Bioethics and Nursing Patient Is

Bioethics and Nursing Patient is a 59-year-old man, overweight and hypertensive, with a history of alcoholism. Patient has been diagnosed with end-stage renal disease, but refuses to adhere to diet, medication, and abstinence from alcohol. Jane Martin, APRN, is concerned about her roles and responsibilities concerning Patient. What are Jane's professional responsibilities to Mr. Tate? As a licensed professional, Jane's responsibilities are to use her skills and to the best of her ability do whatever is necessary to assist in Patient's continued treatment.

Under NRS 632005, the State of Nevada specifically indicates that nurses should assist in maintaining the health, safety, and welfare of their patients. Further, the practice of professional nursing 632.017-18, indicates care of the ill, injured or infirm. As a nurse, Jane is responsible for carrying out the doctor's orders to the best of her ability.

She is not responsible for Patient's adherence to protocol or instructions, but she is responsible for informing (even if on a continual basis) Patient of best practice instructions, and letting him know that she is also responsible for notifying her superiors that he is not participating appropriately in his care. Jane's role is, however, not as a diagnostician. Her role within the care system is to assist and provide professional care for the patient.

It is also not her role or responsibility to introduce her own sense of morality or justice in determining what the best use of advanced care, medications, or procedures might be. Since Patient is "of sound mind," and mobile, it is her responsibility to take her concerns over the Patient's health to the proper authority. With whom could Jane Martin discuss her ethical concerns regarding Mr.

Tate? Jane should do the following to protect the Patient and herself: a) Document her concerns on the Patient's chart with dates, times, conversations, observations and any clinical data that might be appropriate; b) Ask for a physician review of the chart and perhaps have tests ordered to confirm her suspicions of non-adherance; c) Discuss the case with her superior in the Renal Clinic, the Charge Nurse or Medical Director, and, if possible, the attending physician in charge of the case.

It is also possible that Jane could ask for psychological assistance for the Patient in order to ensure greater chance for compliance. What are Jane Martin's responsibilities with regard to respecting Mr. Tate's autonomy and right to self-determination? The State of Nevada both acknowledges and supports a sane, adult Patient's right to self-determination as long as that is not harming others.

That does not mean, though, that Jane should ignore the symptoms and concerns she has, it only means that the State has no right to force treatment on an individual should.