NUR3020:Choice and Supported Decision-Making in Nursing - Assessment Answer

Introduction

• An outline of the informed choice and supported decision-making is presented based on the fact sheet and case study of a patient.
• The information is aligned to focus on consumer choices, issues and related concerns regarding undertaking risk behaviours.
• Vince’s case is focused on acknowledging mealtime restrictions, food consumption conditions and underlying risks of choosing regular meals.
• He has been guided to consume soft textured foods during a hospital stay.
• Dissatisfaction on food taste leads to poor eating habits of Vince; thus affected his nutrition and weight gain.
• Under a speech pathologist’s options, he started to consume regular meals although potential risks prevailed in the process.
• Two ethical principles were raised for the registered nurse (RN) to uphold their duty at mealtimes:
• To promote, advocate for and equally protect the patient’s rights, their health and safety.
• To enhance authority, accountability as well as responsibility to their practice, make informed decisions and take actions relevant to provide the necessary care.

SN: In this presentation, an illustration of a case scenario is presented to develop a synopsis of ethical principles aligned with the RN’s duty of care at mealtime and underlying risks. A case study explains Vince's condition who was guided to consume soft textured foods during a hospital stay. Due to dissatisfaction with the food taste, under the speech pathologist's options, he started to consume regular meals although potential risks are presented. Therefore, ethical principles are adopted for RNs to monitor effectively and preset informed choices regarding the eating/drinking conditions of Vince.

Synopsis of Ethical Principles Arising

• Ethical values can be considered to be essential aspects for medical providers (Haddad & Geiger, 2018).
• It presents moral principles that govern individuals’ behaviour and attitude in presenting them.
• Considering the current case and the resident’s informed choices two ethical principles for RNs are introduced.
• The first principle acknowledges privacy guidelines and advocacy concerning patient care and identifiers (NsiahSiakwa&Ninnoni, 2019). Herein, RNs must understand the informed choices made and accordingly disclose their role in patient care.
• Focusing on the second principle, inherent accountability aligned with care aspects is concerned with active decision-making (Oshodi et al. 2019). Since Vince’s diet has restrictions although he decided to have regular meals, the RN’s decision must be well-planned and implemented purposively to reduce adverse effects.

SN: Upon introducing the two principles which not only focus on the role of a registered nurse in attending to patient care but also concern Vince’s case and informed decisions made to reduce the risk. Based on this slide, it is understandable that ethical values are essential for medical providers during patient care. Focusing on the first principle, a sense of recognition for privacy guidelines is accounted for which is relevant for patient care and identifiers. Through this principle, it can be stated that provocative choices of participation in care and measuring progress can enable patient protection and prevent misconduct in safety. Concerning the second principle, a basis for understanding is aligned with how the choices and decisions of RNs are aligned with the provision of patient care. It shows the accountability, power and responsibility of the RN to make decisions on how Vince’s eating condition can be improved without disregarding his food choices.

Registered Nurse and Ethical Decision-making

• According to Zhang et al. (2019), the service behaviours of ethical nurses have a critical implication on patient care.
• Ethics are considered to be inherent and acknowledgeable part of prescribing medicines and providing necessary treatment and care (Varkey, 2021).
• Based on the case scenario, it is clear that Vince needs to follow a proper diet which is essential for his health and also reduces adverse risks. This can increase ethical dilemmas for the RN.
• Concerning the scenario, even though the first principle can be followed without issue, RN’s accountability and responsibility for patient care can be restricted from informed choices.
• It can lead to uncertainties in care, which can harm the patient’s health.

SN: Considering the case scenario, it is understandable that the RN can face challenges with informed choices and upholding ethical principles. As per the implication of studies, it has been observed that registered nurses faced challenges in patient care related to informed choices. Discrepancies occur concerning the care environment and following the process of informed choices/consent. Based on the current scenario, it can be determined that informed choices for Vince’s eating habits need mutual decision-making to prevent adverse effects on the patient’s health. Moreover, prejudiced circumstances can be experienced under extreme conditions of following ethical principles for both nurses and the referred patient.

Strategies

• In regular practices, the registered nurse serves fundamental roles in patient care, especially during the informed consent process.
• According to Nursing & Midwifery Council, (2023), the RN should meet the essential needs of patients and enhance informed choices with suitable ethical responsibility.
• To mitigate challenges and prioritise ethical responsibilities concerning resident choice and patient safety, strategies are considered by the registered nurse.
• Autonomous capacity in informed decision-making can present a positive relationship between the patient and the RN (Molina-Mula& Gallo-Estrada, 2020).
• Beneficence empowers nursing roles to ensure that the choice of patients is considered (ANA, 2023). Herein, acknowledgement of ethical principles should be associated with the patient’s choice and act accordingly to improve health and safety.
• Nonmaleficencedepicts the avoidance of harm under any circumstances during patient care.
• According to American Nurses Association, (2023), the RN should provision safety, reliability and high-quality care. Considering the case scenario, it is imperative to consider that patient’s interests are taken care of with informed choices and without hurting them physically or mentally.

SN: In this slide, three significant strategies are determined that can enable the mitigation of challenges and deduce a positive relationship between the patient and the RN. Each of the strategies explained in this slide is highly influential in making ethical decisions in nursing practice and building resilience while supporting resident choice and patient safety through duty of care.

Reference

American Nurses Association, (2023). Why ethics in nursing matters? https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/why-ethics-in-nursing-matters/

Haddad, L. M., & Geiger, R. A. (2018).Nursing ethical considerations.https://www.ncbi.nlm.nih.gov/books/NBK526054/

Molina-Mula, J., & Gallo-Estrada, J. (2020).Impact of nurse-patient relationship on quality of care and patient autonomy in decision-making. International journal of environmental research and public health, 17(3), 835. https://pubmed.ncbi.nlm.nih.gov/32013108/

Nsiah, C., Siakwa, M., &Ninnoni, J. P. (2019).Registered nurses' description of patient advocacy in the clinical setting. Nursing Open, 6(3), 1124-1132.https://onlinelibrary.wiley.com/doi/full/10.1002/nop2.307

Nursing & Midwifery Council, (2023). Standards for competence for registered nurses.https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-standards-for-competence-for-registered-nurses.pdf

Oshodi, T. O., Bruneau, B., Crockett, R., Kinchington, F., Nayar, S., & West, E. (2019). Registered nurses’ perceptions and experiences of autonomy: a descriptive phenomenological study. BMC nursing, 18, 1-14.https://link.springer.com/article/10.1186/s12912-019-0378-3

Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17-28. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7923912/

Zhang, N., Li, M., Gong, Z., &Xu, D. (2019). Effects of ethical leadership on nurses’ service behaviors. Nursing ethics, 26(6), 1861-1872.https://journals.sagepub.com/doi/abs/10.1177/0969733018787220

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