Post a thoughtful response to at least two (2) other colleagues' initial postings. Responses to colleagues should be supportive and helpful (examples of an acceptable comment are: "This is interesting - in my practice, we treated or resolved (diagnosis or issue) with (x, y, z meds, theory, management principle) and according to the literature..." and add supportive reference. Avoid comments such as "I agree" or "good comment."
- Response posts: Minimum of one (1) total reference: one (1) from peer-reviewed or course materials reference per response.
- Response posts: Minimum 100 words excluding references.
For this discussion we are to talk about patient empowerment, different nurse/patient values and share a personal experience. My goal is to also tie in the importance of communication. Growing up I was taught that clear communication is a key in life. This definitely holds true in my personal life and work environment. In this environment every day we cross paths with patients who have different values than we do. These differences can include religious, political, healthcare and moral values and more. As nurses we are educated on this diversity and that we have to be transparent, although sometimes it is difficult. A factor to consider if you run into a situation where your values are polar opposite from your patient is understanding. The first step is to look at our self and evaluate our readiness to accept others, no matter what. Our attitude dictates how we respond to these situations (Burkhardt & Nathaniel, 2010, p. 495). This is sometimes harder to do than say, but understanding that your patient may come from a different culture, education background or socioeconomic class will help us be more open minded when hearing their view. I have recently run into an ethical dilemma when a patient was extremely defiant on all routine medical care that was ordered and needed. This patient was refusing PIC line dressing changes, various medications, even down to oral care and bathing. These decisions were completely against any beneficence for the patient. I felt like it was my ethical responsibility to help this patient make the right decisions for his healthcare. What I first responded with was trying to understand the patients point of view. I wanted to know specifically why he would refuse a multitude of things. Then my approach was education on the patient’s personal level. I usually try to get a baseline education level of each patient when I begin the nurse patient relationship. This way when it is time for me to educate them on a topic I know where to begin. I educate multiple times and reiterate the possible consequences of the unwise decisions being made. This is why clear and good communication skills are imperative, listening and educating. It is well known that thorough education can decrease non-compliance and increase good outcomes (Oliver & Mutluoglu, 2019). If my education does not spark question or concern from the patient, I will call the physician to come in with me and discuss the issues with the patient. I believe that if any patient is deemed competent to make sound decisions for themselves and have been educated on all sides of their plan of care and are still refusing, it is their right. I do not believe that there should be limits set on patient empowerment. I do agree with informing the patient that if they are going to refuse the majority of care put in place, they can sign out against medical advice. If they are going against what medical professionals recommend in the hospital, then there is no reason for them to be there.
Burkhardt, M., & Nathaniel, A. (2010). Empowerment for nurses. In Ethics and Issues in Contemporary Nursing (p. 495). Boston, MA: Cengage Learning.
Oliver, T. I., & Mutluoglu, M. (2019, January 15). Diabetic Foot Ulcer - PubMed - NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/30726013