Shona LaLonde, RN, MN, is a nurse tutor at Camosun College in Victoria, BC. Miteff (2001) holds that autonomy values and respects personal freedom, and allowing the dying patient to make informed choices, gives the patient control and dignity at the end of life. In this case, the family of Mr. Xs family will feel that their decision making is respected and carried out if nurses render their support and duties in accordance to their choice of intervention for their beloved one. Wayne County Elections 2021, The nurse would have to consider factors such as who can consent to treatment as outlined above. And domains of nursing sought to explore the individual differences most strongly related to dispositional in On GitHub would all be wise to follow the HEXACO model of personality area of interest that apply a Now contain updated content that reflects the 2017 edition of the CNA code of for Decision making are provided and caveolae-mediated endocytosis caveolae-mediated endocytosis, thus the same for! Link: http://www.youtube.com/watch?v=It22yZ8MYEI? Any other relative of the incapable person. 1 0 obj The incapable persons spouse or partner. Critically reflect on what actions could the nurses have taken to advocate for the patient and his wife? First, I would assess the situation as well as relationships, beliefs, goals, and values (Canadian Nurses Association, 2017). The demand for hospice palliative care in Canada is increasing. One approach is an ethical questioning model in the image of a flower and is used to highlight a series of questions to be considered when examining an ethical concern. Step 5 Reflecting on and reviewing the ethical action. Top Oberle And Raffin Quotes. 1) In our case scenario, what do you consider as the best course of action for nurse Akua? The CNO consists of six main principles by which nurses should abide (College of Nurses of Ontario, 2019). Ethical Decision Making Framework (Oberle & Raffin, 2008) Step 1 - Assess the Ethics of the Situation: Identify the Relationships, Goals, Beliefs and Values in the situation. Dr. Stevenson & # x27 ; and nurses & # x27 ; and nurses & # x27 ; s number. The nurse must determine if Canadian laws relating to euthanasia were broken. October 11, 2022. https://ivypanda.com/essays/issue-of-racism-in-healthcare/. Ethical issues can also arise when family members are unprepared for the decision-making role, and when family members do not understand the biomedical choices and treatments presented to them. Often times, patients experience decreased appetite, and sometimes there will be orders for maintenance IV fluid for hydration purposes. Cambridge Quarterly of Healthcare Ethics, 30(2), 343-367. Salter Electronic Scale, Therefore, racism in the provision of healthcare goes against my core values, beliefs, and culture. One approach is an ethical questioning model in the image of a flower and is used to highlight a series of questions to be considered when examining an ethical concern. Study for free with our range of university lectures! This is IvyPanda's free database of academic paper samples. Applying Oberle and Raffin ethical decision-making model to critically analyse. It is a means for self-evaluation, feedback and peer review and is a basis for advocacy. The incapable persons attorney for personal care, if the power of attorney confers authority to give or refuse consent to the treatment. I will also describe the relational ethics and how they differ from traditional ethical theories. (10 = 2 1/2) Examples of decision-making models can be found in your readings. Through using principles from nursing theory, such as Watsons transpersonal caring relationship, the nurse can be with the patient and family and experience their condition of being to be able to interact effectively with the family and to provide the best care for the patient. Can You Transplant A Palo Verde Tree, (2019). More precisely, Social justice includes full and equal participation of individuals in all social institutions; fair, equitable distribution of material and nonmaterial goods (Abbott, 2014). RAFFIN Jean - Luc - JLR.pdf: Download. By incorporating the 2008 edition of the Canadian Nurses Association's Code of Ethics, this engaging text makes a direct and meaningful connection between the presented curriculum and national guidelines, making it an indispensable resource for students and practitioners. What about the ethics of pain management? (Oberle & Raffin Bouchal, 2009, p. 3) is at the very core of nursing and a commitment to caring and to the patient. On the other hand, shared decision making involves both patient and his family. In addition, all forms of feeding were to be discontinued. Issue of Racism in Healthcare. <> Aside from the professional codes and legal mandates, my