Nursing Roles and Value Task 1

treat Roles and Value Western Governors University nurse Roles and Value NVT2 Competency 724. 7. 1 Ethical Leadership Competency 724. 7. 2 Continuing Competency in breast feeding Marisha Grimley Course Mentor March 04, 2012 Nursing Roles and Value The mark of this paper is to evaluate a instance study addressing ethical leadership, analyzing industriousness of standardized grave of ethics on treat pr spotice, and discussing issues in preventative for quality enduring c atomic number 18.This paper go away support the importance of confidentiality when discussing saved tolerant avouchation. In addition, the need for continuing education and training for treat through identification of federal and State regulations as applied to reserve got practice will be addressed. The discussion will touch on how these regulations are applied in specific treat settings and the professional function of misgiving for in the ever changing surfaceness reverence spoken confabula tion system.State regulation or standard of prevail practice The contemporary rendering of care for according to the Scope and Standards of Practice (2010) is Nursing is the protection, promotion, and optimization of wellness and abilities, prevention of illness and injury, all in alleviation of suffering through the diagnosis and interposition of human response, and advocacy in the care of individuals, families, communities, and populations. (p. 66).According to the Standards of professional Nursing Practice, this scenario violates nursing Standard 7 morals which states The registered Nurse Delivers care in a way that preserves and protects healthcare consumers autonomy, dignity, rights, values, and beliefs. (The Standard of professional Performance, 2010, p. 47). The fellate does non follow the standards of practices booster cable to the several(prenominal) implications. When asked by Dr K. to look in the graph to determine if whateverone was responsible for Mr.Es me dical mark fashioning, the nurse fai direct to inform Dr K that the diligent of had an Advance leading (AD) that specified he not be placed on a ventilator or grant cardiopulmonary resuscitation. By not bringing forward this information the nurse did not fulfill her duty of protecting the patients autonomy. She neglected the AD that Mr. E, despite creation a mildly developmentally delayed, had throw up into place sooner this hospital admission. Mr. E accomplished this task with the back up of the nursing home patient advocate thus providing documentation roughly his medical wishes.Seven years prior, Mr. E had shown the superpower to make his own health care decisions. He chose the pathway of his care by checking himself into a nursing home. The nurse assumed, because the provider had stated that the patient was hypoxic (88% room air is hypoxic), that Mr. E could not make his own medical decision. Mr. E verbalized judgment of what his progression of care would be by s tating to Dr. K, shaking his head and grammatical construction Go away No No Take me home. In this instance, the nurse did not act as a patient advocate.The nurse should hit relayed this information to Dr. K. If Dr. K had insisted that the patient was in an impaired hypoxic state, the nurse should accommodate reported the situation to her immediate nursing supervisor who could fuddle intervened as a patient advocate, working to insure that the patients wishes be granted. The nurses failure to act as a patient advocate and watch over Mr. Es right to self-determination resulted in the patient cosmos intubated and placed on a ventilator against his wishes. The nurse also failed to uphold a patient right to confidentiality.She go against the Federal health Insurance Portability and Accountability Act (HIPAA) confidentiality laws. The nurse did not handle up and question the provider when the patients wishes were being questioned, leading to the patients rights, values and beli efs being disregarded. Nursing enactment of Ethics by ANA The nurse violated more than one preparedness from the Nursing Code of Ethics. One of the provisions that apply to this case study is provision 3, which states The nurse promotes, advocates for, and strives to protect the health, safety and rights of the patient. (Code of Ethics for Nurses, 2010, p. 16). The impact on a professional decision, according to provision 3, would be that the nurse should deem provided a private place for the doctor to discuss the case with the family component. Furthermore, the nurse cannot plunder the fiduciary duty of confidentiality by allowing the provider to speak with a family member that was not part of the power of attorney. As well, the nurse has to remember that it is a breach of confidentiality and trust when she speaks with others, such as colleagues in a cafeteria that are not touch with the patients care.The ethical implications ca utilise by placing Mr. E on a respirator were t hat the patients right of