Title: Nursing Advocacy in the Clinical Setting: A Case Study
Introduction:
Nursing advocacy is the act of supporting and protecting the rights of patients, promoting their welfare and interests, and ensuring that they receive safe, effective, and compassionate care. As advocates, nurses must speak up for patients, facilitate communication between patients and healthcare providers, and help patients make informed decisions about their care. This paper presents a case study of a patient-care situation in which an RN should intervene and advocate for the patient. The Bioethical Decision Making Model will be applied to this situation, and the role of nursing advocacy in the clinical setting will be discussed.
Clinical Situation:
Ms. X is a 65-year-old woman who has been admitted to the hospital for elective surgery. She has a history of hypertension, diabetes, and chronic kidney disease. Her surgeon has explained the risks and benefits of the procedure to her, but he has not mentioned the possibility of a blood transfusion. The patient has signed a consent form for the surgery, but she is not aware that a blood transfusion may be necessary. The RN who is caring for Ms. X has reviewed her medical history and has noticed that she is a Jehovah’s Witness.
Bioethical Decision Making Model:
The Bioethical Decision Making Model is a framework that can help healthcare providers identify, analyze, and resolve ethical dilemmas. This model consists of six steps: (1) identify the ethical dilemma; (2) gather information relevant to the case; (3) identify the stakeholders and their values; (4) articulate the options; (5) apply ethical principles and values to the options; and (6) make a decision and take action.
- Identify the ethical dilemma:
The ethical dilemma in this case is whether the RN should inform the patient that a blood transfusion may be necessary during the surgery, even though the surgeon has not mentioned it. The RN must balance the patient’s right to informed consent with her religious beliefs as a Jehovah’s Witness.
- Gather information:
The RN should gather more information about the patient’s religious beliefs and values regarding blood transfusions. She should also consult with the surgeon and the hospital’s ethics committee to clarify the risks and benefits of the procedure and the legal and ethical obligations of healthcare providers.
- Identify stakeholders and their values:
The stakeholders in this case are the patient, the surgeon, the RN, the hospital’s ethics committee, and the patient’s family. The patient values her religious beliefs and her right to make informed decisions about her care. The surgeon values the success of the surgery and the patient’s health. The RN values patient autonomy and informed consent. The ethics committee values ethical principles such as respect for persons, beneficence, non-maleficence, and justice.
- Articulate the options:
The RN has several options in this case. She can inform the patient about the possibility of a blood transfusion and seek her consent. She can consult with the surgeon and the ethics committee to explore alternative treatments or procedures that do not involve blood transfusions. She can respect the patient’s religious beliefs and withhold information about the blood transfusion, but risk potential harm to the patient if a transfusion is necessary.
- Apply ethical principles and values:
The RN should apply ethical principles such as respect for persons, beneficence, non-maleficence, and justice to the options. She should respect the patient’s right to informed consent and autonomy, but also ensure that the patient receives safe and effective care. She should avoid harm to the patient and consider the potential benefits and risks of the surgery and the blood transfusion. She should also ensure that the patient’s religious beliefs are respected and not discriminated against.
- Make a decision and take action:
Based on the information and analysis, the
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