Case Scenario

Thus far we have reviewed articles about patient advocacy that identified obstacles, we have reviewed the Patient's Bill of Rights, foundations of medical ethics, and viewed a YouTube video depicting various scenarios of advocating for patients. Now we will review a case scenario.

You are coming on shift in a busy emergency department, you go to the nurse's station to sign in on the computer to check your assignment and to get a quick report; while doing this you over hear a physician discussing advance directives with an elderly couple. The husband is the patient and his wife is sitting at the bedside discussing DNR status with Dr XYZ. You over hear the elderly couple explicitly tell the physician that they want everything done that is possible. The physician soon excuses himself as he is going to write admitting orders and tells them it should not be too long before they get moved to the medical unit. Approximately a half hour later the physician hands you this patients chart and reviews the admitting orders in case there is any questions. You are surprised to see that the physician has written the patient's resuscitation status as DNR. What is your first step?

Video

Class, take a look at this Youtube video.
http://www.youtube.com/watch?v=zfS3q0v4U4E

Patient Advocacy

The American Nurses Association is a well known and respected nursing organization that represents millions of nurses (ANA, n.d). They bring the nursing profession to higher standards and lobby congress for change. Of the many position statements; they also address the nurse as a patient advocate. Go their link and explore what you can find about their views on advocating for patients.
http://www.nursingworld.org/default.aspx

NURSE PRACTICE ACT

Each state has their own nurse practice act; and as such may have slight deviations in the expectations of the registered professional nurse. Explore these four sites of each different state and examine what, if any, is discussed about being a patient advocate.

NYS practice act
http://www.op.nysed.gov/prof/nurse/article139.htm
Vermont practice act
http://www.leg.state.vt.us/statutes/fullchapter.cfm?Title=26&Chapter=028
California practice act
http://www.rn.ca.gov/regulations/npa.shtml
District of Columbia practice act
http://hpla.doh.dc.gov/hpla/lib/hpla/nursing/nurse_practice_act.pdf

Patient Bill of Rights

To be an effective patient advocate we have already discussed the importance of being knowledgeable of basic ethical principles as many times an ethical dilemma is precisely when a patient may need assistance from you, and you have to step in and advocate for the patient. You must also be familiar with the Patient's Bill of Rights. Please review this power point presentation.
https://docs.google.com/leaf?id=0B1wGQQ6SBKvANmVlNzg4M2MtOGNmMi00NmFjLWIyMTUtZjRiYTJhZTYzNmQ5&sort=name&layout=list&num=50

<iframe width=100% height=560px frameborder=0 src=https://docs.google.com/viewer?a=v&pid=explorer&chrome=false&embedded=true&srcid=0B1wGQQ6SBKvANmVlNzg4M2MtOGNmMi00NmFjLWIyMTUtZjRiYTJhZTYzNmQ5&authkey=CIjW87MC&hl=en></iframe>

Patient Advocacy Article

Please go to the following link and read about patient advocacy, it provides an overview as well as identifying some obstacles as perceived by nurses in adequately advocating for their patients.

http://nursinglink.monster.com/training/articles/929-patient-advocacy-barriers-and-facilitators

Week Two

Hello everyone, to start out with I thought we would review the basics of medical ethics, as some situations in which one may be advocating for a patient may also be one that is an ethical dilemma. I think it is important to review the basic principles of ethics before we continue, please review the attached Power Point Presentation.

You will have to go to the following link (I am posting the two links in case one does not work and you will have to download the presentation)

<iframe width=100% height=560px frameborder=0 src=https://docs.google.com/viewer?a=v&pid=explorer&chrome=false&embedded=true&srcid=0B1wGQQ6SBKvAZTdkZTUwOTctYzA2NS00MzE2LTgwNTktNDhiMTRjNTJmY2Iw&authkey=CNyc4dUH&hl=en></iframe>

https://docs.google.com/leaf?id=0B1wGQQ6SBKvAZTdkZTUwOTctYzA2NS00MzE2LTgwNTktNDhiMTRjNTJmY2Iw&sort=name&layout=list&num=50