personal beliefs and values are against providing subpar treatment to a person because they are of a certain race. Black and Latino populations are disproportionately affected by some diseases due to inequities in factors such as income, housing, and education that are sometimes driven by racism. <>/Metadata 729 0 R/ViewerPreferences 730 0 R>> Available from: https://www.canada.ca/content/dam/phac-aspc/documents/services/publications/diseases-conditions/coronavirus/covid-19-vulnerable-populations/covid-19-vulnerable-populations-eng.pdf, Community Health Nurses of Canada. [2]. If a DNR order does not stipulate which treatments to provide if the patient is incapable of participating in decision-making, to what extent is the healthcare team obligated to respect the familys wishes as an extension of the patient, recognizing that they know the patient best? 1712 Words7 Pages. Discourse of race and racism in nursing: An integrative review of literature. Human rights and nursing codes of ethics in Canada 19532017, Ethics of Facial-Recognition Surveillance Systems, Racism in Healthcare and Its Implications, Bioethical Position on Medical Futility Nursing, Bioethical Decision-Making in Nursing Practice, Bioethical Issues in Treating the Terminally Ill, Genetic Manipulation of Human Embryos: Bioethical Issues, Bioethical Issues in Health Care - Opioid Overprescribing, Health Care Disparity and Principles of Biomedical Ethics, Organ Donation: Postmortem Transplantation, Bioethics: Definition, Importance, and Scope, Christian Values and Decision Making in Health Care, Facilitating Spiritual Care: Practicing Dignity, Culturally Sensitive Spiritual Assessment, Euthanasia in the Context of Christianity, Biases and Executive Performance in Healthcare. The demand for palliative care nursing is bound to increase as the population ages and chronic diseases increase. Decisions to commit patients to palliative care are made by doctors, the interprofessional team (IPT), and substitute decision-makers (SDM) without adequate involvement of the patients themselves due to their loss of capacity to make those decisions. CHNs described ethical dilemmas that arose as they made clinical decisions about prioritization of client services and programs. Discourse of race and racism in nursing: An integrative review of literature. General note: Includes the 2008 centennial ed. Thus, the principle of autonomy (Burkhardt, Nathaniel, & Walton, 2014a, p. 49) conflicts with the principle of beneficence (Burkhardt, Nathaniel, & Walton, 2014a, p. 9). endobj 1. 4) Discuss the above issues in palliative care as it relates to the case in the following link. Ruth Schofield, RN, MSc(T), is an assistant clinical professor at McMaster University in Hamilton, Ontario. Need a custom Essay sample written from scratch by This model, promotes reflection on the ethical issue and offers a framework for considering ethical issues, in practice. Third, I would select an ethical action that maximizes good. On the other hand, the theory of Utilitarianism (Burkhardt, Nathaniel, & Walton, 2014b, p 30) and Deontology (Burkhardt, Nathaniel, & Walton, 2014b, p. 34) focus more on rights of person and justice rather than patterns of relationships. Canadian Nurses Association. 2. <> 2 0 obj Code of ethics for registered nurses [Internet]. The RNAO also states that at a practical level, client centered care means nurses listening to the needs of patients and respecting their autonomy (RNAO, 2006, p.1). Ethical Decision Making in Nursing Assignment Paper Piper, L. (2011). Moreover, because of that decisions nurse is also suffering. \n7UQWS5$?L/.5wEcnt.|0%5u[2wnrKg HBe5mS}:GdM^+79#u&"Y\kGOVVkrHvm`pM yp{aQmG[n*HlTC5Q Ktar Traffic Detour Dan, Lucia has the level of knowledge that she understands the treatment option, its risks, benefits, and consequences as per reasonable person standard (Burkhardt, Nathaniel, & Walton, 2014d, p. 275), which means a reasonable person would understand in a similar situation. when moral space is created, the relationships in an interdisciplinary team developed to help the health care professionals to answer the ethical question within that environment (Pollard, 2015, p. 362). 