Discuss about the Inquiry for Professional Nursing Practice.
The medical issues of Mr. Alphonse Martinez are myocardial infarction, chest pain, and severe heart attack. The patient has recently made an Advanced Health Directive (AHD) that prevented him from being resuscitated in case he experiences a heart failure. He is a retired Italian man having a close family loving family who is willing to do anything for his condition including acting in contrary to the directive (Alphonse Martinez (Hawley, 2007)). In addition to the family, he is a religious man usually, goes to church on Sunday. He also believes in the Christian rites by ordering the priest to come and pay him a visit. The ethical issues seen in the hospital is beneficence and the lack of autonomy even among the medical practitioners. The legal issues of the patient are his Italian citizenship, guardianship, and refusal to treatment in case of another severe heart attack. These facts and issues will be explored throughout the paper to identify the various principles of professional nursing.
The medical condition of Mr. Alphonse is myocardial infarction characterized by a severe heart attack. It occurs when the flow of blood to the heart is cut off. Since coronary arteries are the most prominent vessels ensuring the pumping of oxygenated blood to the rest of the body organ, their blockage can lead to severe and acute heart failure. It is commonly caused by the deposition of low-density lipoprotein along the walls of heart vessels causing interference with the transfer of blood to the other parts of the body. Most patients who are susceptible to the condition are those having historical backgrounds in obesity, hypertension, having high blood sugar level and diabetes. Another prognosis could be the age situation, persistence stress, and drug use.
The condition of the patient is acute since he always resuscitated whenever he experiences the severity of the condition. Also, while at the hospital as soon as his buzzer went, he suffered the cardiac arrest. This happened after Mark left him alone at the bedside to talk to RN. It implies that his situation is highly prompted by stress causing high blood pressure hence the cardiac arrest (Chaska, 2001).). The surgical procedure can be used to remove the clotting that might have deposited along the walls of the heart vessels. Other alternative treatments for the condition can be the use of stress relieving through psychiatric means. This will offer professional assistance to avoid stressful moments thereby avoiding anxiety and depressions.
The condition typically creates a large impact on the life of the patient and mostly his family members’ regarding their social existence. He will suffer depression due to acute coronary syndromes often acquired after clinical processes have been done. It sometimes increases high chances of developing mental illness. Moreover, the patient will develop psychological trauma caused by the fear and embarrassment of surgical scars. On the other hand, the family is primarily affected as the condition is frequently characterized by a decrease in the life expectancy hence they will feel less protected considering his state.
The moral principles include; the principle of autonomy which holds the call for one to have respect to the obligation of another person. The principle of beneficence states that every individual has a duty to bring out the best in some actions taken (Tschudin, 2003). Thirdly, the principle of non-maleficence that says that the measures taken should be aimed heightening the real and reducing the harm. It merely illustrates the motivation one should have to avoid harming the other individual. Lastly, the principle of justice which holds that each and every person is liable to be treated and attended to fairly and equally by providing them with what they deserve. In the principle of autonomy, Mr. Alphonse preferred that he was not to be resuscitated in case he experienced another severe heart attack (Wheeler, 2012). Furthermore, he orders Mark to contact his priest to give him the last rites in the hospital. As per the Singapore Nurses and Midwives Act, the ethical code of practice expected of the nurses to show kindness and values patients decisions at all costs. The risks that can be associated with the preference of the patience can lead to a total failure of the heart causing him his life hence a conflict in the two principles. Conducting the procedure will also result in the lack of autonomy regarding Mr. Alphonse. To avoid the situation contradicting the moral ethics in the act. Generally, a third person can intervene to address the matter. An assessment can also be processed concerning the requirements of both the parties.
Moral conflict arises when various ethical principles are confronted in a collision in amidst promoting the interest of the parties that are involved in the decision making. Most of the above illustrated moral principles are contradictory to each other in that in trying to satisfy one; another one is likely to be affected. For instance, in upholding the principle of autonomy, the principle of beneficence is highly underpinned i.e. failure to perform resuscitation procedure may not be entirely aimed at achieving the best of what is expected to the patient (In Fulton, In Lyon, & In Goudreau, 2014). It is likely to cause the life of Mr. Alphonse; a severe harm causal that prevention as stated by the principle of non-maleficence. On the other hand, performing the process to achieve ultimate benefit is a clear violation of the principle of autonomy which causes uninformed decision making in the facility as opposed to the regulatory act. The conflicts occur as the doctors are bound to various codes of ethics especially in the appraisal of patient’s decision. The Australian National Board require nurses to act within the practices and principles that are listed on the framework, and this includes setting competent care and standards of treatment within the hospital (Principle of Beneficence) (NMBA, 2008). The codes also should be guided by professional judgments i.e. those attending to a patient should be competent and qualified nurses. It may be resolved through the efforts of nurse leaders who are centrally involved in the diffusion of such kinds of conflicts. The nursing codes of ethics should be adhered to with the aim of providing an ultimate solution. These include supporting the health and preserving trust among the patients.
This law provides a guide and a directive to various codes that are expected of nurses in the execution of their duties besides their professionalism standards. The law is a bunch of different qualifications that every nurse and midwife must meet. The standards that are contained within the act are a composition of various codes of conduct, ethical practices, guides to different industries and the standards of their practices (Australian Nursing Council, 2005). The method recognizes various rights of patients and obligation of the nurse in ensuring that ultimate care and protection. As to the case study, regarding the role of nurses, they should respect and offer kindness to most patients. They also are mandated to make informed decisions regarding the service provision of patients. Decisions made during their operation and practices according to the legal and ethical frameworks that helps to guide nurses and the midwives to satisfy the public interest and that of the patient.
