Originally Posted by babyjoyce78 A 65 years old female was admitted to hospital after a fall. She was diagnosed with left CVA stroke. Patient refused to eat and drink and was in a denial stage for her condition. She tried to eat but unable to swallow properly, therfore, lead her to deny all food and drink served a couple of days. Doctor in charged thus ordered a ryles tube insertion for her to replace oral intake.
Upon insertion, patient refused the procedure, family members were contacted to persuade patients to undrego the procedure but they were not supportive of the idea as they feel that the patient was capable of ingesting orally.
Despite the family and patient disagreement of ryles tube insertion, the nurse incharge proceeded with the Dr’s order.
This is one case study i can think of. What i have to present is
1)the evidence of critical analysis( what does it mean?) or can give me some exapmles or structures
2)discuss ethical principles issues and values central to the case study
3)application and critcal evluation of nurse's code of ethics to the case
4) the best ethical resolution of the case
Joyce,
I'm not going to do the assignment for you, but you may want to think about a few things in this situation:
1. the evidence of critical analysis means what problems can you see in this situation? What must be "critically" thought about? Does she have a living will or advanced directives? Has she had a swallowing evaluation and/or a video swallow? What are the risks of oral feeding with inadequate swallowing ability? (this is just a few)
2. Think about the controversy here. Like, should the patient be allowed to refuse? Is she in the right state of mind to make a life and death decision? Has she been adequately assessed for depression? Should the family be "persuading" the patient to consent to the tube, and why or why not? Has thorough counselling been done with the family (by Dr. and/or case manager)? (to pick a few)
3. Should the nurse carry out a physician order that the patient and family do not consent to, and why or why not? (one example)
4. Only you know your ethical stand on this issue, Joyce.
Hope it helps you get started.