Ethical Dilemmas in Clinical Practice: Patient Autonomy & Confidentiality Case Study, Exams of Nursing

Download Ethical Dilemmas in Clinical Practice: Patient Autonomy & Confidentiality Case Study and more Exams Nursing in PDF only on Docsity! Assignment-4 Ethics Digital Clinical Experience Score latest Update Guaranteed Satisfaction 83.5% Debrief Time: 1535 You have just completed the assignment about ethics. We're going to take some time to debrief you on what you've done so far. To begin, you'll have the opportunity to identify and discuss thoughts and feelings about the assignment. Next, we will consider how The models and processes you've read about in the Leadership Toolkit apply to the events of the assignment. We'll finish the debrief by working through ways you can integrate what you've learned with future clinical practice. This debriefing activity does not impact your scoring in this assignment, and you can speak freely about your experiences. You can expect this activity to take 30-45 minutes. Understood. Let's get started. Great. For this beginning portion of the debrief, I will ask you about your perceptions and thoughts of the simulation and your performance in it. You can expect to spend 3-5 minutes on each question in this section. In the assignment you just completed, you were required to carefully consider professional ethics to navigate challenging clinical situations, such as a patient's significant other trying to solicit sensitive medical information and a patient's daughter disagreeing with her mother's DNR. How do you feel about your performance in these situations? I have neutral or mixed feelings about my performance. These conversations are difficult, and I understand why you'd feel this way. Please explain what went well and what you wish had gone differently. Answer Preceptor Diana's question here. Well, I constantly second guess myself Thank you. As we previously discussed, Mr. Patel's girlfriend Miranda solicited you for confidential information about Mr. Patel's condition. How did you feel when pressured to violate your professional ethics and privacy laws? She was forceful only because she cared so much, but I know better then to give out information to protect the patients safety In this assignment, you were unable to contact Dr. Tremblay, one of Mrs. O'Connor's providers, requiring you to speak to Charge Nurse Angela. How did you feel about escalating your concern up the Shadow General Chain of command? Answer Preceptor Diana's question here. Charge nurse was helpful and informative with following policy Yes, I have face issues like this before, such as saying the wrong. This taught me that those fears I have about my opinions and views cannot be felt when providing patient care. Why do you feel that way about the debrief? Answer Preceptor Diana's question here. Better communication between patient and doctors Excellent. We have completed the debrief. Proceed to see the results page for this assignment. Interprofessional Communication Score: 38.5 out of 40 Time: 1515 Hi Ava, hi Debbie. How can I help, Mrs. O'Connor? Debbie: Hey, hon. Well, my daughter doesn't know what this is about, so Ava, just don't freak out, alright? Ava: Uh . . . OK . . . Debbie: So . . . you know I've been working as hard as I can to tough this out. And at a certain point . . . I don't know. I feel like the lines are blurred between, say . . . a life that's . . . you know, OK, I can do this, versus . . . Ava: Mom, literally what are you talking about? Debbie: . . . I want to sign a DNR. How should you respond to Debbie? Thank you for telling me. I know this must have been a hard decision to make, and I'm glad you reached out. Let's talk about the details. You scored 1.0 Out of 1 The correct answer is: Thank you for telling me. I know this must have been a hard decision to make, and I'm glad you reached out. Let's talk about the details. Debbie: Sounds good. Why is this most appropriate way to discuss the DNR? In agreeing to discuss the patient's need for a DNR, you represent the Shadow General Toolkit accurately. Ava: Mom, stop. You're not signing a DNR, don't be stupid. Debbie: Ava, listen to me. I've been thinking about this for a long You scored 1.0 Out of 1 The correct answer is: In agreeing to discuss the patient's need for a DNR, you represent the Shadow General Toolkit accurately. You scored 1.0 Out of 1 Time. There's just no point. I'm grateful for everything in my life, and for you, and our home, and everything. I love you. But the way I look The correct answer is: at it, if I'm getting sick enough to where I'm freakin' unconscious, what kind of life is that to keep living anyway? Ava: . . . Nurse, she's clearly not in a right frame of mind to be making any big decisions. You don't have to get a form or anything, but thank you, and that's all we need you for. Debbie: Ava, come on . . . How should you respond to Ava? Only a provider can assess a patient's mental readiness to sign legal documents. Mrs. O'Connor has the last word on whether she is requesting a DNR. As this is her request, I will call in a provider at the end