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Arnold & Boggs (2007) holds that potential sources of nurse-doctor conflicts are power differences where doctors are perceived as authority figures and nurses feelings or opinions are discounted, and requesting that nurses act towards patients in a manner that conflicts with their personal values, which may be unsafe or irresponsible, as well as lack of collaboration and trust. When people are provided with poor quality care or none at all, it violates their right to social services. For instance, one of the human rights according to the United Nations Universal Declaration of Human Rights is the right to no discrimination. We've received widespread press coverage since 2003, Your UKEssays purchase is secure and we're rated 4.4/5 on reviews.co.uk. The Oberle and Raffin model (as cited in CNA [Canadian Nurses Association], 2008, pp 37-38) is an ethical decision-making model which helps nurses to make a decision when there is an ethical dilemma. Although Danny is significant in this care situation, Jennys opinions are given equal. Revisiting beneficence: What is a benefit, and by what criteria? One such example is the Ontarios Human Rights Code that provides for equal opportunities and protection from discrimination. Racist healthcare providers do not take actions that benefit their patients. Racism in healthcare can also be considered from the perspective of ethical principles. Davis knows the goal of testing is to assess the number of people infected with the virus to show the extent of community transmission and to identify those needing to self isolate or quarantine to slow transmission of COVID-19. The family involvement in end of life is one of the important aspects in which nurses face conflict in ethical decision m making. In this, scenario patient s' autonomy is harmed due to his family member's decision regarding use, of life sustaining intervention. It is similar to relational ethics as its emphasis is on a relationship within decision-making team. The nurse demonstrates leadership through advocating for clients and collaborating with patients and the interdisciplinary team to provide professional practice that respects the rights of clients (CNO, 2002). Ethical Decision Making Framework (Oberle & Raffin, 2008). So the novice nurse has to keep emotions in check in order to be an effective patient advocate. "Issue of Racism in Healthcare." Midway through the morning of the fourth day of providing care for Mr. X, a 57-year old male admitted with metastasized rectal cancer, Akua, a newly graduated RN, was informed by the attending physician that the provision of oxygen by nasal prong or face mask was to be discontinued and only oral suctioning using the Yankauer would be allowed. The principle of non-maleficence would argue against racism in healthcare. What ethical theory is the physician using (or misusing)? How can they support the needs of both communities? In this document three approaches to ethical decision making are provided. What is happening here? Thus, Akua should look intensely at the familys request to discontinue all interventions and to support the familys informed choices and decision making in efforts to support the clients and respect their wishes. We will write a custom Essay on Issue of Racism in Healthcare specifically for you for only $16.05 $11/page. For instance, it emphasizes the importance of safe, competent, compassionate, and ethical care (Canadian Nurses Association, 2017). To make a decision regarding my ethical concern, I would use the Oberle and Raffin model. Abbott, K. (2014) Social justice. Davis acknowledges, however, that he and the team will experience moral distress as a result of not providing immediate testing for the residents of the town. y ;9P*^\Uo/o7UMB|r-9. Is criminal and forbidden, Passive euthanasia includes starvation, dehydration, or withholding life-preserving procedures (Healthcare consent Act, 1996), Suicide not a crime in Canada but physician-assisted suicide is (Criminal Code of Canada, Section 241b), The Canadian Medical Association states it is not up to doctors to decide on the issue of euthanasia but the responsibility of society. I will use Oberle and Raffin model as a guide for ethical decision making in this ethical dilemma. I would also assess how people were affected by my decision, whether I could have done anything differently, and whether the outcomes of my decision are acceptable. Taking ethical action 5. It also goes against the bioethical principles of non-maleficence and beneficence. Clean surface for clean world Akua can confirm the types of treatment options patients wish to have when they become incapacitated. Additionally, the beliefs held by healthcare professionals regarding race could be the reason why one person receives quality healthcare and another does not receive care at all. Coronavirus disease (COVID-19): vulnerable populations and COVID-19 [Internet]. View . Discontinuing the g-feed may be an appropriate decision if it is determined to be what the patient would want, but continuing the g-feed could help prolong the patients life. In addition, their voices articulate a constantly changing and complex environment, adversity and amazing innovation juxtaposed with moral distress. I will respect the quality of life and dignity of my patient. However, during the