I recently submitted a paper and was returned to me. The case study was about a patient who was in a coma and his advanced directives said no tubes no vent no cpr etc, and his brother was his durable power of attorney. the dr spoke with the nephew (not the brother) and put him on a vent. (uhoh!) the part of my paper i got returned to me was about the extent of the "extent of the nurses obligation" to report the doctors mishap, and "the nurses accountability for patient outcomes and advocacy for the patient in this type of situation"
I wrote about HIPAA and how the nurse should take steps to remind the dr not to violate it (by talking to the nephew), and that the nurse should tell the nurse manager of the situation and be adviced as per hosp policy on how to procede, but since I got that part resubmitted I'm assuming I missed something.... ahhhhh
As for the nurses accountability I wrote we are accountable for our patients and have to act as advocates (previously in the paper I discussed patient advocacy and what that means for the nurse) so i totaly dont see the difference.
at the end of the day if the dr is going to do whatever he wants to do how/why is the nurse to handle this.....
I contacted my professor (its online) 2 times in the alst week and no response - i just want to resubmit this and move on - any advice? ahhh
Dec 6, '11
every hospital has an ethics committee. if the patient's poa was bypassed, that's unethical, and they could help the md do what's right. you are incorrect in saying the md will do whatever he wants anyway-- that's part of the point of your paper, to get you to understand that you, the nurse, can advocate for your patient. not just by turfing it off to the nurse manager (although that's a decent first step, to notify him/her of your findings) but by pursuing the mechanisms in place to protect your patient's interest. that's how, and why, to handle it, because it is your responsibility.
taking it to the ethics committee would be your next step, if speaking to the md wasn't enough.
Dec 6, '11
but after the vents and tubes have been put in what more can be done? isnt the damage done at that point? If the question was still to intubate or not to intubate then the nusre 100% should be advocating but it's been done...
Dec 6, '11
tubes can be removed. there is no reason to think otherwise.
Dec 6, '11
ok thank you so much - i apologize if i sound ignorant. i was also just wondering - in regards to a nurses accountability i wrote nurses are accountable for ensuring patients safety and for providing optimal nursing care. and they want me to expand on that - which makes sense since it's really just 1 sentance. the only issue is i have no idea. i wrote a whole 1-2 paragraphs on patient advocacy that got no corrections back, and i feel like im just being repetative
Dec 7, '11
safety can mean many things, including the patient's right to self-determination and dignity. you're not ignorant-- this is just the first time you've had to think about something like this, which is why you're in school and your faculty wants you to, well, think about it .:d
Feb 6, '12
i am currently working on the SAME paper... i just joined this site to research the same question... the RNs obligation to report... i seem to have the same idea you did.. let me kno if you have any info that would help me!!!
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