Ethics help!

[KatieFRN]

So I'm wondering what to do in this case. If a patient wants more options of treatment than what their doctor suggests, is a nurse allowed to give information on alternative treatments? The dr doesn't want to offer or talk about other treatments because he doesn't believe in them.

[Horseshoe, BSN, RN]

DeeAngel said:

Stay out of that discussion and refer them to their own doctor or the internet. Patients can figure that out on their own without input from the traditional staff whose interventions are being rejected.

I would never refer a patient to refer to the internet. There is so much incorrect information put out on the internet as facts. Lay people often have trouble distinguishing factual information from total rubbish. Refer patients to medical professionals.

[JadedCPN, BSN, RN]

DeeAngel said:

Stay out of that discussion and refer them to their own doctor or the internet. Patients can figure that out on their own without input from the traditional staff whose interventions are being rejected.

With all due respect, referring patients to the internet is a horrible idea. There is so much information on the internet, whether it is accurate or not, that can be misleading and confuse the patient even more.

[Rebeeksma]

I currently am a student and am learning about complementary and alternative medicine aka CAM. You could always recommend some ideas like Reiki, Healing Touch, massage therapy, yoga, etc. which they could either talk to a doctor or go to someone certified to do it. It definitely has a lot of benefits. My friend who is a pediatric oncology doctor said in his unit they use a lot of those therapies and he also said that it was very beneficial! Here is a link to more about CAM therapies: Complementary and Alternative Therapies in Nursing Education: Trends and Issues

[Ruby Vee, BSN]

KatieFRN said:

So I'm wondering what to do in this case. If a patient wants more options of treatment than what their doctor suggests, is a nurse allowed to give information on alternative treatments? The Dr doesn't want to offer or talk about other treatments because he doesn't believe in them.

Is this a homework question?

Do you work for the doctor? Stay out of it. If this is a frequent issue, find another job.

Do you work for a hospital in which the doctor has privileges? Perhaps the most you can do is agree with the patient or family's idea of getting a second opinion.

[AliNajaCat]

meanmaryjean said:

I always reminded patients that the doctor works for them- not the other way 'round.

That's usually enough to get the seed planted.

And whenever I have a patient ask me, "Do I have to do that?" I always tell him he can do anything he wants, I'll back him up, and ask what he's heard about. Then I might say something like, "You could look into X, Y, and Z along those lines." The internet is a wonderful thing we didn't have in our pockets twenty years ago. Of course I tell them that some of it is crap. Most often this is actually a conversation that's leading us all to hospice.

[oldpsychnurse]

It depends on the situation. I had a very nice female patient admitted for something minor (can't remember exactly but think it was gall bladder problem). She, like every admission to that hospital, was put on the Potassium protocol even though it had nothing to do with her medical condition. She and her husband explained to me that they didn't have much money and no insurance and asked me if they should agree to the IV K ordered. I explained to them the normal parameters (I think 3.5 -5 in that facility). She was literally 0.1 low. I explained to her what normal was and what she would experience if her K got too low. She was completely asymptomatic and decided to refuse the K. After she made her decision, I told her that she could take a multi-vitamin after discharge, or eat bananas and other high K foods, to come to normal levels. Pt was discharged in good health.

[Extra Pickles]

Rebeeksma said:

I currently am a student and am learning about complementary and alternative medicine aka CAM. You could always recommend some ideas like Reiki, Healing Touch, massage therapy, yoga, etc. which they could either talk to a doctor or go to someone certified to do it. It definitely has a lot of benefits. My friend who is a pediatric oncology doctor said in his unit they use a lot of those therapies and he also said that it was very beneficial! Here is a link to more about CAM therapies

That's all good, but you're misunderstanding the issue. She isn't asking what alternative treatments exist, she's asking about boundaries from a professional and potentially legal standpoint because the physician she works for doesn't believe in what he doesn't recommend. I'm going to guess that the OP is certainly aware of CAM, as any working nurse should be, but doesn't want to overstep her role.

[KatieFRN]

I'm not sure if that was suppose to be an insult or not. But yes, I am an RN and not on TV. However, I was approached to take professional pictures for a nursing textbook. Apparently some of them are real nurses too...

Yes it is homework, I am not looking for an answer on here, but insight. I am not working in a hospital because I do not have my BSN. All of these ethics questions are difficult. I'd like to answer with my gut, but wondering if there is a "real" solution.

[KatieFRN]

Nothing, its hypothetical

[KatieFRN]

thank you everyone. Many of the things that were said was what I was thinking. I just needed to know I was going in the right direction. Yes, it is homework.

[meanmaryjean, DNP, RN]

KatieFRN said:

thank you everyone. Many of the things that were said was what I was thinking. I just needed to know I was going in the right direction. Yes, it is homework.

It's helpful if you are up-front about this in future.

[KatieFRN]

meanmaryjean said:

It's helpful if you are up-front about this in future.

I didn't realize it would make a difference in the outcome. However, I apologize if you think I was being deceitful for some reason. That was not my intention