Reference no: EM133913035

Question

Guiding Ethical Decision Making: Resources for Nurses

CASE 1. Patrick accepts a new position on a busy Surgical Unit where many of the patients are older adults who have had hip surgery after falling at home and have developed delirium post-surgery. He is surprised to notice that many of his colleagues use physical retrains to prevent patients from falling. Patrick has received his certification in gerontological nursing from the Canadian Nurses Association (CNA), and he is aware that the legal and professional expectation is to make minimal use of restraints. He has also learned that evidence-based practice shows that there are other ways to decrease the risk of falls in patients suffering from delirium. Patrick feels very uncomfortable because he knows his colleagues' use of restraints in some circumstances may be unethical and not in accordance with standards of practice or legislation in some provinces. Patrick's colleagues are critical of him when he says he is reluctant to use hand restraints on a patient. Patrick wants to do what is in the patient's best interest, and ensure his own safety. He decides to try to influence practice to achieve higher ethical standards. His goal is to provide safe and dignified care for the patients on the unit.

Questions

1. Discuss how the CNA Code of Ethics for Registered Nurses could support Patrick when he asks his colleagues to consider other ways to care for older adult patients suffering from delirium. How do you suggest that Patrick work with his colleagues to change their practice to meet ethical, professional, and legal expectations?

2. Despite Patrick's best efforts, the staff are not willing to adopt a policy to reduce their use of restraints, so he decides to seek support elsewhere. What people, departments, and organizations could he consult with in his effort to change nurses' practice on the unit?

3. Patrick's colleagues ask him why he cares so much about older adult patients. He replies that nurses have a duty to advocate for vulnerable persons. His colleagues say that they think calling patients "vulnerable" is an exaggeration. What could Patrick say in response to help his colleagues understand the concept of vulnerable persons and nurses' responsibilities to this group of patients?