The Singapore Act pledges that a patient should be attended to and receive the best form of treatment as possible i.e. principle of beneficence. It is the obligation of the nurses under the act to provide competent and quality service provision that will be aimed at bettering the state of the patient. In relation to the principle of justice, he has the right to acquire legal decisions as per his wills on the type of treatment he ought to obtain (Jones, 2010). Moreover, they are legible to minimize any possible risks that the patient is likely to be experiencing and reduce the harm. The practice standards in the act are the ethical relations of the nurses and their patients, withholding and preservation of trust of patients based on the management of their information, the various capacity building of the nurses to heighten the confidence of the community and other individuals within the society (SNB, 2011).
Moreover, the act also is regarded by the role of the nurses to provide an efficient information that is accurate and impartial regarding some patients within the hospital. In the Human Tissue and Transplant Act, the person who is undergoing the operation should be guided and efficiently accessed regarding the various effects of the procedure and ways of ensuring the success of the process. The practice standards require nurses and other practitioners to provide an effective information and best care, especially when dealing with the transplant of these tissues. No information should be left out from the patient regarding the risks and the form of treatment that is likely to be applied to the patient (Nurses & Midwives Board of Australia, 2002). The Age of Majority Act also applies to the case study as the patient is most likely to be experiencing the condition due to his age. The act applies that much care and attention should be given a lot of considerations and care as they lack those that can attend to them. Regarding the Human and Tissue Transplant Act, the patient should be provided with adequate information, and he/she should have a prior knowledge regarding the procedure. No patient should undergo the operation without the lack of consent from the patient.
The clinical, moral decisions should make medical indication through the analysis of the various causes of the condition, how it is diagnosed, treatment process and how the goals of care are assessed. The decision made by the patient should be aimed at ensuring their preferences and the decisions they made when admitted with an aim to improve the trust of the patient. The decision is justifiable especially after the patient opposed to being resuscitated in the event of another heart attack. The framework of the Nursing and Midwifery Board of Australia points out various ethical standards of accountability regarding nurses especially those handling the patient (Western Australia, 2010). The principles of the nurses of comprehensive assessment ensure that standard practices are properly adhered to. The principle of reliability upholds that the preferences of the patient should be maintained after consideration by the nurse officials on his basis and several implications. The guidelines were based on the greater good of both the patient and his family pertaining the treatment process by the use of psychologist and nurse leaders. The statutory bodies are also an instrumental key in the determination of the case regarding the principles of the ethical concern of most nurses to their patients (Young & Hayes, 2002). The right facts of the patient refusal to be treated are likely to impact on the principle of beneficence. The ethical decision will be to perform the process to Mr. Alphonse in the case of the attack and act on the contrary to his decisions. His life is still an important factor to both his family and the reputation of the doctors. It will be against the doctors’ mandate of saving the life to ignore and what can be caused a psychotic disorder and distress.
According to Nurses & Midwifes Board of Australia. (2006), the ethical decision will be assessed through the guiding principles of nurse leaders and the various standards of practices that are held legible. The efficacy of the decision will be based on its ability to provide and determine a solution to the case (Lyons, 2010). The document will be stored on the relevant sites of the institution and its principal catalogs. The documents can be well preserved in the nursing home to provide authenticity for the case and ensures that they are stored accurately and more conveniently.
References
Alphonse Martinez (Hawley, G. (p 212, 2007). Ethics in clinical practice: An inter-professional
Approach. London. Pearson Education Ltd.
Australian Nursing Council. (2005). Code of professional conduct for nurses in Australia. Canberra: The Council.
Australian Nursing and Midwifery Council. & Nurses & Midwifes Board of Australia. (2008). Codes of professional conduct & ethics for nurses & midwives in Australia 2008. South Australia: Nurses Board of South Australia
Chaska, N. L. (2001). The nursing profession: Tomorrow and beyond. Thousand Oaks: Sage Publications.
In Fulton, J. S., In Lyon, B. L., & In Goudreau, K. A. (2014). Foundations of clinical nurse specialist practice.
Jones, I. H. (2010). The nurse’s code: A practical approach to the code of professional conduct for nurses, midwives, and health visitors. Houndmills, Basingstoke: Macmillan Education Ltd.
Lyons, N. (2010). Handbook of reflection and reflective inquiry: Mapping a way of knowing for professional reflective inquiry. New York: Springer.
Molinari, D., & Bushy, A. (2012). The rural nurse: Transition to practice. New York: Springer Pub. Co.
Nurses & Midwifes Board of Australia. (2006). Nursing & midwifery: NMBA bulletin. Adelaide: NMBA.
Nurses & Midwives Board of Australia. (2002). Nurses and Midwives Board of Australia. East Perth, W.A: The Board.
SNB. (2011) Standards for practice for nurses and midwives. Sage Publications.
Singapore Nurses and Midwives Act (2000) Scope of Nursing and Midwifery.
Wheeler, H. (2012). Law, ethics, and professional issues for nursing: A reflective and portfolio-building approach. Abingdon, Oxon: Routledge.
Western Australia. (2010). Health Practitioner Regulation National Law (WA) Act 2010: (no. 35 of 2010). Perth, W.A.: Govt. Printer.
Young, L. E., & Hayes, V. E. (2002). Transforming health promotion practice: Concepts, issues, and applications. Philadelphia: F.A. Davis Co.
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