Mr. Rodriquez, a 78-year-old man who recently immigrated to the United States, was admitted to the medical unit, and diagnosed with acute lymphocytic leukemia. The hematologist caring for this patient has explained reasonable treatment options for an individual of Mr. Rodriquez’s age and general medical condition. His daughter, who is distraught and unable to comprehend everything happening, tearfully asks the staff nurse, “If it were your father, what would you do?” The staff nurse repeats much of what the physician has said, attempting to clarify whether the daughter understood the recommended treatment and palliative care measures.
Although her father appears to accept these interventions, the daughter continues questioning the nurse, repeatedly asking the nurse what she would do if it were her father. She tells the nurse that she does not want her father to suffer, but she also wants her father to live as long as possible. She has also used the Internet to learn more about possible treatment options and has questioned many of the staff nurses on the unit about whether they would insist that more be done to preserve the life of a loved one.
The staff nurses have now come to you, the nurse manager, for advice on working with this patient and family.
Determine which ethical principle or principles are the most appropriate to consider in this instance and which principle or principles would best assist in guiding staff members.
What role, if any, does health literacy play in this scenario?
- Are there additional resources within the facility that you might ask to assist in helping the staff care for this patient and family?
- How might you begin to ensure that the staff nurses can better deal with such issues in the future?
Expert Solution Preview
Introduction:
In this scenario, the nurse manager is approached by staff nurses who are seeking advice on how to work with a patient and their family. The patient, Mr. Rodriquez, has been diagnosed with acute lymphocytic leukemia, and his daughter is emotionally overwhelmed and struggling to comprehend the recommended treatment options and palliative care measures. The daughter continually questions the nurse, seeking guidance and expressing her desire to balance her father’s quality of life with prolonging his lifespan. The staff nurses have turned to the nurse manager for guidance on ethical principles to consider, the role of health literacy, additional resources within the facility, and ways to improve their ability to handle similar situations in the future.
Answer:
1. Ethical principles to consider:
In this instance, the ethical principles of autonomy and beneficence are the most appropriate to consider. Autonomy refers to the individual’s right to make decisions about their own healthcare, and it is crucial to respect Mr. Rodriquez’s autonomy in making treatment decisions. The principle of beneficence emphasizes the duty to act in the patient’s best interest and ensure their overall well-being. By considering and respecting the autonomy and beneficence principles, the staff members can guide their interactions with the patient and their family, addressing their concerns while promoting the patient’s best interest and quality of life.
2. Role of health literacy:
Health literacy plays a significant role in this scenario. The daughter’s struggle to comprehend the information provided by healthcare professionals and her reliance on internet sources indicate a potential lack of health literacy. Health literacy refers to an individual’s ability to access, understand, and use healthcare information to make informed decisions about their health. It is the responsibility of healthcare providers to ensure the information is communicated clearly, at an appropriate level, and in a culturally sensitive manner to enhance health literacy. In this scenario, the staff nurses should take a patient-centered approach, promoting health literacy by using plain language, providing visuals, and utilizing interpreter services if necessary.
3. Additional resources within the facility:
To assist the staff nurses in caring for this patient and family, it is important to utilize additional resources available within the facility. These resources may include social workers, case managers, spiritual care providers, and ethics consultation services. Social workers can help address emotional and practical concerns, provide support and resources for the family, and facilitate communication between the healthcare team and the patient’s family. Case managers can assist in coordinating care and navigating healthcare services. Spiritual care providers can offer guidance and support based on the patient’s and family’s spiritual beliefs and values. Ethics consultation services can aid in resolving ethical dilemmas and navigating complex decision-making situations.
4. Ensuring staff nurses can better deal with such issues in the future:
To improve staff nurses’ ability to handle similar issues in the future, it is essential to provide education and training opportunities. Conducting regular ethics-focused education sessions can help enhance the nurses’ understanding of ethical principles and their application in clinical practice. Addressing communication and empathy skills can also be beneficial, as effective communication is essential in navigating such challenging situations. Role-playing exercises and case studies can be used to simulate scenarios and offer practical guidance on addressing patient and family concerns. Additionally, offering opportunities for reflective practice and debriefing sessions can promote self-awareness and help nurses process their emotions in challenging situations.
By considering the ethical principles of autonomy and beneficence, promoting health literacy, utilizing additional resources within the facility, and providing education and training opportunities, the staff nurses can better support patients and families in situations similar to the one with Mr. Rodriquez and his daughter.
