Roles and Values

A. Discuss the evidenced-based practice regarding advance directive DNR

Nursing care is purposed to meet the comprehensive needs of both the patients and their families throughout their healthcare process. This is especially fundamental in the care of patients and their corresponding loved ones at the end of life. Nurses are advocates for the rendering of honourable and compassionate care. Nurses actively take part in examining and ascertaining the responsible and suitable use of interventions so as to decrease any instances of unwarranted treatment and patient anguish and suffering (American Nursing Association, 2012).

B. Discuss the nurses moral responsibility by doing the following:

1. Describe the nurses responsibility to the patient in the scenario

In the case of Mr. Miles, the nurse has a moral responsibility to provide advocacy and protection of both the patient and his desires, which encompasses his request to be a do not resuscitate patient. Despite the fact that there may be apprehension amongst other professionals within the healthcare institution and also amongst Mr. Miles family concerning his decision to be a DNR, a patient that is well knowledgeable and capable has the freedom and right to decline treatment and lifesaving procedures. The main responsibility of the nurse in this regard would be to make certain that Mr. Miles is fully aware and comprehensively understands his diagnosis, the course of his medical condition, and the options available for treatment. Subsequent to ascertaining that the patient is fully competent, the nurse ought to conduct an exhaustive discussion of the prospective risks together with the benefits that are associated to the form of treatment to confirm of his understanding. Thereafter, the nurse is responsible for conveying such information to other healthcare professionals and work mates, including the patients attending physician.

a. Discuss a potential moral dilemma that the nurse in the scenario may encounter. Include resolution strategies in your response.

In the scenario encountered for Mr. Miles, the nurse faces a moral dilemma. To begin with, in the event that the nurse decides to support the decision for Mr. Miles to be a DNR, then he or she may end up being dismissed from the patients care team by his family. To make matters even worse, the nurse may experience shunning from his or her colleagues in the healthcare facility. In this sort of scenario, Mr. Miles would continue to be a full code patient with the medical team providing emergent procedures in an endeavour to resuscitate him against his wishes, continue to worsen from a health point of view, experience a cardiopulmonary arrest, code for a period of time and pass on. On the other hand, if the nurse manages to get the attending physician to set the DNR order delineating patient treatment objective and comforting measures, then it implies that Mr. Miles would be a DNR as he desires, continue to worsen from a health point of view, experience a cardiopulmonary arrest, code for a period of time and pass on. It is imperative to note that despite that the final outcome is the patients death, there are two completely different routes with moral consequences.

However, there are resolution strategies to this scenario.

One of the key solutions is to grant Mr. Miles the chance to see out his own advanced instruction before his medical condition worsens. Another strategy would encompass setting up an emergent family meeting at the time when Mr. Mile is septic prior to being medically...…contradictory to the wishes of the patients. In the same manner, regardless of being presented wishes by the patient, the legal rules demand actual signing of the form and therefore the nurse cannot implement such wishes.

3. Discuss potential nursing actions to prevent conflicts identified in part D1 among the organization, the patient, and primary care physician

The potential nursing actions to avoid conflicts amongst the patient, primary care physician and the patient is not to implement the advance DNR owing to the fact that Mr. Miles failed to sign the form prior to losing his consciousness. Rather, the nursing actions to be undertaken ought to include medical interventions that facilitate life and health of the patient, for instance conducting CPR. This is to ensure that the patient regains consciousness. Once this takes place and it is guaranteed that the patient is of sound mind, then Mr. Miles can make the decision on whether to proceed with advance DNR. To further avoid any conflicts, the nurse can inform the attending physician and the family as well in order to see the patients consent and also the process of signing the form subsequent to having a comprehensive informative dialogue with the patient (Griffith and Tengnah, 2017).