Advance

Advance directives are used to describe the types of treatments someone would want depending on how sick one is. They also are a benefit as they will most likely outline what types of treatment one may want no matter how will they are. Patients will want to include types of information that will either consent to or refuse certain treatments, services or procedures that would affect them in a way they do not want. These advance directive should include what types of diagnostic tests, surgical procedures and medications one would

It was not long after I started my job at a long term acute care center that I had a patient who came for vent weaning to our facility. This patient was unresponsive for a while and her oldest child had the durable power of attorney (DPOA). By the time the patient came to us, she was able to communicate by mouth wording or using the alphabet board. She was alert and oriented sometimes, and confused other times. Her problems started with stroke and respiratory depression, but doctors found out that she had very progressed form of cancer and not much chance of survival as they were treating her for stroke. The problem was that DPOA still wanted the patient to be full code and would not listen to the health care members to consider her mother’s

Healthcare providers rely on advanced directives as a means to communicate to patients once they determine that they have lost their decision making ability. As a result, the advanced care directives are expected to preserve the patient’s autonomy. They do this by allowing a patient’s values and wishes to guide treatment even when they have lost their decision making capability. At the time, it allows the patient to express their preferences to the health care providers with regards to treatment, without verbalizing it. In the end, the patient’s freedom to choose a certain course of treatment in still preserved even though the patient is

The nurse knows the specifics of the patient’s illness and will be able to help the patient understand their rights and give examples of situations when they may need to exercise those rights.

It is very important to educate the hospital staff properly how to manage and use an advance directive. This is an effective tool to eliminate conflicts regarding treatment decisions. It also protects both staff and patients to avoid from any misunderstanding or misinterpreting of their desires on how to proceed with their

The patient is a 95-year-old female who presents to the ED accompanied by her nursing aide. The patient fell from an upright position at home while walking. She sustained an injury to her right elbow and claims that she did not lose consciousness. The patient's medical history is significant in that she is hard of hearing and she is legally blind I believe that she has had a retinal detachment in the past. The home health aide relates that the patient does not have any family members and is under a state agent whose name is Karen Sesto. Karen Sesto was contacted and she gave additional history stating the patient has been refusing 24/7 live-in help. She does not let people in the house, throws them out of the house, she finally agreed

Patients cannot always be saved, medical personnel can help patients understand their outcomes. In the listed scenario a 17 year old has Duchene Muscular Dystrophy and multi organ failure. Although the patient is alert, his health continues to decline. Medical personnel feel from a medical perspective they cannot save the patient. The patient is unaware of his declining condition, because his parents asked the medical personnel to remain optimistic and encourage the patient to work towards getting better. The nurse should help the parents understand that they are ethically obligated to be honest and forthcoming with patients. It is the patients’s right to know his medical diagnosis. When everyone is aware of the current medical state of the

The patient was a female and is classified in the 75-80 age range. She was admitted to the hospital due to a fall, resulting in a spinal cord injury in the cervical and thoracic regions. The patient was taken to a Medical-Surgical Unit and was then transferred to a Rehabilitation Unit, where she is able to heal and efficiently practice ADL’s around his or her spinal cord injury. As a nursing student, my role was to provide my patient with education concerning her diagnosis and safety precautions that apply. The patient was taught about fall preventions, pressure ulcers and aspirating as well as learning about the function and importance of her spinal cord. Fall prevention was a topic that was very important to the patient due to falls on previous occurrences. I had talked to my patient about pressure ulcers because she has decreased mobility due to her spinal cord

It might be useful to view the moral principles that apply to this case. First, patients have the right to made a decision on whether or not to receive medical treatment. This follows

The patient is an 88-year-old female who fell while walking at home in the assisted living facility where she lives and sustained a fracture of the right wrist. She was evaluated in the ED by her physical therapy they felt that she was very unstable. She need moderate assist for all activities and they were really unable to walk her, therefore she is admitted. She is known to have coronary artery disease, CVA, Parkinson's disease, increased lipids, and chronic atrial fibrillation. The patient is admitted inpatient and despite intensive inpatient therapies she was requiring tremendous amount of assistance and I believe she required acute inpatient hospitalization because she was an unsafe discharge. She will require follow-up in a subacute

Patient autonomy follow the rights and choices that a patient make and is unimpeded by bias. Patient autonomy is typically exercised in a case where the patient is given the opportunity to direct and make decisions about the course of their own health. In the case of Sue Ellen, this patient is in a comatose state and is unable to exercise her rights to autonomy. It is not disclosed rather or not Sue Ellen has an advanced directive on file signed. According to MedlinePlus (2016), Advance directives are legal documents that allow individuals to spell out the decision about end-of-life care in advance.” Advance directives are important and give the individual an opportunity to express to family, friends, and health care professionals what he or she wants. This is a great way to avoid confusion that could later arise from this particular matter. Living wills include which treatments the individual wants if they are dying or in a situation of comatose state such as Sue Ellen. This case scenario is very similar to the 2005 Terry Schiavo case. Terry was unconscious, had no advance directive and was unable to make her own medical decisions. The “Surrogate Consent Acts” has been passed and mandates surrogates to make decisions about the care of individuals that are not in a state of mind to make decisions on their

Supports independent decision making. In clinical settings clinicians respect a patient’s autonomy, allowing the patient to make a decision regarding treatments. For example, if a patient who has a chronic lung disease decides not to be intubated in the case of the exacerbation of the disease, to protect themselves in this kind of situation and to ensure that their wishes are followed the best is to obtain advance directives (Burkhardt and Nathaniel, pg 310, 2014). Having advance directives in place not only does protect the patients but protects the family from having a burden to make a decision for a loved

This writer advocates for ensuring that everyone address the issue of advanced directives to anyone over 65 coming into the facility. The Patient self determination act in December 1991 has mandated that health care personnel invite patients to complete their advance directives. However, the frequency of preparation has remained static for the last 15 years (Dobbins 2007). According to Ethicists Beauchamp and Childress : The fundamental requirement is to respect a particular person’s autonomous choices . Respect for autonomy is not merely ideal in healthcare; it is a professional obligation (Beauchamp, et al., 2001). In a report published by the Institute of Medicine in 1997, the authors concluded that individuals should be able to

Advance directives (AD) are written medical preferences about a patient’s wishes and treatment options and the ability to choose a surrogate as a decision maker on one’s behalf in the event that one is unable to do so due to illness or incapacity. Thus, patients along with their families should be encouraged to make such medical decisions and make their wishes known while competent (ABA, 2014). When a patient becomes

The second one is the advanced directives, it is a legal document based on the principle of autonomy that expresses the desire about life support of the patient in relation to different medical treatment; when the patient is unable to make those decisions due to unconscious or incapable of expressing them.