Directions: Read the case study provided. In essay style, apply and discuss the questions listed below:
In the case of the patient R.J his autonomy has been taken away from him, as he is no longer able to make any decisions on his own. His ability to make his own choices for his health are gone he has lost all control of how he would want to be treated. Even before he was brain dead I would question if he really ever had autonomy with the decision to have the surgery – was he made aware of the complications that could happen? Was he given the proper consultation and was he ever asked if he had a family member who had problems with anesthesia?
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As for justice, I feel that it will never be served because my own belief is that you cannot get the person back to what you knew them as before. They have changed forever and so have you. No amount of money would fix this problem for most. I feel justice in this case will never be gotten. The family has lost trust in the medical field they do not trust what is being told to them because they feel they have been lied to from the start. They feel this could have been prevented with some extra care. Could this have been prevented with just a few more questions from the anesthesiologist and should the patient have brought up the family history of complications during surgery? Unfortunately surgery is risky and accidents happen and patients are informed of the risks but how much information can a person take in while someone is talking to then in medical jargon?
As Anderson and McFarlane point out: “Beneficence is perhaps one of the strongest guiding ethical principles of health care professionals.” (2010, p.________) This being said, I do believe the doctors were responsible for what happened to this patient. They are the experts and they have the knowledge to handle difficult situations. Did the fact that the member has the extra weight cause the physician to not be able to intubate the member? Did the physician ever call a code or ask for assistance? This is all information that needs to be available in order to see if the members rights were protected. I personally worked in surgery for many years and saw many mishaps. I have seen surgery on the wrong patient and the wrong body part. I believe we should implement more resources to protect the patient that goes into surgery but time is money and rushing through the process is what causes mistakes.
The non-maleficence in this case is that the member had the right to be protected from harm, this was not the case for this patient nor his family. His life will be forever negatively changed and so will his family’s. The mistrust the family has with the medical system will make this very sad case even worse as they will begin to see the health care system as the enemy. The family has been affected by the non-maleficence as they too have been hurt emotionally and probably financially, spiritually and in ways we can never imagine. It is obvious the physician did not set out to do this to the patient but the fact is that it did happen and he is responsible as he was unable to intubate. This is a risk of surgery and patients should be advised more than not that surgery should be the last resort.
The family needs time to grieve. They have lost a very valuable member of their family very unexpectedly. I would first begin to assess what they understand about his condition. I would gently tell them what his prognosis is and I would also have a family meeting with a spiritual leader of their choice, a social worker, a psychiatrist and also all the physicians involved. I would ask the family to say what they needed to say to get their feelings out, their concerns, frustrations and anger. I would make sure before the meeting was over that they understood the health of the patient and that there was no hope for recovery. I would have them explore what type of person he was and if he would want to live this way. If this is what he would want then they would move to find him a place to live long term. If this was something he would not have wanted then offer them some choices such as taking him of life support and letting him die with dignity. This would be a very difficult decision and this would have both a positive and negative as nothing will be resolved except for the comfort of the patient. The family will probably never get a positive outcome.
Page four paraphrase- this is good
Each nurse needs to understand the responsibilities and concerns that are integral to the nursing profession. Working with a team of health care professionals to provide care for patients in need requires a discipline and internal and external composure that stays steady throughout the day. Knowledge, expertise, team work and compassion are hallmarks of professionalism in nursing that I try to express in my practice. “The nurse in all professional relationships, practices with compassion and respect for the inherent dignity, worth and uniqueness of every individual. Unrestricted by considerations of social or economic status, personal attributes, or the nature of the health problem.” (American Nurses Association, n.d.)
A nurse has to take up a great deal of responsibility and must prove worthy of it. Everything from responsible patient care, to monitoring delicate equipment to which the patient is hooked, to responsible handling of medication is the nurse’s lot. A professional nurse is one who takes this responsibility very seriously and understands the consequences of mistakes.
I take responsibility for my patient from the moment I am given report and until I leave the hospital. I am a professional to my patients and to me that means being present. Doing for them what they need to be comfortable and safe. I am there for them not for the social talk or the coffee break. I am there to take care of the patient and if I can help them in any way that’s what I do.
