END OF LIFE ISSUES DISCUSSION
NURS 457 – Palliative Care
(Please see paper linked below)
Purpose of Assignment:
​
This discussion will help the student to gain understanding of ethical dilemmas revolving around end of life issues that may occur during patient care. Understanding of the use of ethical strategies in patient care decisions is vital.
Student Approach to Assignment:
​
I approached this assignment by reviewing the American Nurses Association (ANA) Code of Ethics and selecting one experience from my practice that presents an end of life issue. This assignment reflects in a way that stresses the importance of upholding all legal responsibilities of bring a nurse. Throughout the assignment, I acknowledge that confidentiality is an essential component of nursing. Each day, I ensure that patient information remains confidential; this is one principle of my nursing practice.
Reason for Inclusion of this Assignment in the Portfolio:
​
This assignment should be included in my portfolio because it stresses the importance of making the right decisions during the EOL process. In this paper, I reflect on ethical decision making. As a nurse, making ethical decisions is crucial. This project represents my nursing practice by highlighting the importance of maintaining patient confidentiality.
Professionalism
​
-
Differentiates between general, institutional, and specialty-specific standards of practice to guide nursing care
Upon review of the ANA Code of Ethics, I discovered that confidentiality is a general standard of practice. This means that confidentiality is applied throughout all hospitals and healthcare facilities/agencies. Institutional standards of practice are those that change from hospital to hospital; it is not a set of unanimous rules. Specialty-specific standards are applied to certain specialty areas, such as labor and delivery suites, ICU, etc. In this particular ethical dilemma, the nurse should have abided by the ANA code of ethics/ general confidentiality standard and ensure the patient’s health status remained private.
o Understands the effect of legal and regulatory process on nursing practice and health care delivery.
The nurse violated the ANA code of ethics, which is punishable by law. Nurses are legally responsible to abide by their standards of practice, failing to do so could reap legal repercussions (such as lawsuits, imprisonment etc.). The nurse mentioned in the assignment violated ethical and HIPPA principles that were placed to protect and respect the patient. After the death, the nurse not only upset the family of the deceased patient, but also her coworkers; she was reported to the Office of Civil Rights (OCR) for the violations in privacy and was fired from the hospital.
-
Applies an ethical decision-making framework and legal guidelines to clinical situations that incorporate moral concepts, professional ethics and advocacy for patient well-being and preferences
There are nine steps to help assist nurses construct an “ethically supportable decision” (Matzo &Sherman, 2015); this specific case does not integrate a decision-making quality because the patient was no longer alive. However, if I were to formulate my outward position using the nine steps as a guide, I would firstly review the situation (patient has passed away) and compile the facts of the case. I would then identify the members of the family that would be involved by the actions (Facebook announcement). Then, I would identify the conflicts of any ethical principles (breach of respect and dignity) and identify the purpose of the action (to express sympathy and grief). The factors affecting decision making would be evaluated (emotions), and then the action would not be implemented. As stated previously, this ethical dilemma was not concerning what was “right” or “wrong” for the patient right before death, but more so focused on the disrespect for the patient during and after the death of the patient.
-
Advocates for professional standards of practice using organizational and political processes
In this assignment, I stress the importance of maintaining professional standards, such as confidentiality. I believe that the nurse’s actions were grounds for termination. The pertinent information should have never been released. This caused emotional trauma for the family and friends who were unaware of the recent death. I support the prohibition of cell phones while working in a healthcare facility. Cell phones enable individuals to access social media instantaneously and therefore increasing the risk of exposure of personal information on the internet. Ventola (2014) notes in her article that “A HCP may breach federal HIPAA/HITECH or state privacy laws in a number of ways when posting information, comments, photos, or videos concerning a patient to a social networking site. Whether communicating with or about patients on social media, breaches of patient confidentiality can result in legal action against an HCP and potentially his or her employer” (Ventola, 2014). The nurse made an ethical mistake and did not fulfill the wishes of the patient or family. This drama caused more stress and the attention was then focused on getting justice for the family, instead of focusing primarily on the deceased.
​
​
​
​
​
​
​
​
​
​
​