Online Companion: Fundamentals of Nursing Standards and Practice 2E
How can the nurse
assist clients and their families to make decisions about critical matters such
a terminating life support, providing fluids to a terminally ill client?
One of the most important actions for the nurse to take in these situations
that pose ethical dilemmas for clients and their families is to protect the
client/family's right to make their own decisions. This is the nursing role
as advocate. The first step in this role is to develop a meaningful relationship
with the client/family. The nurse initiates dialogue concerning the client's
wishes. Then the nurse assesses the client/family's understanding of the situation
and the options that are available to them. Allow time for the client/family
to explore values and to communicate with each other. The next step is to facilitate
communication of the client/family's wishes to other health care providers.
The nurse should resist offering an opinion of what the nurse would do in similar
situations; the client/family often asks for the nurse's opinion as a way of
opening the discussion of what their concerns are.
The nurse is aware
that the practice of a physician on staff is incompetent. What steps are taken?
The nurse begins by carefully considering the evidence for the judgment that
the MD is incompetent. There is a series of questions listed in Chapter 24 that
should be asked and answered before the nurse makes this serious charge. There
are inherent risks in whistleblowing behavior. The nurse then investigates what
procedure is followed in that health care agency for dealing with incompetent