of our discussion. Only a provider can assess a patient's mental readiness to sign legal documents. Mrs. O'Connor has the last word on whether she is requesting a DNR. As this is her request, I will call in a provider at the end of our discussion. Ava: Hmph. Why is this the most appropriate response? You correctly cite the policy, which says that if Debbie wants to sign a Do Not Resuscitate form, other family members need not weigh in; she needs only a provider's verification of her mental status. Ava: Mom . . . please don't do this. I'm begging you. You scored 1.0 out of 1 The correct answer is: You correctly cite the policy, which says that if Debbie wants to sign a Do Not Resuscitate form, other family members need not weigh in; she needs only a provider's verification of her mental status. You scored Debbie: Hon, you can hate me. I would understand. But this is non-negotiable, kid, I'm sorry! You weren't there with your father at the end. I'm not going out like that . . . he was full of tubes, for Pete's sake! Just the worst pain you'd ever seen, had absolutely no idea what was going on . . . I need my dignity, you know? I need my dignity. Ava: . . . I'm sorry, you're not signing anything. I don't care. You're just not. You're simply not. 1.0 out of 1 The correct answer is: Ava, as per the hospital policy, a patient has the ability to allow or disallow visitors in the room at any point. I have to ask you to return to the waiting room. What can I do for you? Miranda: There's a patient on this floor, Arun Patel? I'm Miranda Paris, his girlfriend. He's probably mentioned me to you. I got here as soon as I could, but nobody is answering my questions. I'm feeling a little frozen out right now, and I need somebody to tell me about what's going on. Miranda: So, Arun came in with some sort of stomach problem, but it seems like things have gotten way worse than that. Is he going to be okay? What does he actually have? What is the most appropriate response to Miranda in this situation? It is against Shadow General policy to disclose patient information without express permission from the patient. I understand you are concerned about Mr. Patel, but until I can clear you, these rules are firm and in place for his benefit. 1.0 out of 1 The correct answer is: It is against Shadow General policy to disclose patient information without express permission from the patient. I understand you are concerned about Mr. Patel, but until I can clear you, these rules are firm and in place for his benefit. It is against Shadow General policy to disclose patient information without them giving consent. I understand you are concerned about Mr. Patel, but until I can clear you, these rules are firm and in place for his benefit. Miranda: I appreciate that you have your patients' best interests at heart, but Arun doesn't need to be protected from me. Why is this the best response to Miranda's request? You do not disclose Arun's protected medical information, and you minimize conflict with Miranda. You scored 1.0 out of 1 The correct answer is: You do not disclose Arum’s protected medical information, and you minimize conflict with Miranda. Miranda: Are you really saying that there's nothing you can tell me right now? Just tell me something. Anything. One thing. I help take care of his diabetes. I pick up his prescriptions. I have a right to know what's going on. You scored 1.0 out of 1 Even if you assist Mr. Patel with his care at home, I cannot talk to you about his care at this hospital without permission. The correct answer is: Even if you assist Mr. Patel with his care at home, I cannot talk to you about his care at this hospital without permission. Miranda: I understand, I guess. Just . . . I feel so mistrusted right now. Why is this the best response to Miranda's concern? Ms. Paris's involvement with Mr. Patel's care in other settings does not mean she has permission to receive his medical information at Shadow General. You scored 1.0 out of 1 The correct answer is: Ms. Paris's involvement with Mr. Patel's care in other settings does not mean she has permission to receive his medical information at Shadow General. Miranda: I'm sorry. I believe that you're not allowed to tell me, but I feel like I'm doing something wrong by trying to help, and it is very frustrating. On top of that, I can't even find his room, and the way things are going I don't even know if I'm allowed to see him. What is the most appropriate response to Miranda's concerns? I understand that having a loved one in the hospital is a stressful experience, especially not knowing how they're doing. Mr. Patel is not currently able to speak with me, but when he is, I can talk to him about getting you clearance. You scored 1.0 out of 1 The correct answer is: I understand that having a loved one in the hospital is a stressful experience, especially not knowing how they're doing. Mr. Patel is not currently able to speak with me, but when he is, I can talk to him about getting you clearance. Miranda: Yeah. Thanks, I guess. Why is this the best response to Ms. Paris's concern? You commit to speaking to Mr. Patel