Come up with a patient-care situation in which the RN should
intervene and advocate for the patient (this can be real or made-up situation).
An example of such a situation might be when a patient has not been given
complete informed consent.
YOU MUST ANSWER ALL 12 QUESTIONS
1.
What is the dilemma in your patient-care situation story: Use your own words to describe the problem. State it in a way that others can quickly understand your dilemma.
Review
2. Identify the medical facts:
Describe the facts that are relevant to the dilemma.
3. Remember that the diagnosis
and prognosis are medical facts.
4. Identify the non-‐medical facts (patient and family, external influences):
a.
Patient and family facts such as
culture, religion, social, economic, the existence of an Advance
Healthcare Directive, verbal
preferences made by the patient, how the patient lived his/her life.
b.
Those that you discuss should be relevant
to the situation.
5.
External influences include:
organizational policies, federal
and state laws, practice acts, code of
ethics. These should be relevant to the situation.
6.
For both step 2 or 3, separate the
facts from the assumptions: Sometimes all healthcare professionals allow assumptions to guide their decision-‐making. These must be identified so that these assumptions do not interfere with the process.
7.
Identify items that need clarification. Your paper should
identify facts that you need to
clarify. When initially discussing an ethical situation, it is not unusual to
not have all of the answers.
8.
Identify the decision makers: Is
the patient an adult competent to make their own choices? Is the patient a child who is old enough to have a say in the decision.
If the patient cannot make their own decision, who is the decision
maker? How was this person selected?
9.
Review the underlying ethical
principles: Review which ones and why they apply t this
particular case: beneficence, nonmaleficience, veracity, fidelity, autonomy and justice.
10.
Define alternatives: One-‐Way to proceed may be apparent at this point. However, sometimes there are different choices. They should be addressed identifying the benefits and burdens for doing one thing versus the other.
11. Follow-‐up: Define the process to be used with the chosen alternative.
12. Conclude with a discussion of
nursing advocacy in the clinical setting and the nurse’s role as a patient
advocate.
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