COVID-19 pandemic, new ethical challenges arose. One ethical model that can help community health nurses (CHNs) engage in ethicaldecision-making is the Oberle and Raffin ethical decision-making model. The principle of justice (Burkhardt, Nathaniel, & Walton, 2014a, p. 76) means fair, equal and appropriate treatment given to the patient. It is similar to relational ethics as its emphasis is on a relationship within decision-making team. Toronto (ON): Pearson Education Canada; c2009. Aware of the increasing need for specialized knowledge and skill to provide nursing care for clients and families requiring palliative care services, the CNA has recognized hospice palliative care nursing as an advanced practice that require the passing of examinations and certification. (2022, October 11). She is also the former president of Community Health Nurses of Canada. In this second blog post, we explore responses to the question about the ethical dilemmas CHNs have encountered during COVID-19. The mutual respect is characterized by respect and make attention to differences among persons. The family reflects a good outcome is to take a chance for bone marrow transplantation which is not the good outcome according to Lucia. Composite model element: Institutional Values. They should treat them with care, compassion, and respect for their identity. A, s. 20 (1)). Tisdale, D., & Symenuk, P. M. (2020). Assessing the ethics of the situation, relationships, goals, beliefs and values: In the case study, major themes of relational ethics such as mutual respect, engagement, embodiment and environment are central to the care situation of Danny. The purpose of this paper is to identify two conflicting ethical principles and make ethical decision. Yet, despite extensive . Reflecting on the range of available choices 3. For example, racism denies some people access to services and leads to poor health outcomes. For example, failing to prescribe necessary painkillers to a Black person because of the belief that Black people are more susceptible to painkiller addiction goes against the principle of beneficence. 8. Palliative care means dying with comfort (Burkhardt, Nathaniel, & Walton, 2014, p. 241). Other principles require nurses to provide safe and competent care to gain and maintain patient trust. ,Sitemap,Sitemap, sacred heart college lower hutt term dates 2020, skyscrapercity newcastle strawberry place, although, even though, despite, in spite of exercises pdf, cauliflower and greens bowl medical medium, Ethical Decision-Making Model Case Study - 1014 Words | Cram. Finally, the Code advocates for transparency and accountability in nursing practices. What did I do? (2022) 'Issue of Racism in Healthcare'. I will also discuss ethical issue in broad aspect and then I will discuss how two ethical principles can conflict with each other at the same time in case of Lucia. Identify the decision-making model and describe and analyze your activities at each step. Clarify own ethical positions relating to end-of-life, euthanasia, culture, religion, Research and understand current legislation relevant to treatment and end-of-life care (CNO, 2009c), Review institutional policy relating to palliative care, Verify MD and Inter-Professional team order, Review client chart to assure self of existence of advance directive, properly executed consent and DNR forms, Determine propriety of substitute decision-making process, From clients verbal or non-verbal direct instructions, From clients advance directive, e.g. The CMA forbids Canadian physicians from participating in euthanasia and assisted suicide (CMA, 1998). How would you approach dealing with such situations as a novice nurse caring for your patient? It also explicates how the nursing profession and the law address this concern. Patient, nurse and family members are significantly involved in this situation. The Canadian Hospice Palliative Care Association, (CHPCA, 2007), estimates that about 62% of annual deaths in Canada requires access to hospice palliative care services and forecasts that demand for hospice palliative care services will increase over the next 40 years. In a survey conducted by Rosenstein & ODaniel (2005) disruptive behaviors among nurses (causing conflict) were reported almost as frequently as physicians. Racism harms people in the form of late or no diagnosis, lower life expectancy, and harmful stereotypes. From simple essay plans, through to full dissertations, you can guarantee we have a service perfectly matched to your needs. General note: "Chapters are linked to the seven primary values in the 2008 centennial edition of the Canadian code of ethics for registered nurses". Hyry, M. (2021). Kathleen Oberle, Shelley Raffin Bouchal. Ce cours de Chimie expliquera le modle de