6. Mission and Philosophy of the Division of Nursing
A. Describe what aspects of the mission and philosophy you feel are evident in the coursework in the RN-BSN program. My own words no citing
The mission and philosophy I feel as evident in our coursework over the last few years have been the exploration of cultures and beliefs of other cultures. We have learned from each other our differences but also our similarities. I have learned to be tolerant when I did not agree with some of my cohorts especially when we did religious classes and the tension in the class room escalated from friendly to hostile. I learned to just listen and to explain part of my religion but to also keep an open mind to the beliefs of others. I also felt they needed to understand that this was a Catholic university and to be respectful of the courses that were presented as this was part of the curriculum. We all knew what courses we were to take coming into this program and if there was a conflict of interest that should have been introduced at the beginning of the BSN program not while the class was being taught by a highly respected professional.
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The course definitely made me a more critical thinker and made me learn not to accept answers on a superficial level, it helped me to look into matters with a more educated and focused approach to what was being presented to me as fact. Health is wholeness derived from the harmonious internal interaction of the body, mind, and spirit and the harmonious balance between person and environment. This statement is very much how I viewed the courses that were offered to me at part of the Immaculata program, they all taught us about the harmonious internal interaction of the body. We had many courses that helped us explore the holistic approach to taking care of the patient and therefore we learned a lot about ourselves. This helped us grow to become more patient centered and to focus on the task at hand and to become aware of the person we were taking care of whether they can communicate with us or not.
I enjoyed the courses that were offered and I will say that I grew with each course that I completed, I felt better about my nursing career and I truly felt like I had grown as a person and as a nurse. This was a big change for me as before I took this BSN program I did not think it would help me, I actually looked at this journey of getting my BSN as something that I had to do in order to keep my job. I began fully to see that program became so impotent to who I was as a person and it became so important to who I am that I am going to miss going to class and I am going to miss my fellow students. I am especially going to miss some of the teachers who I have come to respect.
B. What has been your experience with the culture of faculty interactions with students?
My experiences with the faculty and their interactions with students have been positive overall. So many of the courses we took were geared towards accepting other cultures and beliefs. The class had a nice mixture of different beliefs and they were all respected by the faculty. We felt free to discuss our differences without feeling we were being judged for being different. I also feel this is an individual and personal finding and it may not reflect on how others in the class perceived the faculty and its interactions with the students. In some cultures the, students are more accustomed to seeking help from peers than from the professor. This may be because the student feels self-conscious approaching an authority figure, because seeking extra assistance is viewed as inappropriate “hand-holding,” or because asking for help is associated with weak or desperate students, and is thus stigmatizing.
While soliciting help from peers can be helpful under some circumstances, there are times when peers are not in a position to provide helpful feedback. Students enter your classroom with expectations and interpretations shaped by their own cultural conditioning. Your expectations regarding appropriate classroom behavior, faculty and student roles, good writing, etc., may not be theirs.
This is a product not only of cultural differences but of variations in the teaching styles of different faculty members. Even students who are familiar with the U.S. educational system have to adapt to the differing expectations of their various professors. Thus, it is helpful to all your students to spell out as concretely and specifically as possible – on your syllabus, in class, on tests and assignments, etc.
– What your expectations are in regard to issues such as the following: A percentage breakdown of the graded components of your course not only helps students make reasonable time-allocation decisions (see Time Allocation); it also alerts international students to the fact that their course grade will be determined on the basis of multiple graded assignments (exams, papers, lab reports, designs, etc.) Seeing all the course requirements and their weighting can be particularly helpful for students from cultures in which only end-of-term examinations really “count understand what is expected of them in a college classroom, it is helpful not only to spell out clearly what you expect of them (see Make Your Expectations Explicit) but also to provide models of the kinds of work you want them to produce andthe kinds of skills you want them to cultivate. Seeing illustrations of good work can help students identify skills they need to develop. You might, for example:
- Provide examples of outstanding student work (e.g. outstanding designprojects, stage sets, engineering solutions, papers) and discuss with your students what makes them effective. This can help students (a) identify the elements of good work as they apply to particular assignments within particular domains, (b) become more conscious of these elements in their own work, and (c) understand what you, as an instructor, are expecting of them. Models of excellent student work can also help students think more broadly about an assignment, consider alternative approaches, etc.
- Model the kinds of discussion and debate behaviors you want students to develop. Some faculty members, for example, invite a colleague to class to debate an issue. Watching two faculty members engaged in an animated debate can help students understand how to participate in a respectful but intellectually challenging exchange. It also illustrates the dynamic nature of academic discourse.
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