to understand why some of the primary healthcare providers allowed family members to be present and other primary healthcare providers insisted that family members not be present during resuscitation efforts. When asked, primary healthcare providers often noted that the behaviors and attitudes of the family members were a factor in their decision, and that one could not know in advance if the family members might be hostile or belligerent and thus distract or prevent the healthcare team from being able to provide necessary care. Additionally, no clear hospital policy existed, many of these primary healthcare providers were more comfortable in not having the family members present, and the current practice was to assign a chaplain and social worker to provide supportive services as well as comfort and information to family members when such situations arose. Thus the family members, though not present within the patient’s room, were also not alone during this time and had the opportunity to ask questions.
We then looked at the issue from an ethical perspective. For many patients and family members, being present during this crucial time could have many positive effects, thus beneficence and respect for others were the two ethical principles that most clearly seemed to support family presence. Seeing for themselves and understanding that everything possible was being done to save their loved one’s life were the most positive outcomes to support family presence. Family members could later have an opportunity to more fully question why certain aspects were performed, and the nursing staff as well as the primary care provider could then explain in more detail answers to the family members’ questions.
Viewing the literature about this topic was enlightening. We discovered that this topic has continually been studied, dating back to the early 1980s. These studies almost uniformly noted that family presence did not alter the effectiveness of the healthcare team’s interventions, nor did family presence interfere with the duration of resuscitative efforts or selection of medications. Some of the more recent studies addressed the issue of interference by family members and noted that very few family members were aggressive or in conflict with the team’s performance and that family members excluded from being present expressed regret at not having been present during resuscitation. Interestingly, some of the reviewed studies continued to question how to best determine which family members should be given the option of viewing resuscitation measures or if all families should be given this option. At present, we continue to explore possible guidelines concerning family presence during resuscitation, recognizing that such a complex issue cannot be rapidly resolved.
Would this be a suitable approach for you? Why?Accountability of Care and Ethical Issues