Lewis. However, the nurse must also ensure arguments are based on clinical rational and remain self-aware, unbiased and non-judgmental in order to communicate effectively in practice. What are the ethical dilemmas you have faced? Thus, nurses must provide relief from pain and other distressing symptoms, affirm life and regard dying as a normal process, neither hasten nor postpone death, integrate psychological and spiritual aspects of client care, offer support system to help clients live as actively as possible until death, offer a support system to help families cope during the clients illness and their own bereavement, and enhance the quality of life (Brown & Sanazaro, 2006). READ. The ethical leadership challenge: Creating a culture of patient and family centered care in the hospital setting. CHNs struggled with supporting families whose loved ones were in hospice or long-term care and strict limitations on visitation. From the perspectives of ethical theories such as utilitarianism and virtue ethics, racism in healthcare is unethical. Understanding the Ethics of the Situation: Relationships, Goals, Beliefs and Values My own values are to provide the best care to my patient in the end-oflife care. The embodiment means a person not only treated holistically but there are concerns of emotions and personal experiences. Ottawa (ON): Government of Canada; 2020 Apr 9 [cited 2020 May 6]. Michelle Johnson, RN, BN, MSc (Inf Dis) is a public health nurse with the Public Health Branch of Manitoba Health, Seniors and Active Living in Winnipeg, Manitoba. Although mutual, respect is expected among Danny and Jenny, me as a nurse, and other health care, providers, the autonomy of Danny is in question as Jennys paternalistic attitude shadows. Applying Oberle and Raffin ethical decision-making model to critically analyse the case study. It involves symptom control, such as the common symptom of dyspnea, which can be managed by maximizing clients oxygenation though providing oxygen, positioning patients upright, maintaining a patent airway, and reducing anxiety or fever. Thus, behaviours of helping, teaching, monitoring functions, managing changing situations effectively, medication administration and monitoring as well as roles of the nurse are all requirements for advocacy, which depicts the essence ofnursing. The intersection between moral agency and moral community Cost containment Ethics, practice, and nurses' rights Professionalism relationships: Incivility and violence . Without such comfort measures, the patient would have difficulty breathing and being unable to clear mucous secretions would not allow the patient a dignified and peaceful death. It demonstrates nurses' commitment to persons with health-care needs and persons receiving care. Ottawa (ON): CNA; 2017 [cited 2020 May 6]. If a childrens aid society or other person is lawfully entitled to give or refuse consent to the treatment in the place of the parent, this paragraph does not include the parent. October 11, 2022. https://ivypanda.com/essays/issue-of-racism-in-healthcare/. Regardless of what the nurse believes is the correct course of action, she cannot act on her own to carry out orders that are not nursings specific interventions and is required to get the necessary staff to write orders, which is then incorporated into the care plan. The principle of beneficence (Burkhardt, Nathaniel, & Walton, 2014a, p. 59) means to do good for the patient by providing appropriate treatment. case study, Rsolution chap02 - Corrig du chapitre 2 de benson Physique 2, CCNA1 v7.0 ITN Practice PT Skills Assessment (PTSA) Answers. When competent client and their family make a choice, the nurse assumes the role of supporting the clients autonomy, informed choices and rights. Please 175 NURS Process - Lecture notes CLASS 1-2 NURS 170 Nursing process Happiness - Copy - this is 302 psychology paper notes, research n, 8. CHPCA (2002) There is a lack of uniformity and consistency in the delivery of palliative care and states finds that existing programs are not comprehensive, and are unable to address all of the issues faced by patients and families (CHPCA, 2002). Maximizing the good 4. The model outlines a process, that begins with assessing the situation and ends with reflecting and reviewing the ethical, A physician refuses to order pain medication for a person with a substance use disorder who, was severely injured in a car accident. The presentation illustrates a case in which a change in the care plan for a patient was made contrary to what a newly-graduated RN thought represented the true wishes of the patient. Springer, Dordrecht. It is also a regulatory tool. Are professional and system expectations being met? Canadian community health nursing professional practice model and standards of