decision making his own path of handling was violated. The patient Bill of Rights (Roux & Halstead, 2009) allows the patient to avert medical treatment. Like every individual, Mr. E. has the power of controlling the type of care given to him, a keen-sighted with having control to make decisions that influence self without hinderance of others. Mr. E, through narrative ethics, had set his healthcare decision precedents. He had make his wishes known by signing an AD. Once Mr.E was intubated further ethical makeations will surface because he may be ventilator dependent or he may die from ventilator induced complications. These possibilities would be avoided by adhering to his original AD. In order to give ethical consideration to this decision, before agreeing with his brothers intubation and placement on the ventilator, Mr. Y should have requested that all the facts be made available to him. Through the manner in which the case scenario is presented, Mr. Y is not involved in Mr. Es demeanor decisions even though he is entrusted with Mr. Es final manners history decisions.Any hospitalization is a stressful situation for all parties, the patient and family. In this scenario it is even more stressful because it is a life and remnant decision. Mr. Ys brother is diabetic with a muniment of high blood pressure. Mr. Y has to face the ethical issues of quality of life versus quantity of life in deciding to follow his brothers wishes or not. Mr. Y most likely did not understand a lot of what was happening and may have felt that it was too atrocious a decision to let his brother die if no adventurous measures were passn. Mt. Y asked for his nieces opinion, indicating Mr.Ys inability to make a decision. As a patient advocate, the nurse should engage in multidisciplinary support to foster family understand the court-ordered aspects and obligation of the power of attorney in making life end decisions and the legal obligations of the Ad vance Directives. Nurse must be firm in stressing these considerations to family so they may realize the full legal and ethical implications of their decisions. The importance of end of life issues and decisions are now being discussed at the time of admission to most acute care and long term acute care facilities.More attention is being placed on these specific decisions to ensure that the patients quality of life is considered and maintained even when death may be eminent. It is essential to keep in mind that Mr. E may have been hypoxic, but he had not shown any signs of not being able to make decisions. The scenario does not describe Mr. E exhibiting any signs of profit hypoxia, such as an altered metal state, cyanosis, tachypnea, cardiac arrhythmias or coma. Mr. E verbalized his disagreement to the procedure by saying Go away No No Take me home. Factors that complicate Mr. Es advance directivesThe validity of Mr. Es AD is not in question. The State of California has a specific form for AD that describes the necessary steps for the AD to be valid. (Form PS-X-MHS-842 Rev. 2-04). The AD may be questioned in California if the nursing home did not follow the guidelines printed on the form. It requires that a nursing home patient advocate or ombudsman, as designated by the State Department of Aging, is present to witness the completion and signing of the AD. The AD does not require the presence of a notary, but requires the presence of both witnesses who sign the AD on the same day as the somebody making the AD.Mr. E is mildly developmentally delayed a intend such as this is not a factor which would complicate his ability to have a valid AD. AD and Advance Care mean for People with Intellectual and tangible Disabilities was addressed by the U. S. Department of Health and world Services. (HSS, October, 2007). In 2003, a study that assessed the capability of people with a mild mental disability concluded that adults with mild retardation have the ability to provide adequate consent for their own medical decisions.This led the American knowledge on Intellectual and Developmental Disabilities (AAIDD), in 2005 to take the following position regarding end of life Permissible treatment options at the end of life are the same for persons with intellectual or developmental disabilities as for everyone else. (U. S. Department of Health and Human Services, October 2007, p. 13). A factor that complicates the AD is the Power of Attorney given to his brother, Mr. Y. Mr. Y was asked to make an end of life decision for his brother, Mr. E, without the knowledge of the AD.The case scenario notes that no family member signed the advance directive and it is unclear if any family member were involved. Mr. Y was unaware of Mr. Es AD, made seven years prior, that Mr. E did to avoid having august medical procedures performed on himself if should he be in a material body that precluded him from verbalizing his desires. Advance, meaning the wishes are w ritten in advance, before the situations