Healthcare enframement is the most challenging and compels workplace where nurses meet with a wide range of challenges, including the most complex ethical dilemma that requires critical thinking, innovative ideas, and active engagement of patients, families, and healthcare professionals to facilitate making informed decisions about patient care and patient treatment plan. As presented in the second case study on the issues regarding patient’s informed consent and cultural competency, it is worth noting that a nurse, when faced with an ethical dilemma while handling a patient with serious health issues, is always advisable to refer and uphold nursing principles of ethics which permits patients to have exclusive rights to decide guidance of healthcare provider on the most effective and beneficial treatment and care plan that not only meets health needs of a patient but also care and treatment plan that respects patients culture, spiritual and faith-related matters (Holtz & Byrdsong, 2020). Studies have shown the application of evidence-based interventions concerning nursing principles of ethics and cultural competency (Holtz & Byrdsong, 2020). As per the American Nurse Association, nurses and physicians must always act as professionals by educating patients or families about all the possible alternative treatments and care plans that could be adopted to meet patients’ health needs. This creates awareness and improves patients’ or families’ understanding of the treatment alternatives to select from regarding patient autonomy in deciding how they should be treated.
Patient education is essential in the sense that it highlights all the potential benefits and side effects, both short-term and long-term side effects associated with all the available treatment alternatives, as this will enable families and patients to make appropriate choices when deciding the final intervention for the treatment of their health issues. Note that when deliberating on the best alternative for the treatment of patients with serious health issues, patient autonomy should be made paramount to empower patients or family health agents- those that make decisions on behalf of critically ill patients to make appropriate decision that provides more significant benefit to patients (Ilkafah et al., 2021). To achieve this, nurses and other healthcare professionals should always embrace effective communication, collaboration, and the creation of a good rapport that improves patient confidence and trust in sharing vital information with them to facilitate the process of developing a culturally competent and patient-centered care plan. As noted in the case study, informed consent is a pivotal aspect of nursing practice that promotes patient-centered care and captivates collaboration and care conditions between patients and care providers.
Summary of the Key Facts in the Case Study Informed Consent and Cultural Competence
The case study selected is informed consent and cultural competence. In the case study, we learn that Dr Emily Clark, a cardiologist at Mercy General Hospital, receives a patient named Mr. Rajan Patel, who is 58 years old and an immigrant from India. The patient – Mr. Rajan Patel, has been diagnosed with a heart condition that requires urgent interventions to help the patient live an everyday life. According to the doctor in the case study, the patient needs a surgical procedure, which, according to the doctor, has a higher success rate but is associated with higher risks (Jessee, 2021). From the case study, the central ethical dilemma is that even though the surgical procedure for heart conditions is anticipated to have a higher success rate, several risks and benefits come with the said procedure. Therefore, to avoid legal and ethical issues from the suggested healthcare intervention to help the patient, there is a need for the doctor to educate the patient about the benefits of undergoing the surgical procedure and the potential risks and health complications that may result from the procedure (Jessee, 2021).
Given that Mr. Rajan Patel, – the patient, is an Indian immigrant, he never fully understands the doctor’s language regarding the implications of the anticipated surgical procedure. The doctor is in a dilemma since she can only conduct the procedure with the patient’s consent. On the other hand, the patient is facing challenges associated with the language barrier, making it difficult for the patient to understand the reason and risk factors related to surgical procedures when treating his heart condition (Jessee, 2021). Due to the language barrier, there is an ethical dilemma regarding how the doctor will guarantee patient autonomy in deciding whether to undergo a surgical procedure for his heart issues or not. Generally, the main parties involved in this ethical dilemma are the doctor, Mercy Clark, and the patient- Mr. Rajan Patel.
Articles selected for analysis for the case study above were based on the CRAAP test model, which ensured they provided peer-reviewed information that is most current, factual, and with reviewed reputable authority targeting to answer questions on nursing principles of ethical and ethical dilemmas in nursing practice.