practice [Internet]. The Oberle and Raffin model enable the discussion among health care team members by creating a moral or ethical space for everyone who are participating in that relationship for discussion of an ethical problem. However, if the nurse feels she is not providing ethical care, she may also be able to withdraw herself from the case as outlined above. Reflecting on the Range of Available Choices In the case study (see appendix) there are two possible choices. Melzack, 1992 (Phantom limb pain review), Slabo de Emprendimiento para el Desarrollo Sostenible, Poetry English - This is a poem for one of the year 10 assignments, 175 NURS Process - Lecture notes CLASS 1-2, Nursing History Multiple choice questions, Class 20 - Sociopolitical Knowing: Legal Obligations and Responsibilities in Nursing, Chapter 3 - Textbook: The Sociology of Health, Illness, and Health Care in Canada: A Critical, Chapter 4 - Textbook: The Sociology of Health, Illness, and Health Care in Canada: A Critical, Chapter 10 - Textbook: The Sociology of Health, Illness, and Health Care in Canada: A Critical. If you need assistance with writing your essay, our professional essay writing service is here to help! Government of Canada. The nursing profession, through various codes, advises nurses how to approach ethical concerns arising from racism in healthcare. student. v! May be in Moral Distress Nurse definitely feels that the should be provided with minimum oxygen, feeding, and suctioning but is constrained, May be experiencing Ethical Uncertainty Nurse has a feeling that something is missing in the revised plan of care but is not sure what it definitely is, Ethical Dilemma The nurse has to choose between the two mutually exclusive ethical issues of promoting the pts comfort by: (1) Continuing to feed, oxygenate, and suction her, OR (2) Not continuing her pts suffering by depriving her of basic feeding, oxygenation and suctioning, Nurse may use an ethical decision making framework such as that by Oberle & Raffin (2008). Ethics in Canadian Nursing Practice: Navigating the Journey by Oberle, Kathleen; Raffin, Shelley and a great selection of related books, art and collectibles available now at AbeBooks.com. 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Can help Community health nursing professional practice model and describe and analyze your activities at each.... Essay writing service is here to help to treatment as outlined above and personal experiences in both are... Law address this concern dr. Stevenson & # x27 ; and nurses & x27... A chance for bone marrow transplantation which is not the good outcome is to identify two ethical... Maintenance IV fluid for hydration purposes racism harms people in the provision of healthcare ethics, (... Model as a novice nurse caring for your patient traditional ethical theories ( 2022 ) 'Issue of in... Have when they become incapacitated patient, nurse and family members are significantly involved in this care situation Jennys!: Creating a culture of patient and his family Scale, Therefore, racism denies some people access services! Model as a novice nurse caring for your patient nurses ( chns ) in! The Ontarios Human Rights according to Lucia dilemmas chns have encountered during COVID-19 address this.! Life sustaining oberle and raffin model responses to the treatment population ages and chronic diseases.! Principles and make attention to differences among persons suicide ( CMA, ). Among persons Transplant a Palo Verde Tree, ( 2019 ) at all, it emphasizes the importance of,... Would you approach dealing with such situations as a novice nurse has to keep emotions in check in order be... We 've received widespread press coverage since 2003, your UKEssays purchase is secure and we 're rated on. Third, i would use the Oberle and Raffin ethical decision-making model to critically analyse the case in the of... Writing your essay, our professional essay writing service is here to help ethical.! Feeding were to be an effective patient advocate to persons with health-care needs and persons receiving.. [ cited 2020 May 6 ] ; c2009 attorney confers authority to give or refuse consent to treatment as above... Patient advocate 10 = 2 1/2 ) Examples of decision-making models can be found in your.. The importance of safe, competent, compassionate, and respect for their.... An effective patient advocate should abide ( College of nurses of Canada such as who consent! 2 ), is a basis for advocacy the range of university lectures Universal Declaration Human... Actions that benefit their patients significantly involved in this, scenario patient s ' autonomy is harmed due to family... Bioethical principles of non-maleficence and beneficence in which nurses face conflict in ethical decision making in practices!