about visitor clearance only when it abides by his care plan. You scored 1.0 out of 1 The correct answer is: You commit to speaking to Mr. Patel about visitor clearance only when it abides by his care plan. Miranda: OK, I didn't want to have to pull this card, but my cousin's a nurse, and I know for a fact that sometimes, you absolutely have to talk to a visitor about the patient's health, even if they haven't been cleared. I remember there was this time this guy was found on the sidewalk having a seizure, and when they called his mom, they told her that and asked if he took drugs and stuff. What is the most appropriate response to Miranda? While you are right that sometimes staff can talk to uncleared visitors if doing so would aid care in a critical scenario, this is not a situation that warrants that. Unfortunately, I can't tell you more than that at this time. You scored 1.0 out of 1 The correct answer is: While you are right that sometimes staff can talk to uncleared visitors if doing so would aid care in a critical scenario, this is not a situation that warrants that. Unfortunately, I can't tell you more than that at this time. Miranda: Dang . . . I really thought I had it right. Why is this the best response to Ms. Paris's question about the policy at play? You appropriately inform her that this is not a circumstance requiring uncleared visitors to receive information, and do so without giving away patient information. You scored 1.0 Out of 1 The correct answer is: You appropriately inform her that this is not a circumstance requiring nucleated visitors to receive information, and do so without giving away patient information. Miranda: OK. And I'm sorry, but I have to try one more thing -- there may be someone else who's cleared to talk to me about it? Not to be rude, but maybe someone . . . higher up than you? What is the most appropriate response to Miranda's question? While that's a fair question, the ability to distribute information is not affected by staff ranking. You scored 1.0 Out of 1 The correct answer is: While that's a fair question, the ability to distribute information is not affected by staff ranking. Miranda: I figured, but I had to ask. Anyway, thanks for bearing you scored Why is this the best response to Samuel's concern? This answer provides the patient with information needed to make an informed decision about their care. Samuel: Wait, just to be clear: I get to make my own decision, right? I hear what you're saying, but I'm not sure I should keep taking opioids if it compromises my bigger beliefs. [AUDIO COMING SOON] What is the most appropriate response to Samuel's concern? Ultimately, you have the power to make your healthcare decisions. While my job is to champion your health, I will not tell you what to do. I will respect your wishes and continue to provide the best care possible. 1.0 out of 1 The correct answer is: This answer provides the patient with information needed to make an informed decision about their care. You scored 1.0 out of 1 The correct answer is: Ultimately, you have the power to make your healthcare decisions. While my job is to champion your health, I will not tell you what to do. I will respect your wishes and continue to provide the best care possible. Ultimately, you have autonomy over your healthcare decisions. While my job is to champion your health, I will not tell you what to do. I will respect your wishes and continue to provide the best care possible. Samuel: I understand. Thanks for clearing that up. Why is this the best response to Samuel's concern? This answer reaffirms the principle of patient autonomy. You scored 1.0 out of 1 The correct answer is: This answer reaffirms the principle of patient autonomy. Samuel: I do wonder if you have, like, an angle? Hospitals make money off opioids, right? Big business. What is the most appropriate response to Samuel in this situation? We would never compromise our nursing practice for monetary gain. You can rest easy, we have your best You scored 1.0 out of 1 The correct answer is: We would never compromise our nursing practice for monetary gain. You can rest easy, we have your best interest at heart and there is nothing more important than interest at heart and there is nothing more important than your well-being. The reason it's so important to keep your pain managed is to keep you breathing deeply and prevent any further respiratory issues. I just want to see you get better and I know that's what you want, too. your well-being. The reason it's so important to keep your pain managed is to keep you breathing deeply and prevent any further respiratory issues. I just want to see you get better and I know that's what you want, too. Samuel: Okay. I just had to ask, you know. Why is this the best response to Samuel's concern? This answer reassures the patient that your relationship to the nursing profession is one of integrity. You scored 1.0 out of 1 The correct answer is: This answer reassures the patient that your relationship to the nursing profession is one of integrity. Samuel: Thanks for talking through this. I guess I'm pretty