Reply 1 Elizabeth
When nurses encounter their health promotion values conflicting with a client’s values, according to Edelman, Kudzma, and Mandle (2014), they should do the following things: identify the patient’s values by asking about what’s important to them and what they value, reflect and reword what they tell you to ensure you understood them correctly, and then help identify conflicts between their values and actions (p. 83).
It’s important to establish a relationship with a patient and really listen to what they’re saying and why they’re coming from where they’re coming from. I think a lot of times we just try to cram education down people’s throats without having a real conversation with then. So often we’ll leave a room and be like, “well they’ll be back,” without listening to where they’re coming from. It’s important to identify our own opinions so we can separate them from those of our patients’.
Reply 2 Aureen
As nurses we are advocates for our patients and their care, it is important to have a therapeutic relationship in order to effectively communicate and understand the needs of the patient. Often times we encounter situations where our own values and insights are in conflict with the patient’s own values and insights. When we are faced with this kind of situations, we must still continue to do our duties and be able to work through this barrier. Even with differences with insights and values, we should work towards what is best for the patient and set aside our own personal opinions. Our responsibility is towards the patient. As their advocates, we must promote their health and wellbeing, protect their right and safety. In order to have effective patient care, we must understand patient’s own beliefs and values. Having good communication and listening skills is key to therapeutic relationship. When in conflict, we must not argue with patients, instead, use therapeutic skills. Involving family and friends in supportive role will also help have cooperative relationship with the patient.
Discussion Prompt #2
What ethical issue have you recently encountered when teaching health promotion strategies to a patient? What ethical decision-making process did you use?
Reply 1 Maria Katrina
The healthcare workers’ role in improving the health status of the patients, through effective understanding and delivery of health promotion practice, is evident throughout the international literature (Pati, Chauhan, Mahapatra, Sinha & Pati. 2017.) Health promotion is important in public health nursing that is why it is essential to learn and understand it. Health promotion is sometimes described as the practice of allowing people to improve their health. It focuses on improving an individual’s health by changing their lifestyle choices and practices to achieve a more optimal way of life. As a nurse, we may encounter ethical challenges that may be sometimes difficult to resolve. I have encountered a patient that was diagnosed with diabetes. This patient is a frequent flier due to uncontrolled blood sugar levels. I assessed why she frequently gets admitted for the same reason and found out the patient was non-compliant with her diet and often misses insulin administration. Regarding the ethical values portrayed by a public health nurse, it is my responsibility and duty to provide education so that the patient will fully understand why she keeps going back to the hospital despite being discharged with proper medication regimen. I had to add interventions and health promotion strategies through persuasion and evidence-based practice.
Reply 2 Valerie
As a nurse there are always ethical issues that arise when caring for patients. In my current position I assist the primary care physician with patients who require sexually transmitted infection, STI, and disease, STD, screenings. Based on my assessment of patient sexual history I advocate for patients when the request or refuse testing. In one case I had a heterosexual male who came in and wanted to refuse the anal swab for STI. His reasoning was that he does not participate in anal sex so he would like to refuse the test. I made the physician aware of the patients refusal and documented it in the chart. At first I was uncomfortable with challenging the doctors order but I had to respect my clients right to refuse this test.
The PLUS strategy is the ethical decision making process I use in practice and it is from the ethics and compliance initiative (Ethics & Compliance, 2019). The letters stand for Policies, Legal, Universal and Self (Ethics & Compliance, 2014). Each have a question attached to them that makes health care providers reflect and make ethically appropriate decisions. In my opinion the self is the one that supports empathy in caring and is where you ask yourself if the decision is congruent with what you see as fair, right or just (Edelman et al, 2014).