End Of Life Issues Ethical Decision Makingend Of Life Issues Ethical ✓ Solved

End of life issues: Ethical Decision making End of Life Issues: Ethical Decision making 1. Reflect on a time you had ethical dilemma 2. Also, describe the condition and reflect on the challenges that face nurses on frequent basis regards to end of life issues. Create a positive patient experience 1. Now, Reflect on what “always putting patient first†and “ I am NYP†means to you. Suggested reading: privileged presence: personal stories of connections in Health care by Liz Crocker and Bev Johnson.

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End of Life Issues: Ethical Decision-Making

End-of-life (EOL) issues present ethical dilemmas for healthcare professionals, particularly nurses, who must balance patient autonomy, quality of life, and professional responsibilities. This paper reflects on an ethical dilemma encountered during clinical practice, the challenges nurses face regarding EOL issues, and the significance of patient-centered care in creating positive patient experiences.

Reflection on an Ethical Dilemma

During my rotation in a palliative care unit, I encountered a significant ethical dilemma involving an elderly patient suffering from advanced-stage cancer. The patient, Mr. Johnson, expressed a deep desire to discontinue aggressive treatments and transition to hospice care. His family, however, insisted on continuing curative interventions, driven by fear and a lack of understanding of his prognosis. They could not accept that their loved one was nearing the end of his life.
As a nurse, I faced conflicting loyalties: to the patient’s autonomy and desire for quality of life versus the family’s wishes reflecting their hope and fear. This dilemma raised several ethical questions regarding beneficence, non-maleficence, and respect for autonomy. According to Beauchamp and Childress (2013), the principles of biomedical ethics necessitate that healthcare providers ensure the patient's intended care aligns with their values and preferences.
The challenge was to facilitate communication and mediate the discussion between Mr. Johnson and his family, reinforcing the idea that EOL care should prioritize comfort and dignity. Engaging in this difficult conversation revealed the need for compassion and sensitivity towards both Mr. Johnson's wishes and the family's emotions (Kaldjian et al., 2014).

Challenges Faced by Nurses

Nurses frequently encounter challenges regarding EOL issues, which include:
1. Communication: Effective communication is integral in discussing EOL options with patients and families. An article by Lindley and Rowland (2020) emphasizes that nurses often have to bridge the gap between medical jargon and layman’s terms, ensuring patients and families understand treatment options and prognoses.
2. Emotional Burden: The emotional toll of caring for patients at the end of life can be tremendous. Nurses often experience grief and burnout, with rates of compassion fatigue increasing in high-stress environments (Figley, 2002).
3. Cultural Sensitivity: EOL decisions can be influenced by cultural, spiritual, or religious beliefs. Nurses must navigate these complexities while ensuring that the care they provide is respectful of the patient’s background (Pattison, 2018).
4. Legal and Ethical Considerations: Nurses must be cognizant of legal aspects such as advanced directives, which often complicate EOL decision-making processes (Henderson, 2015). Moreover, ethical dilemmas may arise when family members contradict the patient’s wishes.
5. Resource Limitations: Often, constraints within healthcare systems limit access to adequate palliative care resources, leading to inadequate support for patients and families navigating EOL issues (Cohen & Firth, 2017).

Creating a Positive Patient Experience

Putting "patients first" embodies a holistic view of care that prioritizes the individual needs and values of each patient. In reflecting on what “I am NYP” means to me, I see a commitment to advocacy and empathy. At NewYork-Presbyterian, the ethos encourages healthcare professionals to be not only caregivers but also advocates who empower patients in their care journey.
Ensuring that patients receive care aligned with their preferences can enhance their experiences during this critical time. For instance, employing strategies such as active listening and shared decision-making fosters an environment of trust, leading to a more positive experience (Rider et al., 2008). Engaging in discussions about patient goals and values allows healthcare providers to tailor communication and interventions reflective of the patient's desires, ultimately leading to improved outcomes.
In an environment that promotes empathy, nurses can positively influence the life of patients like Mr. Johnson by honoring their choices and guiding families through the emotional complexities of EOL care. Establishing a rapport with both the patients and their families creates a collaborative approach that can alleviate anxiety and confusion (Lindley et al., 2017).

Conclusion

Ethical decision-making at the end of life is a critical aspect of nursing practice that requires balancing patient wishes, family hopes, and professional ethical principles. The challenges nurses face in navigating end-of-life issues highlight the importance of effective communication, patient advocacy, and an emphasis on emotional care. Adhering to the principles of ethical medical practice not only ensures that care remains patient-centric but also fosters positive experiences during some of the most challenging moments in a patient's life.

References

1. Beauchamp, T., & Childress, J. (2013). Principles of Biomedical Ethics. Oxford University Press.
2. Cohen, L. M., & Firth, L. (2017). Strategies for Improving Palliative Care Access in Health Systems. Journal of Palliative Medicine, 20(1), 1-5.
3. Figley, C. R. (2002). Treating Compassion Fatigue. Brunner-Routledge.
4. Henderson, A. (2015). The Role of Advanced Directives in End-of-Life Care. Nursing Ethics, 22(4), 405-410.
5. Kaldjian, L. C., et al. (2014). “The Role of Nurses in Palliative Care: A Discussion of Ethical Dilemmas.” Nursing Philosophy, 15(4), 289-302.
6. Lindley, L. C., & Rowland, M. C. (2020). Communication Challenges in End-of-Life Care. American Journal of Nursing, 120(2), 34-41.
7. Lindley, L. C., et al. (2017). Patient-Centered Communication in EOL Care: A Review of Evidence. Patient Education and Counseling, 100(1), 113-120.
8. Pattison, N. (2018). Cultural Competence in End-of-Life Decision Making: The Role of the Nurse. Journal of Cultural Diversity, 25(3), 124-130.
9. Rider, E. A., et al. (2008). The Importance of Communication in End-of-Life Care: A Three-Part Model. Journal of Palliative Care, 24(3), 185-191.
10. Wiegand, D. L., & Mitchell, M. L. (2016). “The Emotional Burden of End-of-Life Care: The Role of Compassion Satisfaction.” Nursing Management, 47(6), 42-49.