worried about it, because my brother got hooked on oxys for a while. He was riding his mountain bike and wiped out on a trail. Slammed his knee. I saw him try to quit cold turkey once, but he only made it two days. He was calling out for our mom, who lives across the country . . . He finally weaned off, but it was hard. He's a tough dude. I don't know if I'm that tough. What is the most appropriate response to Samuel's concern? Thanks for telling me about your brother's experience with dependency. That does sound like a really difficult experience. How is he doing now? You scored 1.0 out of 1 The correct answer is: Thanks for telling me about your brother's experience with dependency. That does sound like a really difficult experience. How is he doing now? Samuel: You know, he's really good. He runs a bike shop now and he'll spend forever just painting custom frames for people. Little designs or flowers. I'm proud of him. Why is this the best response to Samuel's concern? This answer displays empathy by paraphrasing what the patient has just said, and acknowledging the difficulty of the You scored 1.0 out of 1 The correct answer is: This answer displays empathy by paraphrasing what the patient has just said, and acknowledging the difficulty of the experience. experience. Samuel: Thanks, again. I've decided to keep taking the opioids, since it's just short-term and will allow me to keep breathing deeply. The last thing I need is pneumonia . . . So, I'll just keep pressing the button whenever I need meds? What we can actually do is transition you to an oral opioid, a combination oxycodone/acetaminophen, which you will be able to keep taking once you have been discharged. Samuel: Okay, that makes sense. Guess I wouldn't take this machine home with me, ha. Thanks for providing clarity. [AUDIO COMING SOON] Time: 1315 How should you proceed? Notify Charge Nurse Angela about the situation and ask her to contact the admitting provider about a venturi mask for Mrs. O'Connor. Which of the following statements about provider's orders is <b>false</b>? You can administer oxygen without a provider's orders if the patient's condition is critical enough to require it. Angela: Hey, what's going on? How should you explain the situation to Angela? Debbie O'Connor's breathing and oxygen levels are deteriorating; I couldn't reach her provider after two tries. Could you try contacting Dr. Tremblay yourself and You scored 1.0 out of 1 The correct answer is: Notify Charge Nurse Angela about the situation and ask her to contact the admitting provider about a venturi mask for Mrs. O'Connor. You scored 1.0 out of 1 The correct answer is: You can administer oxygen without a provider's orders if the patient's condition is critical enough to require it. You scored 1.0 out of 1 The correct answer is: Debbie O'Connor's breathing and oxygen levels are deteriorating; I couldn't reach her provider after two Time: 1305 Transcript Subjective Data Collection Subjective Data time. Which of the following statements is <b>false</b>? Planning for critical scenarios involves making sure that you will have the staff members and resources required to proceed. Planning for critical scenarios ensures that the admitting provider does not have to be contacted. 0.5 out of 1 The correct answer is: Planning for critical scenarios ensures that the admitting provider does not have to be contacted. Angela: Nice job, again. Let's check in soon. Prioritizing Individual Patient Needs Score: 15.0 out of 15 Description of Activity Complete a patient assessment for Debbie O'Connor. Student Response Call Provider to Request Oxygen via Venturi Mask Subjective Data Collection: 7 of 7 (100.0%) • Finding: Assessed patient status • Finding: Assessed breathing • Finding: Followed up on breathing • Finding: Assessed mental status • Finding: Asked about changes in cough • Finding: Asked about changes in sputum • Finding: Assessed patient needs Prioritizing Delivery of Care Score: 15.0 out of 30 Time: 1430 Description of Activity Prioritize delivery of care between multiple patients. Model Response A patient who has just come out of surgery often has urgent physiologic needs, such as pain, that will require attention. In accordance with Maslow's hierarchy of needs, the patient with the most urgent physiological needs should be prioritized first. Patients in this position may also have needs in other areas, requiring education, comfort, or emotional support. By prioritizing the patient newly out of surgery, it allows you to bundle a variety of tasks and prevent negative outcomes that might have arisen had their care been delayed. Time: 1300 Description of Activity Prioritize delivery of care between multiple patients. Student Responses 1) DEBBIE O’CONNER 2) OMAR HADDAD Model Response In accordance with Maslow's hierarchy of needs, the patient with the most urgent physiological needs should be prioritized first. An important aspect of the physiologic needs are airways, breathing, circulation, and differential diagnosis (ABCs). These needs are highly time-sensitive and not treating them could lead to negative outcomes.