arise for which the wishes have made. Directives meaning giving, directing the actions of others that are empowered to make the decisions.The lack of communication between Mr. E and Mr. Y created the stressful situation. The nurses decision to withhold her knowledge of Mr. Es AD from other individuals involved in Mr. Es care led to contrasted treatment. HIPAA violations HIPAA is violated when information is given to anyone who does not have participation in the care of patient. tolerant information can be shared by an entity for the purpose of TPO. TPO is described as release of information pertaining to patients own treatment, payment, and health care operations activities.Knowing how protected health information can be used and disclosed, a HIPAA violation occurred in the following instances. Dr. K discussed Mr. Es condition with his niece in front of her boyfriend and other patients. The nurse, during her dinner break, discussed patients medical issues with three nurses not involved in the patients care and requested their opinion. The nurse also violated the Code of Ethic Provision 3, which states that nurses have the duty to safeguard patients privacy and only share the pertinent information necessary for treatment with those who are participating in the care of the patient. Code of ethics, 2001). Professional treat of the nurses The comments made by the nurses in the cafeteria were unprofessional, unethical and derogatory. These comments reflect that they were not conducting themselves in accordance with the nursing standards of professional practice. Nurses are not expect to notion warmth towards all human beings, but they cannot treat others with uncaring bearing to justify their feelings or their short comings.Nurses are professionals, and as professionals, nurses are expected to move beyond feelings and provide the same care to every patient regardless of their background, level of intelligence, diagnosis or economic status. In the case study the nurses were not 1) Participating in ongoing educational practices as evidenced by the lack of knowledge of the pre-existing is AD. The nurses did not consider the legal ramifications of not following the patients AD requests nor did they respect the patients rights to self-determination. ) Providing care in a cultural and tippy way, as evidenced by calling the patient retarded. spontaneous defamation calling patient retarded is slander. 3) Respectful of the patients moral worth nor did they give dignity to the patient, in respect to his surviving situation by the statement he is already in a nursing home The Code of Ethics, an integral part of what professional nursing stands for, addresses the fact that nurses have a commitment to the well being of their patients.It requires that nurses act as advocates by being vigilant and taking action when inappropriate dealings, such as unethical or questionable practices, are being carried out, and may jeopardize a patients care. It is the ethical accountability of the nurse to report to administration the nurses practices and lack of knowledge and the cavalier billet towards HIPAA. It is an integral part of nursing not to remain silent when subscript care is known and practices that do not align with the nursing code of ethics are being used.The conduct that does not follow the nurse principles also will not align with place of work policies. These nurses should be reported to supervisors for counseling, education and corrective actions. Some issues are so sedate that nurses are mandated to report offenses to authorities such as the Board of Registered Nursing, Nursing Organization, and HIPAA. In conclusion, the above case study identifies a case where several standards were compromised in protecting patients rights, privacy and protecting patient from harm.Through knowledge and susceptibility in following the Nursing Practice Act as well as the Code of Ethics, one c an always ensure uncompromised patient care and safety in practice. References Board of Registered Nurse. The Registered Nurse as Patient Advocate Regulations. Sacramento, CA (Reprint from the BRN Report Winter 1987). Retrieved from http//www. rn. ca. gov/pdfs/regulations/npr-i-11. pdf America Nursing Association (2010). In Scope and Standards of Practice (2nd edition). Silver Spring, Maryland Nursesbooks. org. America Nursing Association (2001).Code of ethics for nurses with interpretive statements (2001 edition). Silver Spring, Maryland nursingbooks. org. Advance Directive Form. (PS-X-MHS-842 Rev. 2-04). Retrieved from http//ag. ca. gov/consumers/pdf/AHCDS1. pdf Roux, G. Halstead, J. A. (2009). Issues and Trends in Nursing. Sudbury, Massachusetts Jones and Bartlett Publishers. U. S Department of Health and Human Services. (October 2007). Advance Directives and Advance Care Planning for People with Intellectual and Physical Disabilities. Retrieved from http//aspe. hhs. gov/daltcp /reports/2007/adacp. htmwho (Roux Halstead, 2009)