Discuss the Effectiveness of the Communication Approaches Presented in the Case Study
The doctor applies effective communication strategies to engage the patient throughout the session and educate him about the risks and benefits of surgical procedures when managing heat-related illnesses. Active and intent listening is one of the communications employed by the patient and the doctor to communicate about risk factors and benefits of surgical procedures in treating and managing heart conditions (Jessee, 2021). The importance of the internet and active listening in the case study is to promote a better understanding of the ideas and concepts shared throughout the patient engagement session. Also, the doctor uses objective questions, asking the patient to repeat the explanation of the intricacies and the benefits of surgical procedures for the treatment of heart conditions. Objective questioning helped the doctor better understand the level of understanding of the patient’s education about surgical procedures (Jessee, 2021). Also, through active listening and being empathic, the doctor was very concerned with ensuring patient autonomy and consent were paramount before starting treatment. Also, nonverbal communication and cues were employed by the patient who had issues understanding English to indicate that he understood doctors’ statements. Active listening, being empathic, objective questions, creation of a good rapport and a conducive environment for patient engagement, and the use of a wide range of communication styles such as verbal, nonverbal, and cues are essential for patient engagement as they minimize misunderstanding and medication errors due to lack of better understanding between the caregiver and patients. Nevertheless, poor communication approaches such as too much information, which, if given too quickly, failure to ask patient questions for clarification, use of vague words, and lack of empathy should be avoided as they can cause mistrust and lack of understanding between patients and nurses (Jessee, 2021). Misunderstanding can also result in medication errors in cases where medication is prescribed without proper guidelines to patients.
Discuss the Effectiveness of the Approach Used by the Professional a Case Study as It Relates to the Three Components of the Ethical Decision
The doctor employs three critical components of the ethical decision-making model, such as moral awareness, ethical behavior, and moral judgment, to prioritize patient autonomy before deciding on the type of treatment the patient will receive. Using moral decisions, the doctor understands the essence of educating the patient on the risks and complications associated with surgical procedures if the patient chooses such an intervention to treat his heart condition. Using ethical behavior and moral judgment, the doctor assesses the patient’s ability to understand and explain the intricacies of surgical procedures (McNamire, 2022). This helped the doctor to ensure that the patient was not exposed to any harm. Also, moral judgment was employed by the doctor to make informed decisions by balancing the patient’s health needs concerning ethical principles of nursing that advocate for harm and the provision of patient-centered care. Moral judgment and mora awareness empowered the doctor to act ethically by educating the patient on the risks associated with surgical procedures for his health issue. The doctor has also employed ethical behaviors to ensure that the patient is sensitized to the benefits and risks of surgical procedures for heart issues.
Apply Ethical Principles to a Possible Solution to the Proposed Problem or Issue from a Case Study
After analyzing the case study concerning the causes of the ethical dilemma, it is good to note that the doctor should embrace patient autonomy and continuous engagement of medical interpreters to promote effective communication and understanding of the importance and risk issues associated with the suggested treatment approach. The essence of medical interpreters is to break the challenges brought by the language barrier, as patients with Indians seem challenged in understanding English. Also, the principle of veracity and justice is essential in ensuring that the doctor remains truthful and transparent when educating the patients about the risks, costs, benefits, and potential complications associated with surgical procedures in treating heart conditions (McNamire, 2022). The principle of non-maleficence and beneficence is also vital in this case (Monagle et al., 2024). The doctor applied the principle of non-maleficence in explaining to the patient the critical risks of surgical procedures when treating heart conditions. This aims to minimize possible complications that will impact patient health now and in the future. By educating the patient on the benefits and risks of surgical procedures in heart condition treatment, the doctor is focused on enlightening the patient on the best alternative for heart condition treatment that has not only many benefits but also has been proven to have a higher success rate (Monagle et al., 2024).
Conclusion
In summary, ethical considerations are context-dependent, which means there is a need to have a thoughtful analysis and active engagement of stakeholders, seek diverse perspectives, and continuously evaluate the impact of the chosen solution to promote patient safety and quality improvement in service delivery. Note that nurses can offer patient-centered care and minimize medication errors and ethical and legal issues by respecting patients’ autonomy and upholding the guidelines provided in the principles of non-maleficence, justice, and beneficence.
References
Holtz, L., & Byrdsong, Q. (2020). Applying ethical principles to enrolling older adults with cognitive impairment in research. https://doi.org/10.4135/9781529716023
Ilkafah, I., Mei Tyas, A. P., & Haryanto, J. (2021). Factors related to the implementation of ethical principles in nursing care in Indonesia. Journal of Public Health Research, 10(2), jphr.2021.2211. https://doi.org/10.4081/jphr.2021.2211
Jessee, M. A. (2021). An update on clinical judgment in nursing and implications for education, practice, and regulation. Journal of Nursing Regulation, 12(3), 50-60. https://doi.org/10.1016/s2155-8256(21)00116-2
McNamire, L. (2022). Self-regulatory organizations’ role in promoting ethical behavior in the industry. Routledge Handbook of Risk Management and the Law, pp. 216-224. https://doi.org/10.4324/9781351107242-19
Monagle, J., Jessee, M. A., Nielsen, A., Gonzalez, L., & Lasater, K. (2024). Observed use of clinical judgment among new graduate nurses. The Journal of Continuing Education in Nursing, 1-8. https://doi.org/10.3928/00220124-20240301-07
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