hospice ppt

8/3/2019 Hospice Ppt

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ETHICAL OR LEGAL ISSUE

DURABLE POWER OF ATTORNEY

FOR HEALTH CARE


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You are an RN working in a

neurosurgeons office. Two weeks ago, a45 year old physician, Dr. Smith, had a

complete neurologic workup because he

was having headaches that wereincreasing in severity and was having

some short term memory loss. At that

time, he was told that he had an operablebrain tumor. He was given the choice of:


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1. Having a type of surgery with minimal

risk of death, but with the likelihood

that he would loss critical brain

function.

2. Having a type of surgery that had a high

risk of death but would not affect his

critical brain function.


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He chose the latter. Today, he and hiswife have come to the office for pre-

operation and teaching. Mrs. Smith tells

you that she is extremely worried abouthis husbands prognosis and potential for

full recovery.


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1. Consider your own feeling as

you encounter the situation.What type of surgery have you

chosen?


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Having put in the same situation, we

would definitely choose the type of surgery

that had a high risk of death but would notaffect the brains critical function.


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Since undergoing surgery is already puttingyour life at risk, might as well choose the latter

because although it has a high risk of death,

the critical function of the brain wont be

affected. We might as well hold on to that

small chance of living that would allow us to

live our life to its fullest potential than live a

life with an important part of us lacking.


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2. Think about 3 different ways you could

respond in this situation and the consequences

of responding in these different ways.


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Will not give false hopes

Giving false hopes is like giving an assurance to

the wife that her husband would most likely live or

fully recover after the operation. If the situation

comes that her husband was not able to survivethe operation, his wife might take legal actions

against the hospital staff or the hospital itself and

might hold them liable for whatever negative

things that would happen to her husband.


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Being empathetic not sympathetic

As a nurse, we should not be too emotionally

attached to our client and his family. Empathy is

truly knowing what the patient is going through, or

at least trying to understand. Being empathetic canoften mean not saying anything. It's being able to

try to understand how another person may feel.

It's about acknowledging that a person has the

right to feel the way they do, although we may notfully understand why they have those feelings.


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Patient Advocate

A client advocate acts to protect the client.

In this role, the nurse may represent the clients

needs and wishes to other health professionals,

such as relaying the clients wishes forinformation to the physician. They also assist

clients in exercising their rights and help them

speak up for themselves.


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3.What additional information would you

need to help the couple prepare for theimpending surgery?


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Adequate information about the surgery

Perioperative nursing management

Patients bill of rights

Ethico-moral standards of nursing care

Methods of stating end-of-life preferences


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4.What information should you provide to them

about advanced directives?What information

should you provide to them about a durable

power of attorney for healthcare? How wouldyou go about discussing these topics?


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Advance directives are a way of making

your voice heard when you can no longer speak.

They allow you to appoint someone to make

your health care decisions for you when you no

longer can and to administer or withhold

treatment and procedures. Advance directives

are not just for the elderly. All people who

desire to direct their medical care in the future

should complete an advance directive.


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A durable power of attorney is one type of

health care directive -- that is, a document that setout your wishes for health care if you are ever too

ill or injured to speak for yourself.

When you make a medical power of attorney --more commonly called a "durable power of

attorney for health care" - you name a trusted

person to oversee your medical care and make

health care decisions for you if you are unable todo so.


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Depending on where you live, the person

you appoint may be called your "agent,"

"attorney-in-fact," "health care proxy," "health

care surrogate," or something similar. Yourhealth care agent will work with doctors and

other health care providers to make sure you

get the kind of medical care you wish to receive.


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When arranging your care, your agent is legally

bound to follow your treatment preferences to theextent that he or she knows about them.

To make your wishes clear, you can use a second

type of health care directive -- often called a "health

care declaration" or "living will" -- to provide writtenhealth care instructions to your agent and health care

providers. To make this easier, some states combine a

durable power of attorney for health care and health

care declaration into a single form, commonly called an

"advance health care directive."


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Explain it on terms that will be understood by the

client. If the client has questions answer it honestly. Do

not overwhelm the client with this information. Talk tothem at any time convenient to the client. Do not force

them in any decision they will make.

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