Combining morphine and Ativan (lorazepam) can be deadly, making the Primary Care Physician (PCP) statement seem contradictory to medical ethics. The specific medical ethical issues addressed in this case include patient autonomy, beneficence, and nonmaleficence. However, there are other ethical issues and dilemmas raised by this case. The nurse faces professional ethical dilemmas in terms of the conflicts between Provision 2 and Provision 8 in the American Nurses Association (ANA) Code of Ethics. Provision 2 indicates that nurses have a primary commitment to the patient, followed by Provision 3, which calls for the professional nurse to actively advocate for and protect the "rights, health, and safety of the patient," (ANA, 2015). However, Provision 8 indicates that the nurse also "collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities," (ANA, 2015). This case shows how the nurse's primary obligation to protect the interests of the patients may conflict with the nurse's work as a collaborator with other health professionals with the ultimate goal of protecting human rights and promoting health diplomacy. Therefore, the nurse in this situation should confer with the PCP to discuss reasons for proceeding to the Ativan. Crucial questions...
If that level of pain remains suitably high after the administration of the morphine, in spite of appearances, then the nurse may need to accept that the Ativan would be necessary. The patient "appears comfortable," according to the case, but appearances can be deceiving. Plus, the patient may be saving face by avoiding the appearance of pain to prevent worrying family members. The nurse is obliged to ask the patient directly and confidentially about the level of pain being experienced and whether the patient would like additional pain relief via medication. Although the input from the family member is helpful, it is not necessarily relevant because the patient is the person who the nurse answers to ultimately. The International Council of Nurses (2012) also suggests that nurses advocate on behalf of patients by providing as much information as needed for the patient to make informed decisions related to healthcare. In this case, the nurse needs to tell the patient of the potential outcomes of combining morphine with Ativan. If the patient is not in a state of mind conducive to making choices, the nurse can confer with the family member and the PCP by citing evidence showing the potential harm of the drug interactions. The possibility for harm needs to be weighed against the ethical push towards beneficence -- providing for the needs of the patient for pain relief. The patient's body weight and medical history may also need to be taken into account when making an informed decision based on evidence rather than a knee-jerk response to the…
The Role of Family Presence in Cardiopulmonary ResuscitationAnnotated BibliographyDe Stefano, C., Normand, D., Jabre, P., Azoulay, E., Kentish-Barnes, N., Lapostolle, F., Baubet, T., Reuter, P.-G., Javaud, N., Borron, S. W., Vicaut, E., & Adnet, F. (2016). Family Presence during Resuscitation: A Qualitative Analysis from a National Multicenter Randomized Clinical Trial. PLoS ONE, 11(6), 1�12.The purpose of this qualitative study was to analyze a series of interviews to characterize experiences of
Katherine Kolcaba Comfort Theory Comfort is an obvious objective in providing a level of quality of care in a nursing environment. Yet, at the same time, most concepts of "comfort" are based off subjective or heuristic accounts and not holistically explored. Katharine Kolcaba begin building her theory of comfort during graduate school and received her PhD in 1997; and since that time her theories have taken root among many researchers. Comfort
Vitiligo is a skin condition characterized by loss of pigmentation in blotches. The cause of vitiligo is the death of melanocytes, the cells that are responsible for producing melanin. According to the National Institutes of Health and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS, 2014), the cause of vitiligo remains unknown. There is some speculation that vitiligo is an autoimmune system disorder, but the condition may
Psychosocial Process Recording Theories thrive in situations where facts are scarce or sparse in human endeavors. Medicine is a field in which such truths are evident. According to Gorman (1990), radical biologists hold the view that all psychiatric complications are caused by brain abnormalities. On the other hand, dogmatic psychologists claim that medical treatment only covers up psychiatric symptoms. They state that psychological treatment gets to the root of the problem
Long-Term Management for Diabetic Patients Under the Home Setting Aubert R.E., et.al, (1998).Nurse case Management to Improve Glycemic Control in Diabetic Patients in a Health Maintenance Organization. A randomized, controlled trial. https://www.ncbi.nlm.nih.gov/pubmed/9786807 This is a report on the research on the comparison of diabetes control in patients receiving nurse case management and patients receiving usual care. The research took a randomized controlled trial model. The research was conducted in primary care clinics
Decision-Making by Caregivers of Family Members with Heart Failure Describe the population for this study. The population for this study consisted of people who are family members of those with cardiovascular issues who may develop heart failure or who are currently living with heart failure. The intention was to find out how prepared family members were to deal with worst-case scenarios regarding the patient's care. How was the sample selected? What are
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