According to the ANA code of ethics, in the first provision, every person, regardless of socioeconomic position, is treated with respect and compassion by the nurse throughout all professional interactions. Nurses must treat all patients with kindness and care (Butts & Rich, 2019). Furthermore, professional nurses adhere to a code of ethics that guides their behavior as they work to improve the health of their patients, their communities, and the people in their care through measures including disease prevention, early detection, and treatment (Butts & Rich, 2019). In the case study, the nurse must make the tough choice of whether or not to prevent an unwilling resuscitation of her patient. The nurse had the added burden of attempting to assist the family members make sense of the situation while under enormous pressure herself.
During this case study, the failure of the father, who had designated that he did not want medical treatment and his children led to some misunderstanding between the certified nursing assistant, the physician, and the registered nurse, who was caring for the severely ill patient at the time of the patient’s passing. The nurse was responsible for advocating for and defending her patient in accordance with the documented healthcare directive he had provided and honoring his choice to maintain a DNR state. Typically, a nurse must speak out for him as an ethically responsible nurse committed to the nursing code of conduct. It is reasonable that children would want their dad to be brought back to life, and as caring nurses, one can relate to the fact that a situation of this kind might cause nurses to question whether or not they are making the proper choice.
Considering all the factors, DNR may be an emotionally charged and complex topic (Coca, 2020). Some patients could be willing to accept DNR procedures that allow them to get blood donations or drugs that might help them recover from their condition. However, a terminally ill patient may not consent to intubation, CPR, or feeding tubes (West, 2020). Preferences like this are included in the advanced healthcare directives. The goal of advance directives is to ensure that a patient’s wishes about end-of-life medical treatment are honored, notwithstanding the patient’s incapacity due to sickness or life-threatening illness (Brovman et al., 2018)
The case study reminded me of a time in my nursing career when I was faced with a scenario quite similar to this one: caring for a 95-year-old man who was willing to accept a DNR designation after finding that he had 18% pericardial effusion and required a feeding tube to support life. His wife remained by his side for a week after discovering his DNR order and persuaded him to make every effort to live. (Haddad & Geiger, 2018). The patient required defibrillation twice, and he was ultimately heavily sedated and admitted to the intensive care unit. When he made this choice, I was remorseful since I knew his wife had probably convinced him to undertake an act he did not desire to do only to satisfy her. He probably did not feel like arguing with her in his weak and aged condition. In the video, I just viewed a family member (presumably his son) with authority to act. I instructed medical professionals to do everything possible to resuscitate his pulseless loved one. It is possible that when the father was first diagnosed with his chronic illness, he wished to be revived. However, attitudes shift when patients realize that their quality of life will deteriorate rapidly. In the final stages of life, ethical constraints may be more challenging to surmount. When it comes to a patient’s treatment and their last desires, it is crucial for relatives and healthcare providers to be in constant contact.
Conclusively, nurses are expected to advocate for their patients, their families, and their healthcare teams. However, it is the role of educators to instill in students a strong sense of professional practices, ethical decision-making, and professional identity. A growing elderly population will only add to the difficulties we encounter as nurses in our everyday work, which mirrors the DNR case study. As nurses in the field, we should believe in our capacity to solve problems like this (Tisdale & Symenuk, 2020). We must also persuade our healthcare colleagues to keep a careful eye on things at work and to prioritize patient welfare above all else, even when doing so presents challenges. We will preserve the ability to deal with challenging issues related to the final stages of life by keeping open communication lines and cultivating a professional attitude.
Brovman, E. Y., Walsh, E. C., Burton, B. N., Kuo, C. E., Lindvall, C., Gabriel, R. A., & Urman, R. D. (2018). Patients with a do-not-resuscitate (DNR) order undergoing elective procedures have postoperative outcomes. Journal of clinical anesthesia, 48, 81-88.
Butts, J. B., & Rich, K. L. (2019). Nursing ethics. Jones & Bartlett Learning.
Coca, A. (2020). DNR Case Study. https://www.youtube.com/watch?v=EqHJgmKbo1M
Haddad, L. M., & Geiger, R. A. (2018). Nursing ethical considerations.
Tisdale, D., & Symenuk, P. M. (2020). Human rights and nursing codes of ethics in Canada 1953–2017. Nursing ethics, 27(4), 1077-1088.
West, E. (2020). Ethics and integrity in nursing research. Handbook of research ethics and scientific integrity, 1051-1069.