According to the Florida Board of Nursing, Chapter 464 section 3(a), the practice of professional nursing entails performance in a manner that knowledge, correct judgment and skills-based upon applied principles of psychology, biological, physical, and social sciences for the wellbeing of the patient (Florida Board of Nursing, 2007). Nursing care involves four major processes and these include; carrying out assessments, planning for care, intervention and evaluation of the care given. Other roles of a professional nurse are teaching and counseling of the ill, promotion of wellbeing, maintenance of health and prevention of illness for those not infected. The act goes ahead to give professional nurses power to plan for health care promotion diseases control and medical traement in consultation with the client or patient. It continues to define nursing as the establishment and implementation of nursing care aimed at the promotion of the patient health and prevention of illness to those not yet infected, education, restoration and maintenance of health (Florida Board of Nursing, 2007).
(B). According to the American Nurses Association code of ethics for Nurses, Nurses in all professional relationships should practice with empathy and respect the rights and values of a patient considering his unique health needs free from any social, economic or personal bias or the nature of the health problem (America Nursing Association, 2001). In this case as a head nurse, the nature of health; mild mental retardation must be put into consideration, the treatment intervention; the installation of the ventilator and the feeding tubes should be done only under the consent of the patient’s health mental state or through a signed consent by Mr. B who was to make Mr. E’s medical decision in his incapacitated state.
Under the code, a nurse’s main commitment is the patient. In this case, the head nurse has done everything possible to make sure Mr. B has arrived to give his consent since he was appointed by Mr. E to do so in case he could not do it himself. However, my advice to the doctor would be to hold the intubation’s procedure until the right personnel Mr. B arrives and provides a written consent. In this case, I would be acting in compliance with the nursing code of ethics which states that as a nurse, my role is to promote the welbeing of the patient, putting in to consideration of their right to proper treatment at their comfort. Mr. E has a right to be heard and the decision made in this case should be based on his wish.
As far as the doctor’s decision to perform the intubation’s procedure, it would be totally unethical; this is because the Doctor has not obtained permission to perform the procedure from the Patient Mr. E or Mr. B who is appointed to make such a decision through a durable power of attorney.
Mr. E has filled out a durable power of attorney authorizing his brother Mr. B to make a medical decision on his behalf in the event he is no longer able to make such decisions. This allows him to be informed of his health status. Therefore, it is not unethical for the brother to authorize a ventilator be put into Mr. E as he was suffering from mild mental retardation which would prevent him from making such decisions.
The goals of nursing practices require that the clinician has or cultivates a predisposition to engage with the patient to understand that person’s particular needs. Care as a facet of nursing requires engagement on the part of the nurse with the patient in a relationship that permits the meaning and the context of the persons need to be exposed (Grace and Grace J, 2008). In essence, the nurse should cooperate with the patient to make sure he understands medical procedure being undertaken. However, in our case the Boards regulations have binded my performance as it requires me to consult the patient as I plan for my nursing care (464.003(3c (3).
The doctor acted contrary to the code of ethics by disclosing the patient’s health condition which is supposed to be confidential to an unauthorized person. As a professional nurse, it is my responsibility to report the incidence to the Board since in all my professional relationships, I should practice with respect for the right of the patient under my care, considering their social and economic state. It is also my duty as a member of the Nursing Association of the United States of America to be responsible for promotion of nursing values through maintenance of the integrity of the professional and its practices.
It is nursing obligation to report any conduct of a medical practitioner that contravenes the values and ethics of the nursing professional as failure to do so will be amounting to breach of Nursing practice act Chapter 464.016(2b) which states that one should not knowingly conceal a professional misconduct of another professional.
In case Dr. G tells Mr. H about Mr. Es Situation, Mr. H cannot authorize Dr. G to use a ventilator as Mr. E has only authorized Mr. B to act on his behalf in case he cannot make such a decision himself.
As a part of the medical team involved in Mr. Es care, I am accountable for the patient outcome. The membership in the nursing professional leads to responsibility and accountability for practice actions and all practice actions are subject to critique related to how well they are likely or able to fulfill professional goals as they have been developed over time (Grace and Grace J, 2008). Grace views clinically good actions as synonymous to ethically good actions.
America Nursing Association (2001).Code of ethics for Nurses. Web.
Florida Board of Nursing, (2007). Nursing Practice Act chapter 464. Florida
Grace, P. and Grace.J.Pamela, 2008. Nursing Ethics and Professional responsibility in advanced Practice. Publishers Jones & Bartlett Learning. Sudbury.